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Why A Cap on Sugary Drinks May Work

Below is my latest blog post for Huffington Post “Why A Cap on Sugary Drinks May Work.”

You can also read it HERE.

The New York City portion cap on sugar-sweetened drinks was back in court earlier this week. I attended the appeals hearing held at the state appellate court. The NYC health department argued against the ruling by Judge Milton Tingling that blocked the cap on sugary drinks larger than 16 ounces from being sold in food establishments including fast food establishments, delis, and other locations which get a letter grade. As reported in the New York Times, the lawyer for the city was met with skepticism from the justices of the First Department of the Appellate Division. It is unclear when a ruling will be issued.

As I previously blogged on The Huffington Post and the NY Daily News, I support the portion-size cap on sugary beverages. In a nutshell, portion size matters and can help in the fight against obesity. As I illustrated in my book The Portion Teller Plan, portion sizes of sodas have increased considerably over the years. Large portions may contribute to obesity because they contain more calories than small portions. While a small soda (16 ounces) at KFC contains 180 calories, the Mega Jug (64 ounces) contains nearly 800 calories. Larger portions also encourage us to consume more and to underestimate our intake. Soda, in particular, offers up no positive health benefits and is pure sugar.

Now, a new study published in the American Journal of Clinical Nutrition found that soda size limits may help in the fight against obesity. The study found that limiting the sale of oversized sodas and other sugar-sweetened beverages could affect 7.5 percent of Americans daily, have the greatest impact on overweight individuals, and would not discriminate against the poor.

As written in HealthDay:

The study found that about 60 percent of Americans consumed sugary drinks daily, but only 7.5 percent of them purchased “super-size” sugary drinks from an eatery on a given day. The rates, however, were somewhat higher for certain groups: 13.6 percent of overweight teens, 12.6 percent of overweight young adults aged 20 to 44 and 8.6 percent of overweight people in general. The investigators also found that low-income and high-income people were equally likely to buy large sugary drinks from restaurants, which challenges the criticism that a ban on the sale of these drinks at eateries discriminates against the poor.

I certainly do hope that the court considers this study when issuing a ruling. Obesity and diabetes are major public health problems in the city of New York as well as in other parts of the U.S., and limiting the sizes of sugar-sweetened drinks is certainly worth trying.

In the meantime, the NYC department of health launched a new ad campaign urging New Yorkers to pay attention to the high sugar content in energy drinks, sports drinks, sweetened teas, and fruit-flavored drinks. While these drinks sound “healthy,” many have more sugar than soda. A 20-ounce lemonade, for example, contains 260 calories and 67 grams of sugar. Sugar-sweetened drinks have been associated with weight gain and and an increased risk of Type 2 diabetes and heart disease.

As the weather gets warmer and while we wait for a ruling from the appellate court, I urge us all to drink more water and pay attention to the sizes of our sugary beverages.

For more by Dr. Lisa Young, click here.

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Plate size matters

Below is my blog post Portion Size Matters for Huffington Post.

You can also read it HERE.

A new study out of Temple University suggests that one solution to helping kids eat less is to give them smaller plates. With childhood obesity rates so high, we need effective strategies to help youngsters eat more healthfully and eat less.

The study, published in the journal Pediatrics, found that plate size matters, at least for first-graders. The research was conducted at lunchtime on first-graders. Eighty percent of children served themselves 90 more calories when using large, adult-sized plates than when using smaller plates. And the students ate about half of the additional calories that they piled onto the plate. According to the researchers, the additional calories on these bigger plates were probably carbohydrates or protein, as kids did not usually serve themselves extra vegetables.

These results make perfect sense to me as a nutrition researcher tracking portion-size trends. As I wrote in my book The Portion Teller Plan, the sizes of plates have increased in recent years, and could certainly be an additional contributor to the obesity epidemic in our country. When given a larger plate, consumers tend to pile on more food.

Indeed, research from Cornell University conducted on adults found that people eat more off of larger plates. They found that a food portion looks smaller when it is placed on a large plate. And this new study confirms this phenomenon in kids.

I often suggest to clients in my private practice to eat off of downsized dishes. Using a smaller dish makes a smaller portions look like more food. And dieters do not want to stare at a half-empty plate. It makes them feel deprived. When one of my clients started eating off of her grandmother’s dishes, she began to lose weight. She ate less without even realizing it.

