Check Your Sugar

Here's a brief update to my last blog entry, Sugar, Sugar, now that I've seen the movie Fed Up! and had a chance to process some of my thoughts.

This movie is an important public service because all of us need the smack in the head about sugar. Even those of us, like me, who are hyper conscious of what we're  eating, can learn from this movie. I appreciated the very simplified (almost dumbed down) scientific explanation of our bodies on sugar.  It made the reason to limit sugar much more clear.  The stories of the morbidly obese teens and families featured are compelling and heartbreaking, bringing me to tears more than once. I'm glad Paul saw it with me and I will take both my grown kids to see it when they're in town.

The experts interviewed are highly respected doctors, nutritionists, scientists and journalists. They are people who have been fighting this fight for many years. People like Margo Wootan of Center for Science in the Public Interest, Dr. David Kessler, a former head of the FDA who wrote The End of Overeating, Michael Pollan, Mark Bittman, the list goes on.

There is no way one can leave this movie without feeling compelled to change their diet and perhaps, try to change the world. This is a documentary with a very clear agenda and it is very persuasive. I truly believe that the future of the health of a large portion of our population is at risk, so maybe extreme measures are called for, but in this case I think the science and the facts are so strong that they really are persuasive without the extra little film tricks used.

Clips of representatives of the food companies are cut and pasted to make them look ridiculous. In the one instance that I noticed of a live interview with an industry representative, she was back lit unflatteringly in contrast with how the experts on the side of limiting sugar were lit, the Q and A was clearly cut and pasted and her interview sounds like it was done by a drone, not Katie Couric (full disclosure: although I differ greatly from her politically, I know the woman interviewed and respect her intellect, hard work, and her general commitment to doing good for others).

The movie also is pretty harsh on Michelle Obama and the turn Let's Move took a couple of years back towards emphasis on getting kids moving and away from the food they are eating. Politics intervened there and caused her to tone down the push on food companies and their very powerful lobby. Recently, now that the President is in his second term, she has helped get the USDA to issue a new crackdown on marketing to children and pushed the FDA get a proposal for a better food label out of its backlog. These are good things and I wrote about them here. I don't know to what extent knowledge that this movie would come out influence the timing of the Let's Move announcements in March, or if they would have occurred regardless.

There is a greater good that can be achieved by this movie despite it's somewhat heavy hand.  As I wrote yesterday, we should all be more conscious of the sugar hidden in our everyday foods.  We know when we eat desserts that we are eating sugar, but the reminder that sugar, in some cases in great amounts, is found in groceries used for breakfast and dinner is an important one. The sugared coffee drinks and free refill super sized soft drinks (organic or not) at every fast food place are filled with so many teaspoons of sugar that omitting those alone could help a person's health immensely.

In the free market economy that we know and love in our country, corporations with shareholders can not be expected to behave ethically just because it's the right thing to do.  They will offer full sugared sodas in massive containers alongside no sugar added products.  They will replace added sugar with some other chemical or substance that can harm us in ways we don't yet even know.  They are not our buddies, Tony Tiger, Dora the Explorer and Ronald McDonald and all the charitable donations McDonalds makes in his name notwithstanding. They are in business to make money. Marion Nestle, who appears in the movie, while speaking at George Washington University (GWU) a few weeks ago, questioned whether corporations with shareholders can even take social responsibility.

So we have to urge our government, our representatives in Congress to stop bending to the food lobbies and require the companies to do so.  We might not be able to expect the big food companies to watch out for our youth and our health, but we should expect that of our elected officials. We should demand it. Companies should not be allowed to market their unhealthy sugared cereals and snack foods and yogurts directly to children, and most importantly, these items should not be available in our schools.

