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Archive for the ‘ Public health ’ Category

Hold the Salt: NYC Warning Labels and Tips to Take to Shake the Habit

Below is my blog post for Huffington Post, “Hold the salt: NYC warning labels and tips you can take to shake the habit.”

You can also read it HERE.

As a nutritionist and health advocate in New York City (NYC), I applaud the New York City Department of Health’s latest attempt to help New Yorker’s get healthier.

Effective this week, diners in NYC will be able to spot foods on menus of chain restaurants that are too high in salt. NYC is the first city in the United States to require eating establishments to post warning labels next to menu items that contain too much salt.

According to the proposal, which was passed unanimously in September by the city’s Board of Health, chain restaurants with 15 or more outlets, will be required to display a salt shaker icon for menus items that contain 2300 milligrams (mg) of sodium–about a teaspoon of salt–and the equivalent of the recommended daily intake.

Certain segments of the population, including individuals over 51, those with diabetes or kidney disease, African Americans, and others, are advised to consume no more than 1500 mg sodium daily.

The salt “warning labels” will apply to an estimated 10% of menu items at the NYC chains.

I applaud the measure. Salt — and lots of it — is commonly found in bread, sauces, condiments, deli meat, and pizza. And, large portions of many restaurant meals.

Many consumers are not aware just how much sodium is found in foods typically consumed. And a large majority of us already eat too much salt, with the average intake around 3400 mg of sodium.

I also support the health department’s initiative as I am hoping it will give restaurants an incentive to lower the sodium content in its overly salty menu items.

After all, one meal should not contain an entire day’s worth of sodium.

It’s pretty shocking just how much salt many restaurant meals contain. According tocompany websites, a cheddar and bacon burger at TGI Friday’s contains 4280 mg sodium and the boneless Buffalo chicken salad at Chili’s has 3460 mg.

I hope other cities follow suit.

I am also hoping that this measure will help raise our awareness as to the relationship between sodium and health as well as how we can be more conscious to steps we can take to limit the amount of salt we consume.

Cutting down on salt can help prevent and control high blood pressure and reduce the risk for heart disease and stroke.

In addition to being on the lookout for the salt shaker icons (if you live in NYC), here are six things we can all do to reduce or salt consumption.

1. Limit the salt shaker.

Just 1 teaspoon of salt contains 2300 mg. In my counseling practice, I urge my clients not to keep a salt shaker on the table. Out of sight, out of mind!

2. Cook more.

Restaurant foods tend to be higher in sodium than home cooked meals. Eating at home can help reduce your salt intake.

3. Use spices to add flavor and zest to your favorite foods.

Oregano, black pepper, thyme, and rosemary are a few spices you can try. Spices also impart many health benefits.

4. Go easy on condiments.

Mustard and ketchup contain lots of salt so here׳s a reminder to go easy with them. Next time you are ready to schmear your sandwich with your favorite condiment, start with a smaller portion–a teaspoon instead of a tablespoon, for example.

5. Eat more fresh fruits and vegetables.

Fruits and vegetables are low in sodium and high in the mineral potassium which can help to lower our blood pressure.

6. Watch your portion sizes.

When you practice portion control and eat less, especially when eating out, you are likely to consume fewer calories as well as less salt and sugar. So next time you buy an oversize sandwich for lunch, my suggestion: eat half!

Follow Dr. Lisa Young on Twitter: www.twitter.com/drlisayoung

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Will new food labels encourage us to eat…more?!

Below is my blog post for Huffington Post, Will new food labels encourage us to eat…more?!

You can also read it HERE.

In February 2014, the Food and Drug Administration (FDA) along with Michelle Obama announced an overhaul to the nutrition facts label required on all packaged foods. Among the proposed changes includes updating the serving sizes.

As FDA states, “These updates would reflect the reality of what people actually eat, according to recent food consumption data. By law, serving sizes must be based on what people actually eat, not on what they ‘should’ be eating.”

The food labels have not been revised in over 20 years, and the current serving sizes are based on portions typically consumed in the 1970s and 1980s.

We eat larger portions than we did 20 years ago, so current serving sizes are smaller–often much smaller–than what people actually eat. As I’ve written in my book The Portion Teller Plan and research articles, these serving sizes may be confusing to people trying to follow dietary advice.