Another suggestion that I offer clients is to use a larger plate for salad (a great way to increase your veggie consumption) and use a smaller plate for the main dish. This way, you do not have to go out and buy new dishes.

Divide-and-conquer is another great approach when thinking about your plate. As USDA’s dietary guidance icon MyPlate suggests, fill half of your plate with fruits and veggies, one-quarter with healthy grains such as brown rice or quinoa, and one-quarter with protein-rich foods such as grilled fish or chicken.

One caveat: When using a smaller plate, remember not to pile on your food. If food can fall off of the plate, you probably served yourself too much.

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Growing portion sizes in the US: time for action

Below is my latest post for Huffington Post. I highlight key points from my latest academic paper on growing portion sizes.

The prevalence of overweight has increased in adults and children and shows no signs of decreasing. As I have previously written, large portions of unhealthy high caloric foods have indeed contributed to this problem.

In my latest paper, “Reducing Portion Sizes to Prevent Obesity: A Call to Action,” just published in the November issue of the American Journal of Preventive Medicine with my NYU colleague Marion Nestle, we discuss recent portion-size trends and offer several suggestions to address the problem with ever expanding food portions.

Here are some key points:

Portion sizes have continued to increase through the first decade of the 21st century. Top fast-food and restaurant chains continue to introduce new large-size portions. Food companies are introducing bigger burgers, burritos, pizzas, and sandwiches. Some of these single-serving items (meaning, they are marketed for one person) contain more than 1,000 calories. For example, Wendy’s Baconator Triple burger contains approximately 1,300 calories and Burger King Triple Whopper contains 1,140 calories.

As we illustrate in our paper, the trend toward larger portions coincides with the availability of calories in the U.S. food supply and the rising prevalence of overweight and obesity.

The food industry has not responded to pleas from public health officials to reduce portions, and most Americans have become conditioned and have come to expect larger portions. So what can we do about this continued trend toward larger portions?

We offer several approaches:

1. Education and Public Health Campaigns
Health professional should continue to advise patients on portion control and healthy eating.

2. Consistent Serving Sizes
The FDA sets standards for food labels and the USDA sets standards for dietary guidance and education. These standards are smaller than typical portions, differ from one another and may be creating more confusion. One uniform system is needed to better advise the public on the relationship between portion size, calories and weight gain.

3. Price Incentives for Small Portions
The food environment must support healthier food choices and encourage consumers to want to buy the smaller size. One way to do that would be to offer price breaks for smaller-size portions. Our current price structure encourages us to supersize. We can often get twice as much food or drink for just a few cents. We need to reverse this trend
by making the smaller size financially appealing.

4. Portion Size Limits in Food-Service Establishments
Policy approaches to limit marketplace portions should be considered. A recent policy conceived by Mayor Bloomberg of New York City, and recently approved by the Board of Health to cap the sizes of sugary drinks to 16 ounces, will be implemented in March 2013. I have been an active advocate of this policy, have previously written for Huffington Post about it, and do hope other public health departments follow in New York City’s footsteps.

In your own life, I urge you to consider such portion size strategies. Whether it be ordering a small instead of a large size, sharing a restaurant entrée, advising others to eat less, or getting active in a health and portion campaign, small steps in encouraging our food environment to support healthier food choices can ultimately result in reversing our obesity epidemic.

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Back to the Future: A Return to Smaller Beverage Sizes

Here is my latest blog post for Huffington Post.

New York City’s Board of Health recently approved Mayor Bloomberg’s proposal to limit the sizes of sweetened beverages. The regulation restricts the sale of sugary drinks larger than 16 ounces in restaurants, movie theaters, sports arenas and delis.

I published an opinion piece in support of the proposal for the New York Daily News.
My piece, “Smaller sodas, healthier lives” can be found herehttp://soc.li/GHG9r5G

As I write: “This campaign makes sense at a time when the debate about soaring medical costs has taken center stage in the presidential election. Obesity is estimated to cost $190 billion a year.… The mayor’s proposal does nothing more than swing the pendulum back in favor of more modest food portions.

Those portions have increased steadily over the years, so much so that we have grown accustomed to oversize portions and have come to expect them.

Portion sizes are now two to five times larger than they were in the 1950s.”

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Just how big have food portions become? The timeline below, which is based on my research in my book The Portion Teller Plan, highlights how our frame of reference has shifted.