For many at-risk children (according to Nestle, 10% of US kids are food insecure), the food they eat at school represents the bulk of the food they eat for the day. Our school districts think we're helping them by filling their stomachs with something, but we're filling their stomachs with sugar in any and every form: Orange juice, sodas, sweetened milk drinks, sugary breakfast cereals, white carbs, syrup, sweetened ketchup, the list is endless. This is perhaps the most upsetting part of the movie. For some people, the sugar (and fat) excess will result in obesity.  For others, the ill effects of an unhealthy diet might not show on the outside, but can still be causing the body to be fat on the inside and still lead to diabetes and heart disease.

I recently saw an episode of Anthony Bourdain's CNN show, Parts Unknown, in which he visited a school in  Lyon, France, where a chef made the 350 kids a lunch that I would happily pay to eat in a restaurant.  Pureed pumpkin soup, fish and vegetables and a light fruit dessert for the equivalent of $1.50 per child.  Here, most of our schools have taken out the food production facilities in most schools and use large food company suppliers to deliver ready to heat foods like pizza and cheeseburgers with fries instead.  These should be once in a while foods, that kids are now eating daily. Even where there are healthier options, if pizza and cheeseburgers are also offered, the kids will rarely choose the healthier meal. In Fed Up! one cafeteria worker summed it up when she bemoaned that they had only sold 25 healthier options out of the 300 + that the sold. When they're offered side by side, it is the unusual kid who will take the healthy choice.

In her talk at GWU, Nestle provided a long list of reasons that obesity went up in the '80s.  Some, but not all, are sugar related.  One item that she mentioned is that the price of fresh fruit and vegetables has gone up 30 - 40 % since 1980. This provides a challenge for many people on a limited budget.  Fed Up argues that in addition to being healthier to cook at home, that it's also cheaper.  While I am a zealot for cooking at home more, I'm not sure that I can wholeheartedly agree with this premise.  It is true that it's healthier to cook at home, and it's true that if you want to eat healthier foods, it is cheaper to cook at home, but at this time, fruits and vegetables are still pricey when compared to fast food. This is also an area that we should be encouraging our lawmakers to change. We have subsidies written into our farm bill that provide financial incentives for production of corn and soy and very little assistance to those growing vegetables for human consumption.

I will hope that the other reasons for the epidemic of obesity don't get lost in the publicity about sugar. The fear of fats is partly what got us here in the first place.  We don't want to substitute one problem for another again. And despite the film's criticism of the First Lady and Let's Move's emphasis on exercise, I do think exercise is also big part of staying healthy both individually and as a population.

So, see the movie. Accept that on the spectrum between polemic and documentary it veers slightly south of even treatment, and take away from it some of its passion on the issue. Go home and read labels, quit soda and cook at home more.

In the movie, Michael Pollan says "cook real food." We need to do that and also help others to do so, and most importantly, make sure places like schools and hospitals do so too. Our health is much too important to outsource to big food.

Sugar, Sugar

Trust in a sales relationship is a funny thing. I remember feeling somewhat unsettled when Paul and I bought our first piece of real estate, back in the day before buyer's brokers. Although I knew in my head and had been told many times, that both realtors worked for the seller, it was really hard to comprehend that even the broker we'd hired to show us potential homes still owed her duty to the sellers she might never have met. If there was some horrible flaw in a property that she wasn't legally bound to tell us, she was not going to tell us. If a particular property was out of our budget, she was not going to dissuade us.  And though we had a pretty nice relationship with that first broker, and she brought us a lovely Portmeiron bowl as a closing gift, I had felt a certain tension throughout the process.  She didn't behave like the stereotypical used car salesman. She was pleasant in a motherly sort of way. So though trained as a lawyer and a skeptic by nature, I still found myself pulled in and had to remind myself to be wary.

In much the same way, our eyes should be open in our relationship to food companies. They are trying to sell us something, and will go to great lengths to do so. I've written before about instances in which the companies create formulations (called, in the real world, recipes) loaded with fat, sugar and salt, designed to hook us to purchase and eat too much. They also market unhealthy foods to children, sometimes inflate or invent health claims on labels, hire very powerful lobbyists to push their agendas with Congress and Federal agencies, and, generally, subtly and not-so-subtly persuade us to buy foods that taste good, but are not good for us.