In a previous piece I wrote for Huffington Post, while I commended the FDA for using more realistic serving sizes, I also offered a note of caution: in particular, that FDA is not telling consumers to actually eat more.

“For the good news, as I discussed on CBS Morning News, the serving sizes will be more realistic and reflect what people really eat. Many people today just glance at the calories and think that whatever amount they eat is a serving. For the ice cream example, a consumer reading food labels will now see 400 calories displayed instead of 200 calories. This may mean that you would think twice before scarfing down the entire pint.

A note of caution: FDA is not telling us to eat more. At least, the agency is not advising us to eat a bigger portion of ice cream. Rather, the agency is informing us as to the calorie and nutrient content in a standard serving size which is more in line with what we really do eat…. It would be useful if FDA follow up with nutrition education materials to further educate the public on the relationship between portion sizes, calories, and obesity.”

While there are clearly benefits to FDA requiring that manufacturers use more realistic serving sizes, a new study, published in the journal Appetite, addresses some potential problems with larger serving sizes. The study explores how consumers interpret the new serving sizes, and how they affect the amount of food they would serve themselves.

In one of several experiments, the researchers showed subjects two different labels for mini chocolate chip cookies–the current label which states 3 cookies as a serving and the proposed new label which lists 6 cookies as a serving. The subjects exposed to the proposed label served themselves significantly more cookies than those exposed to the current label.

Results of all four experiments found that people misinterpret serving size information. The majority of subjects believe that the serving size on a food label refers to how much they should eat. The researchers also found that the increased serving sizes on the proposed Nutrition Facts label can lead people eat more and purchase more food.

Uh oh! This is troubling, especially in a society where many of us already eat too much.

The researchers write, “We found that people misinterpret serving size information, with the vast majority of consumers incorrectly believing that the serving size refers to how much can/should be consumed.”

Lead author Steven Dallas, a doctoral candidate at New York University’s Stern School of Business wrote me the following in an email message: “Our research shows that the increased serving sizes of the proposed label lead consumers to serve more food for themselves and others. Since excessive consumption is a key contributor to obesity, this is a worrisome effect of the proposed label.”

Results of this study confirm that consumers may incorrectly view serving sizes as recommendations. Hopefully, FDA will take these findings into account when finalizing its serving-size rulings for the new food labels.

The authors conclude in their paper, “FDA should be encouraged to consider ways to correct this misinterpretation, such as by mandating the addition of a serving size definition to the proposed Nutrition Facts label. The definition could inform consumers that the serving size refers to how much of the product a typical person consumes in one sitting, and does not refer to how much of the product can be healthily consumed in one sitting.”

I agree!

In my comments last year to FDA on the proposed serving-size change, I suggest that FDA should pro-actively address concerns about the possible unintended consequence that some consumers view serving sizes as portion recommendations. I wrote, ” I recognize that the RACCs used to calculate serving sizes are required to be based on the amount of food people customarily consume, and are not recommended amounts of food to eat. However, given the likelihood of confusion among some consumers, I strongly recommend that the FDA include clarifying language on the label by either: 1) denoting the serving size provided as a “typical” serving size or 2) including a footnote to clarify that “the serving size is based upon the amount typically consumed, and is not a recommended portion size.”

Stay tuned.

In the meantime, we would love to hear your thoughts and recommendations on the new proposed serving sizes.

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A prize may encourage us to eat less

Below is my blog for Huffington Post, “A prize may encourage us to eat less.”

You can also read it here.

Portion sizes have grown over the past 50 years, and so have our waistlines. As I found in my portion-size research, the fact that Americans are eating too much is a perfectly logical explanation to explain the current U.S. obesity crisis. While there is some good news on the horizon suggesting that we are finally beginning to eat less, we still have a long way to go.

Researchers from University of Southern California (USC) conducted several interesting experiments encouraging both kids and adults to select smaller portions. The results, published in the Journal of Experimental Psychology: Applied, found that people will often choose a smaller portion when offered some kind of incentive or prize.

The researchers conducted three experiments, all offering some kind of incentive to choose the smaller portion.