Select Dates in the Supersizing of American Fountain Drinks

1954                        Burger King offers a 12-oz Small and 16-oz Large soda.

1955                        McDonald’s offers a 7-oz soda.

1961                        McDonald’s adds 12-oz soda.

1962                        McDonald’s adds 16-oz soda.

1973                        McDonald’s adds 21-oz soda.

1988                        McDonald’s introduces 32-oz Super-Size.

1989                        Wendy’s adds the Super Value Menu including Biggie

drinks.

1999                      McDonald’s introduces 42-oz Super-Size.
The 32-oz Super-Size is downgraded to Large.

2001                       Burger King introduces a 42-oz King soda.

2004                      McDonald’s phases out the 42-oz Super-Size.
The largest size is the 32-oz Large.

2006                      Wendy’s add the 42-oz Large size.

Wendy’s drops the term Biggie for its 32-oz soda, calling it Medium.

2007                       McDonald’s offers a promotion of the 42 oz Hugo (previously called Super Size).

2011                        KFC introduces the 64-oz Mega Jug.

2012                      According to company websites, the following sizes are now available:

McDonald’s: 12-oz Kids, 16-oz Small, 21-oz Medium, and 32-oz Large.

Burger King: 16-oz Value, 20-oz Small, 30-oz Medium, 40-oz Large.

KFC: 16-oz Small, 20-oz Medium, 30-oz Large, and 64-oz Mega Jug.

Wendy’s: 12-oz Kids, 16oz Value, 20-oz Small, 30-oz Medium, 40-oz Large.

As I wrote in the NY Daily News,  “Bloomberg 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 is a reasonable amount to drink at a time. Sixteen ounces is certainly more than reasonable — a full pint of sugar water. Instead of viewing this as a ban, let’s see it as an attempt to reset the norm for how much soda truly constitutes an appropriate portion.

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It is now time to return to the more reasonable sizes of the past, when obesity rates were much lower. Given the health consequences and enormous cost of our obesity epidemic, restricting large sizes of unhealthy sugary beverages is an excellent place to begin.

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Rightsize your Plate and your Waist: 11 Portion Control Tips that Work

Below is my latest blog post for Huffington Post. You can also read it here.

Practicing portion control is one of the most difficult tasks facing anyone who eats out or even eats in these days. Look around you and everything is supersized. And not just fast- food. Bagels, muffins, steaks, even frozen dinners have grown in size. And of course we know about the big sodas. Mayor Bloomberg of New York City has proposed restricting the sale of sodas and other sugary drinks larger than 16 ounces in many eateries, and the Board of Health is set to vote on the proposal in just over a week. Stay tuned.

I tracked the history of food portions increasing since the 20th century and found that portions are much much bigger than they were in the past, 2-5 times bigger to be exact. And so are people! No surprise. As I wrote in The Portion Teller Plan and in numerous articles, large portions contribute to weight gain because large portions contain more calories than small portions. Simple as it sounds, so many clients that I counsel don’t seem to apply logic to the equation. We know that if a 64-oz Mega Jug of soda is eight times bigger than a standard 100 calorie 8-oz soda, it should contain 8 times the calories. Yes, it contains 800 calories. Simple math?  Yes. But… if WE drink it, we think, how can a soda possibly have so many calories?

Our plates have increased, so have our mugs, glasses, and wine goblets. Our cabinets and  dishwashers are now larger to accommodate our satellite-sized dishes. And, car seats for our kids, who are now pudgier than ever, have also increased. And even caskets have become supersized!

Many of us don’t understand what a healthy portion size is, and for good reason. A pasta portion in a restaurant is easily 3 cups, and many steaks are at least a pound. That is much too much food. The problem is that we’ve gotten used to these jumbo portion sizes and we think that a “portion” is whatever is put in front of us. Getting used to normal sized portions is not an easy task.

Here are some tips:

Practice plate control. For starters, try eating off of plates your grandmother used. Next, change your expectation. Restaurants are in business to sell food, and lots of it. It is time to shift our perspective on what a reasonable amount of food is. If you use a smaller plate, you will probably begin to scale back on your portion.

Fill up on fruits and veggies. We want to scale back on our meat and potato portions and increase our intake of veggies. An easy trick is to fill half your plate with veggies. One quarter of your plate protein (meat, fish, poultry, tofu) and one quarter healthy starch (brown rice, quinoa, barley).