Unlike with cigarettes, we do need food to live and can't just quit it.  So we have to understand the messages we and our children are hearing and what the companies are doing to keep existing customers, attract new customers and get all of us to buy more.  We need to wise up and see that these companies are not on our side, are not in the business of protecting us and get out those reading glasses and read labels for ourselves. This includes foods found at stores considered healthy such as Whole Foods, which despite its pledges to stick to certain types of healthier foods, still carries many that are loaded with added sugar and salt.

Most packaged foods have added salt and sugars even where it seems unlikely, such as pasta sauces, salad dressings, crackers and breads.  Some of this is a result of the low fat movement in the '80's.  Fat out, other additives in.  Reading the labels is crucial, and if the newly proposed nutrition facts label is approved by the FDA, sugars will be much more clearly identified in the future, with added sugars noted separately from naturally occurring sugars.

Sugar is the subject of the new movie Fed Up, a project spearheaded by Katie Couric and Laurie David. Once I've seen it today or tomorrow, I'll have a better idea of the exact position they take, but in a general sense, it appears to be a call to arms that the obesity epidemic is fueled by food producers and added sugar. In my mind, there are several reasons for the obesity epidemic and I'm not sure sugar is the only one, but it is a big one.  I'm curious to see how much they deal with in the movie.

In the meantime, I decided to do a little test.  Generally, labels identify sugars in grams.  I can't imagine that there are many of us who can visualize grams, so the bottom line is that 4 grams of sugar equals 1 teaspoon. When reading nutrition facts labels on our packaged food products, it's important to remember that the sugar category includes the sugar that occurs naturally in certain foods, like milk and yogurt (lactose) as well as added sugars in the form of sugar, honey, syrup, agave, corn syrup, etc.

For my scientific example, I thought I'd use something I eat almost every day. My tub of plain (no added sweeteners) Greek yogurt has 9 grams of sugar in a one cup (8 ounce) serving.  That's the naturally occurring lactose. I measured out what seems to be a pretty hearty serving today and it was less than 3/4 cup (here is the one food whose packaging overestimates serving size!) so I'll round up to the 3/4 cup which is the equivalent of 6 ounces.

My 6 ounce serving contains 6.75 grams (3/4 of the 9 that a whole cup contains) of naturally occurring lactose or sugar.  I add about 1 teaspoon of honey to that.  That's about 5.5 more grams of sugars. Together, my breakfast yogurt has about 12.5 grams of sugar.  That's pretty close to the amount of sugar in the brands of individual cups of yogurt that I've been buying lately - I've been sticking to under 15 or 16 grams.

But I then checked labels on all the available brands of all the individual containers at my local organic market and found that the amount of sugar in the individual containers ranged from that 15 grams,  to as much as 29 grams for a 5.3 or 6 ounce container, with most falling in the mid twenties.

29 grams of sugar is over 7 teaspoons of sugar.  It's almost three tablespoons of sugar! Even if we subtract the yogurt's natural lactose, there are still 22.25 grams of sugar or a little over 5.5 teaspoons.

According to the Center for Science in the Public Interest, that one yogurt contains almost the entire daily recommended max of added sugars for a woman (6.5 teaspoons).

Most fast food places have nutritional info online. If there's an item you order often, you can take a look online and see what it contains.  For example, I checked and one of my favorite sweet treats, a Starbucks tall nonfat chai tea latte has 32 grams of sugar.  Given that a cup of skim milk contains 12 grams, that's about 20 grams, or 5 teaspoons, of added sugar.  I'm now back to a nonfat decaf latte for my occasional Starbucks stop. But if I do choose to have that chai latte, at least I know what's in it.