As discussed in USC News, “In the first experiment, sixth-graders were offered the choice between a 9-inch sandwich and a 4.5-inch sandwich and inexpensive earbuds. The majority chose the latter. In a second experiment with adults, half-sized portions were paired with the chance to win a $100 Amazon gift card or the chance to win 10,000 frequent-flyer miles accepted by all major airline loyalty programs. The majority chose the incentive and made that choice consistently over three days. In a third experiment, the researchers got similar results in a real restaurant setting with customers who came in with the intention of buying a full-sized sandwich, but opted for the half-size and a chance to win a $10 lottery.”

As you can see, the incentive offered does not need to be anything fancy or expensive. And the subjects consistently chose the smaller portion-plus-incentive option even when it was priced the same as the larger portion.

And, best of all, at least from a public health perspective, the smaller portion will not leave you hungry.

The researchers tracked total calories consumed in the second experiment and found that subjects ate fewer calories when compared to their baseline day.

The research findings could be a great way to help reduce our calorie intake and fight obesity along with its associated health care costs.

USC marketing professor Deborah MacInnis wrote me in an email: “Incentivizing consumers to choose smaller portion sizes not only offers opportunities for lower daily calorie intake, it also has the potential to help consumers realize that smaller sized portions won’t leave them hungry.”

She also wrote, “As consumers, we value our freedom of choice. Laws and regulations remove freedom of choice and can backfire by creating resistance and reactance. Giving consumers the opportunity to choose between a full sized version and a smaller version with an uncertain incentive preserves freedom of choice while motivating policy-consistent (and health promoting) behaviors.”

Here are some take away messages.

1. As a nutritionist and portion-size researcher, what I found most interesting was that the subjects were not hungry after choosing the smaller portion. This lesson applies to all of us. We can usually be satisfied with less food. We can always order more food later if we are still hungry.

2. Consider leaving over some food, wrapping up leftovers, or sharing an entree next time you visit your favorite restaurant.

3. How about treating yourself to a reward? Perhaps splurge on a massage if you choose the smaller portion.

4. If you are a parent, try encouraging your kids to choose the smaller — healthier — portion, by offering a small non-food prize or reward. Your kids will probably prefer the prize more than the extra food.

5. It may be economically feasible for the food industry to sell smaller portions. If you are a restaurant owner, consider adding some kind of small incentive encouraging diners to choose the smaller portion. Just be sure not to offer them a free dessert, which would defeat the whole purpose.

Want to learn some portion-control tips and tricks without the reward? I discuss them here.

Follow Dr. Lisa Young on Twitter: www.twitter.com/drlisayoung

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Nutrition panel urges American’s to eat green, limit sugar, drink coffee and more

Below is my blog post for Huffington Post on the new report from the Dietary Guidelines Advisory Committee (DGAC):  Nutrition Panel urges American’s to eat green , limit sugar, drink coffee and more.

You can also read it HERE.

new report by the Dietary Guidelines Advisory Committee (DGAC), which convenes every five years and advises the federal government on the official dietary guidelines, calls for some changes to the American diet.

The purpose of the Advisory Report is to inform the government on the scientific evidence related to diet and nutrition. The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) jointly write the Dietary Guidelines, which are due out later this year.

According to the DGAC:

… about half of all American adults — 117 million individuals — have one or more preventable, chronic diseases, and about two-thirds of U.S. adults — nearly 155 million individuals — are overweight or obese … Poor dietary patterns, over consumption of calories, and physical inactivity directly contribute to these disorders.

Americans eat too much sugar, saturated fat, and salt. We don’t eat enough fruits, vegetables, nuts, whole grains, and fish.

The report further states that:

… individual nutrition and physical activity behaviors and other health-related lifestyle behaviors are strongly influenced by personal, social, organizational, and environmental contexts and systems. Positive changes in individual diet and physical activity behaviors, and in the environmental contexts and systems that affect them, could substantially improve health outcomes.

The report by the committee eased certain restrictions (those for cholesterol, total fat, and coffee) and stressed limits for other restrictions (such as those for added sugar and saturated fat).