Limit liquid calories. You are better off eating—and chewing—your calories than drinking them. Somehow, when we drink our calories, we do not feel full and the calories we just guzzled down do not seem to register. So…we want more. Eat an orange instead of drinking the juice. And steer clear of empty soda calories—choose seltzer or water instead.

Buy single-servings. Steer clear of the jumbo bags of chips, cookies, and nuts sold at price warehouse clubs such as Costco. We all love a good bargain, but beware when it comes to buying food. While you may want to stock up on toilet paper or paper towels, when it comes to food, buy smaller servings. Single-serve bags of chips will really help you practice portion control while snacking.

Order a small. In many cases you have a choice between a small, medium, or large. Order the small size whenever possible. And don’t be fooled by the label; even a drink labeled small, for example, small can be big.

Avoid your triggers. If you can’t stop at one serving of chips, then don’t even start. Choose a treat you CAN control.

Don’t snack out of the bag. Read the food label, serve yourself one portion, and put the rest away. Practice this for chips, nuts, pretzels and other treats.

Don’t be fooled by health halos. Just because a food is labeled organic or trans fat free doesn’t mean you can eat as much as you want. Calories are still calories.

Skip all-you-can-eat buffets. They may be a bargain for your pocketbook, but not for your health. If you must visit a buffet, do a full lap around the buffet before choosing your selection and wear tight fitting clothes (you’ll probably eat less.)

Share, share, and share. Restaurant portions are huge. Order one main dish and an extra veggie dish or salad and share both. And order one dessert for two or three people and you will still feel satisfied.

Eat like a Parisian. Eat slowly, savor your food, and enjoy your company.

Enjoy! Bon Appetit.

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Public Hearing on Sugary Drink Ban in NYC

Below is my latest blog post for Huffington Post on the hearing for the ban on oversized drinks in New York City.

Here is the link.

It was a busy afternoon at the Gotham Center in Long Island City, the headquarters of the New York City Department of Health and Mental Hygiene. Today was the public hearing on Mayor Bloomberg’s proposal to restrict the sizes of sugary beverages to no more than 16 fluid ounces in New York City food establishments. The Board of Health will vote on the proposal in September.

Advocates lined up at the public hearing to speak in favor of the ban on supersized beverages, while opponents complained that the ban was unfair and violated public freedom.

Channel 7 News featured a brief clip of my speech (below is my full speech) and that of several others. More than 60 people pre-registered to speak out while walk-ins were also permitted to sign up speak. It was standing room only.

Speaking in support of the ban was Dr. Walter Willett, a nutrition professor from the Harvard School of Public Health, who called soda in large amounts “metabolically toxic,” and my colleague, public health lawyer Michele Simon, founder of Eat Drink Politics, who succinctly said that “it is the soda industry … that has taken away the choice of reasonable portions.”

A spokesperson for the National Restaurant Association complained that they were being singled out and said the ban “unfairly targets restaurants and small business owners…” and a spokesperson for the NYC American Beverage Association said the ban is “distracting us from the real issues” as they made sure to mention that they are responsible for 8,000 jobs in NYC.

Here is my five-minute speech in its entirety (a bell goes off if you speak more than five minutes) in support of the proposal:

“Good afternoon. I am Dr. Lisa Young. I am a nutritionist [in private practice], author of The Portion Teller Plan, a user-friendly weight-loss book on portion control, and an adjunct professor of nutrition at New York University.

I am in support of Mayor Bloomberg’s proposal to restrict the sale of sodas and other sugary drinks that are larger than 16 fluid ounces in food establishments such as restaurants, movie theaters, delis, and street carts. It would include the popular 20-ounce soda bottle from the corner deli and oversized fountain drinks available in fast-food establishments and movie theaters.

This campaign makes sense at a time when food portions have increased and so have rates of obesity. Obesity is currently a major public health concern in New York City and is caused by an imbalance of energy intake (calories in) and energy expenditure (calories out).

Sugary, sweetened beverages are a major contributor to the current obesity epidemic. 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 a researcher tracking portion size trends, food portions have increased steadily over the years, and so have the waistlines of Americans. 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. Burger King’s small is now 20 ounces and its large is 42 ounces. I think it is time to return to those more reasonable sizes.

In a new paper co-authored with my NYU colleague Dr. Marion Nestle, and due to be published in the November issue of the American Journal of Preventive Medicine, portion sizes in the first decade of the 21st century continued to increase despite public health initiatives encouraging the food industry to reduce portion sizes. It is now time for action.