These companies are doing their job, mostly within the law, just like my realtor did hers. In response, we have to be more savvy and lobby the government to protect us better. These companies are not our friends, even though their commercials pull us in with their appealing marketing and even if we've used this product since childhood (hey ketchup, I'm talking to you!).  Coke might make those of us who grew up in the '70s think of holding hands and singing about peace and brotherhood on a mountaintop, but Coca-Cola is one of the major causes of the obesity epidemic we are currently facing in this country.

We should demand better for ourselves from the companies and from Congress and the Federal agencies charged with our food systems.  "Vote with your fork" if you can and help others who can't. Our food choices and our food systems are political and it's time we all recognize that.

Read the labels everyone, and cook at home!

Marion Nestle Says...

In her latest blog post, Marion Nestle, Professor in the Department of Nutrition, Food Studies, and Public Health and of Sociology at New York University comments on some recent studies about saturated fat and heart disease. Her opinion is that these new studies really don't show anything new or change her thoughts on the issue.  

She says "Focusing on one or another nutrient—fat, saturated fat, cholesterol, or sugar—takes foods out of their caloric as well as dietary context."

"My guess: If you balance food intake with physical activity and are not overeating, the specific proportion of fat, carbohydrate, and protein won’t matter nearly as much."

"While the arguments about fat v. sugar go on and on:  Eat your veggies, vary the foods you eat, don’t gorge, and enjoy what you eat."

So glad to hear an expert with this opinion!  

What a Week and Yes, a Recipe Too - White Beans and Greens!

The week before last was a banner one for healthier food policy. The week started off with First Lady Michelle Obama and Agriculture Secretary Tom Vilsack announcing tighter new federal standards for marketing food to children.  On Thursday, she revealed proposed revisions to the "Nutrition Facts" label on packages of commercial products, which made it to this point in the review process in record time.  The changes are now open to comment for 90 days at the FDA. I think it will be very challenging for the food companies to object too strenuously to these changes, as the First Lady has achieved so much good will with these companies as well as with the press and the public with her health efforts. On Friday, Sam Kass capped the week off by announcing some healthier changes to WIC, the Department of Agriculture's supplemental nutrition program for "women, infants and children." These changes include an increase in benefits for fruits and vegetables and the allowance of yogurt and more whole grains.

What hard work and political finesse led up to last week's announcements! I suspect this was strategically planned to occur in the President's second term, but with enough time remaining to see these changes through.  A lesson that patience and timing (on top of a whole lot of hard work and forging connections) can be everything.

The proposal for the new Nutrition Facts label seems like a great boon for the savvy consumer.  I like that the calorie count will be in a larger font so I don't have to break out the reading glasses to see it.  I really like that information will be based on more realistic serving sizes, and not on arbitrarily created puny ones designed to trick us into underestimating how many calories we consume. Anyone who's read a label has seen instances where, for example,  a bag of chips that appears to be the amount one person would eat alongside a deli sandwich, reads 2 or even 2.5 "servings per container."  Seriously, I only know one person who could open that bag and eat only half the chips.

Another great new revision proposed will be the identification of added sugars.  We've had sugars on the label for years but added sugars would distinguish between the sugar that occurs naturally in the food from the sugar added to sweeten it.  For example, plain yogurt contains sugar, but sweetened yogurt contains that naturally occurring sugar plus however much sweetener a company adds.

I am a big fan of clear, usable information, but I do recognize that the public must still want to use the information.  I was surprised to read studies done recently that even where more markets were added to known food deserts, that people didn't change their eating habits, or that when calorie counts were added to the menus in chain restaurants, that people didn't change their orders.  My habits change when I read nutrition facts and calorie counts. For example, that really delicious quinoa and spelt scone at a European bakery chain - anyone else do a double take on that one? I even had a twitter conversation with someone I follow when she tweeted a photo of the menu with the shockingly high calorie count shown, but didn't identify the restaurant. I recognized it immediately because I'd had the same experience a few weeks earlier. Information is power, people!