Rather than obsess over individual nutrients, the committee urges Americans to strive for a healthy dietary pattern: a diet with more fruits, vegetables, legumes, whole grains, seafood, and low- or non-fat dairy, and less red and processed meat, sugar-sweetened foods and drinks, and refined grains.

According to Dr. Marion Nestle, my NYU colleague, author, and nutrition policy expert: “The DGAC has produced an honest, straightforward, courageous report thoroughly based on research and at long last without mincing words.”

The Center for Science in the Public Interest (CSPI), a consumer advocacy group in Washington, D.C., also supports the report and issued the following statement:

The report of the DGAC is mostly unchanged from the reports of 2010 and years past, and in the ways it differs, the changes are mostly for the better. Contrary to some media accounts, the pendulum is not swinging wildly back and forth on most of these scientific questions; the basic advice to eat less saturated fat, sugar, and salt, and to eat more whole grains, fruits, and vegetables, is largely the same.

Here are some of the committee’s key recommendations.

SUSTAINABILITY

The committee, for the first time, urges American’s to eat green.

The report recommends that the government consider the environment — along with their heart, of course — when advising Americans about what they should eat.

The panel wrote “The major findings regarding sustainable diets were that a diet higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in calories and animal-based foods is more health promoting and is associated with less environmental impact than is the current U.S. diet.”

This move could have a significant impact on how much meat people eat. Not surprisingly, the meat industry called the report “flawed” and “nonsensical.”

ADDED SUGAR

The committee stressed that Americans consume too much added sugar and recommended a daily intake of 10 percent of calories, which amounts to around 12 teaspoons for a 2,000-calorie diet. To put this in perspective, “12 teaspoons of sugar” is just a tad more than a can of soda. Americans currently consume 22 to 30 teaspoons of added sugar daily, half of which come from soda, juices and other sugary drinks. This is why the report recommends that Americans drink water instead of sugary beverages such as soda.

Previous dietary guidelines have included warnings about eating too much added sugar, but this is the first time the committee made a specific recommendation for limiting sugar. Indeed, too much sugar is linked to obesity and chronic disease.

The CSPI welcomed the DGAC suggestions to consume less sugar along with the report’s blunt advice to drink fewer sugary drinks. They said, “The strong recommendations on added sugars are important and have far-reaching policy implications.”

I also applaud the recommendation for limiting added sugar along with environmental and policy changes like those suggested by the committee. As I toldFood Navigator, “The DGAC report supports the possibility of soda taxes as an incentive to promote purchasing healthier beverages, policy changes for SNAP…and limiting food marketing to kids, all steps in the right direction to promote a healthier food environment.”

The American Beverage Association (ABA), however, issued a different sentiment on restricting sugar and sugary drinks. According to Food Navigator, the ABA said: “Numerous studies have shown that restricting one food or food group is not the best approach for achieving calorie balance and maintain a healthy weight.”

Indeed, drinking less soda would be bad for their business.

FAT

The Committee is recommending that we limit saturated fat to no more than 10 percent of total calories. Saturated fat may promote heart disease by elevating blood cholesterol levels. Americans are urged to eat unsaturated fat — found in nuts, fatty fish, olive and vegetable oil — instead of saturated fat, found in red meat, cheese, butter, coconut, and palm kernel oil. While many celebrities and Atkins devotee’s heavily promote both coconut and red meat, the committee report advocates the contrary.

The DGAC, however, dropped a suggestion from previous guidelines to restrict total fat intake to no more than 35 percent of daily total calories. While previous editions of the Dietary Guidelines have advised Americans to eat a low-fat diet, the committee suggests that reducing total fat intake does not appear to decrease our risk for heart disease. Rather, replacing saturated fat with refined carbohydrates — including low-fat cookies and cakes — increases our disease risk.

CHOLESTEROL

The committee dropped its long recommendation that Americans limit their intake of dietary cholesterol from foods such as eggs and shellfish to no more than 300 mg per day. (One egg contains nearly 200 mg cholesterol.) The committee cites research showing that cholesterol from the diet has little or no effect on blood cholesterol levels for most people.