Large portions may contribute to obesity in several ways. They contain more calories than small portions. For example, a small soda (which is 16 ounces) at the fast food chain KFC contains 180 calories, while the Mega Jug (which is 64 ounces) contains nearly 800 calories (and 50 teaspoons sugar). This cup holds a half gallon of soda; it is far too much soda for one person. Indeed, it contains more than one-third of the calories recommended for an entire day for certain segments of the U.S. population.

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.

Mayor Bloomberg 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 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.

As an educator and clinician, I would absolutely continue to advocate for better education and public health campaigns. The NYC 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 to eating less. And restricting the large sizes of unhealthy sugar-sweetened beverages is an excellent place to begin. Thank you.”

It is my hope that by this time next year, it will be hard to find oversized cups on the streets of New York City.

Thoughts? Would love to hear them.

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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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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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Weight of the Nation 2012

I am delighted to be at the 2012 Weight of The Nation Conference in Washington DC sponsored by the Center for Disease Control (CDC). The purpose of this important conference is to bring together policy makers, educators, health professionals, media, and public health leaders to share key obesity prevention priorities and to present policy and environmental approaches that show promise for improving the nation’s health. The theme,” Moving Forward, Reversing the Trend,” is illustrated through informative and thought provoking presentations emphasizing how we can work together to promote healthy eating and active living for all Americans.

This morning,  in the presence of a huge crowd, the Institute of Medicine (IOM) released its latest report Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation . It focuses on five critical goals for preventing obesity:

– Integrating physical activity into people’s lives

– Making healthy foods and beverages available everywhere

– Transforming marketing messages about nutrition and activity

– Galvanizing health care professionals and employers to support healthy living

– Making schools a gateway for healthy weights

Several members of the committee highlighted specific strategies and obesity prevention recommendations to identify how we can work together most effectively in our communities to reduce the nation’s obesity crisis.

This report is released at an important time as the obesity epidemic is a major public health crisis and the food environment is not conducive to weight loss for most of us. Food is available 24-7, portion sizes are huge, and the food industry spends mega bucks marketing sugar, fat, and calorie laden junk food.

At the conference’s opening plenary on Monday morning, the CDC in conjunction with Duke University and RTI International released a new paper just published in the American Journal of Preventive Medicine on obesity forecasts through 2030. The forecasting study found that 42% of the US population could be obese by 2030, suggesting that our healthcare system could be burdened with 32 million more obese individuals within just two decades. According to the researchers, action is needed to keep rates from increasing further.

For the good news, the report found that keeping obesity rates level could save nearly $550 billion over two decades. Hopefully, this thought provoking conference will inspire its attendees to work together to reverse the obesity epidemic. The action steps highlighted throughout the conference will hopefully help us speed up the progress to combat the current obesity crisis.

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Want to lose weight? Eat Less.

Two thirds of Americans are overweight and succeeding at weight loss is quite a challenge for many dieters. A new study just published in the American Journal of Preventive Medicine (AJPM) reported that eating less, exercising more, and switching to healthier food worked best.

The researchers were from Beth Israel Deaconess Medical Center in Boston and looked at data collected as part of the dietary intake survey  National Health and Nutrition Examination Survey (NHANES). The authors wrote in the  study published online that “Liquid diets, nonprescription diet pills and popular diets showed no association with successful weight loss.”

The Los Angeles Times summarized what worked and what did not work for the dieters.

Here’s what the dieters tried that worked:

* 65% ate less food

* 44% ate less fat

* 41% switched to foods with fewer calories

* 4% took weight-loss medications that were prescribed by a doctor

* Joining a weight loss program was also helpful perhaps because of “the structure of being in a program.”

Here’s what the dieters tried that didn’t work:

* 41% drank more water

* 14% ate “diet foods or products”

* 10% used nonprescription diet pills, including herbal remedies

* 7% adopted a “liquid-diet formula.”

I was glad to see this study as I’ve been advocating eating less and moving more for years. While this old fashioned advice may not seem as sexy as some fad diets and supplements, it works for the long haul. And, it will save you money—no need to buy unneeded supplements.

Take home messages:

*  Skip the fad diets and practice portion control instead.

* Go out and exercise. Pick something you enjoy and stick to it.

*  Choose healthier and more nutrient dense foods. A good place to start is by eating more fruits and vegetables!

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