So this recipe happened a couple of times lately, here in the healthier kitchen.  I came across this recipe in last month's Bon Appetit magazine, and even shared the link to it on Facebook because I was so excited about it. The dish has the flavor of the overnight cooked white beans one gets in Tuscany, but done in a more reasonable time frame and with the punch of healthy greens.  Yes, using dried beans makes everything take longer, but as long as you plan ahead and soak the beans the night before, this is a perfect weekend dish to make and enjoy all week. In fact, if you soak the beans tomorrow night, you can make this for the absurd cold snap forecast for Thursday.  I've streamlined the recipe a little so here is my adaptation.

Just make sure to soak the beans the night before!!

This makes a large amount of beans.  If you don't love them as much as I, try making a half batch.  If you do go for the full recipe, you can serve it the first time as a main dish or side dish to some other protein, and make a soup with the remainder.  To make the soup, add stock, either chicken or vegetable to the beans and greens to thin it out and throw in some already cooked tiny pasta shape.  Serve with the same drizzle of olive oil and shaving of Parmesan as usual.

White Beans and Greens

(adapted from Bon Appetit)

Serves 6 - 8

2 tablespoons olive oil, plus more for drizzling
3 anchovy fillets, drained
4 garlic cloves, minced
1 large onion, thinly sliced
scant 1/4 teaspoon Kosher or sea salt
a few turns of freshly ground pepper
1/2 teaspoon Aleppo pepper flakes (if you don't have Aleppo, use 1/4 teaspoon hot pepper flakes), more if you like heat
1 sprig rosemary
1 pound dried cannellini or gigante beans
1 pound kale, chard, spinach or mustard greens (or a mix!), cleaned and ribs and stems removed and coarsely chopped
4 cups arugula or watercress
juice of 1/2 lemon, more if it's particularly small or dry
Parmesan cheese to grate on top

1.  Heat 2 Tablespoons olive oil in a large Dutch oven over medium heat.  Add in the anchovies and stir until they just start to dissolve.  Add the garlic and stir into the anchovies until they dissolve completely.

2.  Add onions into the pan, along with the salt and pepper.  Let cook until the onions turn translucent, about 5 minutes, stirring occasionally.  Add the Aleppo pepper and stir again. Let cook another 2 or 3 minutes.

3.  Add the rosemary, beans, and 8 cups of water.  Raise heat on burner to let this come to a boil then reduce to a simmer.  This will cook for about 2 or 3 hours until the beans get soft and creamy.  You might need to add another cup or two of water if the pan contents start to look a little dry.

4.  With the back of a large spoon or with a potato masher, crush about 1/4 of the beans and mix well.  Add the greens and mix in and let cook until all the greens are wilted and incorporated.

4.  Add the lemon juice and stir.  If it's really thick and dry, add a splash more water.

5.  Top individual servings with a grating of Parmesan cheese and a drizzle of good quality olive oil.  Serve with slices of a baguette or country Italian bread.

"Why Nutrition Is So Confusing"

Yesterday's New York Times included an opinion piece by Gary Taubes, a science writer who's written extensively on food and health, titled Why Nutrition Is So Confusing. He provides scary statistics about the increase of obesity and diabetes and asserts that the nutrition research community has failed to establish what actually causes them. At least he's doing something about that by helping found an initiative to provide for more research on this issue.  And, don't get me wrong, more research is a good thing.

But while I agree that figuring out how to eat right is surprisingly confusing (See f.n. 1- haha maybe you've never seen a footnote in a food blog before) and deserves much more well funded and thorough research, I'm not sure it matters whether it's sugar and white flour that's causing our ills or if it's saturated fat. Taubes is very focused on finding out which it is we Americans are eating too much of.

My guess as a non-expert, but intelligent and self-aware person who primarily cooks and eats at home, exercises, eats the right foods most of the time, limits saturated fats, white carbs and sodium and still grapples with weight, is that we are eating too much of everything.