Dr. Nestle, however, wrote a thought-provoking blog post raising several important points on the research. She states, “I’m wondering if research sponsored by the egg industry could have anything to do with this.” Furthermore, she writes, “if the Advisory Committee is dropping the cholesterol recommendation, could it be because so many people are taking statins that dietary cholesterol doesn’t appear to matter so much anymore?” These are certainly points to consider.

COFFEE

If you enjoy several cups of coffee, you are in luck. The committee advised that drinking 3-5 cups of coffee per day (or up to 400 mg of caffeine) is okay. However, I suggest you watch the size of your mug to partake healthfully in those “five cups of coffee.” As I told Food Navigator, “3-5 cups translates into 2-3 Starbucks-sized cups … I worry that the public may think they can drink more coffee than the guidelines really suggest. Education on serving size is necessary here…”

Finally, will the feds accept these recommendations, and how will we implement them?

The DGAC report states:

It will take concerted, bold actions on the part of individuals, families, communities, industry, and government to achieve and maintain the healthy diet patterns and the levels of physical activity needed to promote the health of the U.S. population. These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide “culture of health” in which healthy lifestyle choices are easy, accessible, affordable, and normative — both at home and away from home.

According to Dr. Nestle, a former member of the DGAC:

Whether the agencies — USDA and HHS — will accept its recommendations remains to be seen. Congress has already weighed in and said that the Dietary Guidelines cannot consider sustainability in making dietary advice. Much will depend on the response to the call for public comments.

Stay tuned.

We would love to hear our thoughts on the DGAC report. And you can tell the gov’t what you think by weighing in here.

Follow Dr. Lisa Young on Twitter: www.twitter.com/drlisayoung

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Bloomberg’s Cap on Supersize Soda May Be Contagious

Below is my latest blog post for Huffington Post “Bloomberg’s cap on supersize soda may be contagious”.

You can also read it HERE.

As Mayor Bloomberg prepares to leave office, his controversial proposed cap on the size of sugar-sweetened drinks may be contagious. While we wait for the courts to determine whether or not a 16-ounce soda will be the default “large” at eating establishments such as fast food restaurants delis, and movie theaters, the United Arab Emigrates (UAE) has decided to ban supersize sodas.

According to Arabian Business:

The UAE has banned supersized fizzy drinks as part of a raft of new health measures announced by the government, as the Gulf state looks to reign in burgeoning obesity and lifestyle disease rates. The federal cabinet came to the decision following the second day of what it described as a “brain-storming” session at a Sir Bani Yas island, and comes on the back of a similar idea being introduced in New York City earlier this year by mayor Michael Bloomberg. According to a recent United Nations report, more than one third of the UAE’s population is classified as clinically obese, while a separate study said that 20 percent of adult Emirati citizens suffer from diabetes.

In Europe, James Quincy, the president of Coca-Cola Europe, acknowledged that many soda sizes are too large. Appearing on BBC, Quincy said that the size of some of the large cups that Coca-Cola is sold in “needs to change” and that “the bigger cups need to come down.” And the sizes of European portions, including soda, are not nearly as large as our portions.

Meanwhile, back in New York City, at a recent roundtable sponsored by the Museum of Food and Drink debating the proposed cap on sugary beverages, I debated the merits of Bloomberg’s proposal. As discussed in Food Navigator, one of the reasons I support the proposed portion cap is that the marketing of supersize sodas has become the norm. In the movie theater, for example, a 32-ounce quart size soda is labeled “small” and a 44-ounce soda is labeled “medium.” Since when is a quart of soda considered small? I also discussed that obesity rates have increased in parallel with growing soda sizes and that calorie labeling alone will not solve the problem. Consumers need an environment that encourages healthier choices. And the healthy choice must be the easy choice.

As I further discussed in the debate and previously wrote in the NY Daily News:

Large portions contribute to obesity because they obviously contain more calories than small portions: A small soda (16 ounces) at KFC contains 180 calories, while the Mega Jug (64 ounces) contains nearly 800 calories — and is more than one-third of an entire day’s recommended calories for some people … 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.

You can listen to the entire debate complements of Heritage Radio Network.

I hope that the courts favor Bloomberg’s proposal and that when we visit a concession stand at a NYC movie theater later in 2014, the largest single-serve soda is 16 ounces as opposed to the 50-ounce size available now.

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Lessons from the Mediterranean diet: 10 foods to eat

Below is my latest blog post  for Huffington Post: ” What we can learn from the Mediterranean Diet: 10 healthy foods to eat.” You can also read it here.

The Mediterranean diet is a heart-healthy eating plan that has been thought to reduce the incidence of heart disease. Now a large study published in the New England Journal of Medicine on thousands of participants in Spain confirms the health benefits of this eating plan. The study found that those following the Mediterranean diet had a 30 percent reduction in the chance of having a heart attack or stroke. The study subjects were people ages 55-80 who had a high risk for cardiovascular disease.

As reported in the New York Times, “About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals.” The study was stopped early because the results were so clear-cut that they found it not ethical to continue.

The Mediterranean diet is an eating plan that is high in fruits and vegetables, and includes whole grains, olive oil, fish, nuts, beans, and legumes. It is low in foods that are high in saturated fats — such as meat and butter — and is also low in processed foods. What I love about the Mediterranean diet is that it is not touted as a weight-loss diet, but rather as a healthy lifestyle plan and a way life.

I previously wrote about the benefits of eating a diet high in fruits and vegetables and rich in whole grains.

So how can we Americans eat more like the Greeks? We can eat more fresh fruits and vegetables, include fish instead of meat, use olive oil instead of butter, and snack on nuts instead of chips.

My clients have been asking me which foods they can include in their diet. Here are some winners.

Olive oil is rich in monounsaturated fat, a heart-healthy fat. Diets high in olive oil have been associated with heart health. Olive oil is also rich in antioxidants, including vitamin E, polyphenols, and beta-carotene, which protects blood vessels and other components of the heart. Drizzle olive oil on salads and steamed veggies.

Tuna is high in omega-3 fatty acids, which have been associated with a decrease in the risk of heart disease risk. The American Heart Association recommends including at least two servings of fish per week, in particular fatty fish. Tuna is affordable, convenient, and versatile. Throw canned tuna on a salad, make a sandwich, or toss it into whole wheat pasta, to get a dose of omega-3s.

Broccoli is one of my favorite vegetables as it is chock-full of the antioxidant vitamins A and C. It is a cruciferous vegetable, and part of the Brassica family, rich in phytochemicals, known to have antioxidant properties. Sautee broccoli in olive oil and enjoy it as a side dish.

Raspberries contain the antioxidant quercetin — which contains anti-inflammatory benefits — and the phenolic compound ellagic acid, and can help fight heart disease. And even more good news: One cup contains only 105 calories and eight grams of fiber. Throw some berries into your morning yogurt for added color, taste, and a healthy dose of antioxidants and fiber.

Walnuts not only taste great, but also provide a heart-healthy addition to your diet. Rich in the plant-based omega-3 fatty acid alpha-linolenic acid, and antioxidants such as selenium, walnuts also provide protein, fiber, magnesium and phosphorus to the diet. Include a handful of walnuts as a snack or toss a few tablespoons into your breakfast oatmeal.

Chickpeas are a great option for plant protein and fiber. They also contain magnesium, manganese, iron, and folate. Hummus, which is made from chickpeas, is delicious with crackers or veggies as an afternoon snack.

Brown rice contains fiber, B-vitamins, and a variety of minerals. It contains nearly three times the fiber of white rice. A half-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. Brown rice makes a healthy grain to include with a meal of grilled fish and vegetables.

Spinach contains the minerals iron and potassium, as well as vitamins A, C, K, and the B-vitamin folate. Spinach also contains flavonoids, which have antioxidant properties that may prevent against certain diseases. For good news, it is available year-round, offering a readily-available source of many vitamins and minerals. A fresh spinach salad drizzled with olive oil and a handful of nuts tastes great.

Blueberries are rich in antioxidants and vitamin C and may benefit heart health. Consuming blueberries may keep your blood pressure in check. Blueberries contain anthocyanins, which may reduce the risk of heart disease in women. Snack on these tasty berries or throw a handful into your cereal.

Lentils contain soluble fiber, protein, and complex carbohydrates and also offers the added benefit of being a significant source of iron. Consider beginning your lunch or dinner with a hot lentil soup.

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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.”

.
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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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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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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