For me, a person privileged enough to be able to buy whatever healthy food I desire, to still be grappling with maintaining a healthy weight means that I have to watch the amount of everything I eat, not just the bad stuff.  Though I definitely think that eating a selection of healthy foods, mostly cooked at home, is the way to go, even too much whole wheat pasta will pack on the pounds.  Other than, perhaps, kale, this is true for most foods (see f.n. 2 - and here, my friends, is your second footnote in a food blog!). I'm guessing this is true for some of you as well.

So then it is particularly galling to have this already really, really hard thing made even harder by restaurant chains where a single plate is delivered to the table towering with enough food for two and at fast food chains where the menus are replete with choices containing a day's worth of fat and calories and a week's worth of sugar and sodium.  I choose to avoid those places and cook at home more often with as few packaged items as possible. When I eat out, I choose places that share my food choices.

But I pay a premium for this.  Fresh vegetables, fish, and grass fed beef and milk, and healthier style restaurants are expensive and unhealthy packaged foods are not. When one shops with a limited budget, it can be challenging to pass up quantity, albeit unhealthy quantity.  When one is at the poverty line, the choice becomes even more Hobson-like. Many items in the grocery store are, much like the dishes at many chain restaurants, full of more fat, calories, sugar and sodium than we should eat in a day let alone in a single serving.

This is not just a matter of personal failings by all these people battling obesity and disease. We are being sabotaged in our efforts by restaurant and food corporations who try to deflect attention from what they're really doing by making donations to schools to renovate playgrounds or gymnasiums.  These corporations need to be forced to really partner in this fight, not just with their token donations, but by cutting out the extra sugar, fat, sodium and additives they add to junk food (and regular food for that matter) to make it so appealing to the kids who attend those schools. And by not targeting their advertising of that junk food directly to those same kids.  And by not insulting and endangering the families of those kids when they have a meal out at one of their establishments.

Willpower can only go so far, people, in the face of food-like substances that have been expressly designed by scientists to get us to eat more (f.n. 3 - yes, one more!) and are only going to make us sick if we do so. Let's demand better for ourselves and our communities.

f.n. 1  Five or six years ago I began reading all I could on food and health and concluded that it just wasn't clear, at least as far as avoidance of heart disease and diabetes, who to listen to.  Most experts advise the avoidance of saturated fats.  Others, including Taubes, believe that the culprits are sugars and processed white grains.  Most agree that we should eat less salt, but there's even some controversy on that.  Throw in the wild card diets gluten-free, dairy-free, Paleo, and vegan and it's like the Tower of Babel out there. There's even some research indicating that the right way to eat might vary from person to person based upon stomach bacteria.

f.n. 2 This is just a mild exaggeration.  I am, of course, including other vegetables in the category of what we can eat in an unlimited way, but even here the discussion is complicated.  Some would argue that starchy vegetables should be limited as well as potatoes.

f.n. 3  Please see The End of Overeating by David A. Kessler, MD.  It is quite shocking what games some corporations are playing with our tastebuds…and our health.

Food News

In the news today, the Senate joined the House in passing the Farm Bill and, as expected, cut $8 billion from SNAP benefits (what used to be called food stamps). This will affect about 850,000 poor families, many with small children, who will lose about $90 per month in benefits. It now awaits President Obama's signature which is expected to happen on Monday.  At least the SNAP cuts are less than what some House Republicans originally sought.

Also, in the spirit of positive thinking, there's this spin on the cold weather we've had this winter.

I'd also like to share this terrific find that I think will not only be a staple in my house but will help me lighten up some favorite recipes.  Labne.  I've made my own and written about it before, but I bought some at a Middle Eastern market recently and not only was it even more delicious than what I made, I had the packaging with the nutritional breakdown.

This could be just the thing when cream and full fat yogurt are called for in, say, an Indian recipe such as Tikka Masala or Makhini.  It is as rich and full bodied as creme fraiche with a fraction of the fat and calories.  And, it is much richer and thicker than yogurt.  I will be doing some serious experimenting with this theory!

Feb 8 update:  Signed, sealed, delivered…yesterday at MSU, President Obama signed the Farm Bill.