A Dietitian's Prayer

This is the prayer I pray before eating:

"Dear God.
Thank you for this food that is placed before me.
Bless it to my body to make me healthy and strong.
May all my cells accept the nutrients and be nourished.
Amen."

Market trans fat like cigarettes

This past weekend I spend time with a group of kiteboarders at the Outer Banks of North Carolina.  We stayed in a big beach house and shared meals.  I did not shop for the food.  But I wish I had.

Almost everything they purchased, almost everything we ate, had trans fat – the Bisquick® pancake mix, the enriched wheat flour bread, the Duncan Hines® brownies…  I just about had a heart attack at every meal.

Why does this concern me?

Two reasons.  Because trans fats are very detrimental to health.  And because the group was composed of intelligent, physically active, health-conscious individuals (teachers and doctors) who should have known better.

To give them the benefit of the doubt, it is possible that the food purchased was not indicative of their typical diet.  They may have simply been trying to feed a big group as inexpensively as possible.  Or perhaps the cuisine was “vacation food” (i.e. junk food you don’t usually allow yourself to eat, but splurge on during vacation).

But what if they really ate that much trans fat?

According to the  2005 Dietary Guidelines for Americans, the “estimated average daily intake of trans fats in the United States was about 2.6 percent of total energy intake” between 1994 and 1996.  Based on a 2,000 calorie diet, that is about 5.5 grams (52 calories) of trans fat every day!  And I’m sure that number has gone up in the last 16 years.

As a registered dietitian-nutritionist, I wince when I see people eating trans fat because I know how bad trans fats are for the body.

Consuming trans fats increases your risk of developing cardiovascular disease (2010 Dietary Guidelines for Americans). Trans fats are worse than saturated fats (which was, until only recently, public enemy number one).  This is due, in part, by the ability of trans fats to raise bad (LDL) cholesterol while also lowering good (HDL) cholesterol.

Trans fats also increase inflammation, which is the underlying cause for most chronic diseases, including diabetes, obesity, and cancer.

Furthermore, there is no reason to eat trans fat because trans fats “are not essential in the diet” (DGA 2010, p 25).  In other words, trans fats are not a healthful food additive. 

So why are trans fats ubiquitous (found everywhere) in the food supply? 

Because they improve taste, provide a consistent and desirable texture, and extend the shelf-life of processed foods.  This is why Twinkies taste and feel the same no matter how long after the “best by” date you eat them!

Trans fats were invented in response to consumer demanded for foods low in saturated fat (which was spurred by the first Dietary Guidelines for Americans in 1980 – but that is a topic for anther blog entry).  To make trans fats, liquid vegetable oils are bombarded with hydrogen atoms until the bent molecules become straight.  This “hydrogenation” process turns the liquid oil into a solid fat.

Once the government realized that trans fat may be harmful, they passed a law requiring “trans fatty acids be declared in the nutrition label of conventional foods and dietary supplements on a separate line immediately under the line for the declaration of saturated fatty acids” (The law passed in 2003, effective January 2006, read the Federal Register here).

However, a manufacturer can report “0 g trans fat” if the amount is less than 0.5 g per serving.  The “per serving” stipulation is important because most people consumer more than one serving at a time, thus consuming more than 0.5 g of trans fat in one sitting.  In other words, manufactures can manipulate product recipes and serving sizes to avoid having to claim trans fat on the Nutrition Facts label.  This is deceptive to consumers who do not know any better.

The best way to determine whether or not a product has trans fats is to read the ingredients list.  If there is mention of any “hydrogenated” or “partially hydrogenated” oils, the food product contains trans fats.

Better yet, I wish there was a law requiring graphic pictures be included on the package of every food containing trans fat, similar to the nine selected graphics the FDA wants to include on every pack of cigarettes sold in the United States to inform and educate consumers.  Of course, the cigarette manufacturers argue the graphic images do more than educate.  They believe the images are meant to advocate a change in behavior.  They brought the case to court, which is still unresolved.  (Read the New York Times article here).

What will happen from here?  I do not know.  But I hope the FDA wins.

If the FDA is able to advocate behavior change against smoking with graphic images, then there is no reason they wouldn’t be able to require graphics of people with heart disease be included on the packaging of products that contain trans fats.

A picture speaks a thousand words.  If we had a better way to educate consumers about the dangers of trans fats, I believe people would finally start to pay attention to how much trans fats they are consuming.

Choose food over nutrients

The CDC recently release their Second National Report on Biochemical Indicators of Diet and Nutrition.  Distilled from 495 pages of detailed data and explanations, the current message being broadcasted in the media is that the "U.S. population has good levels of vitamins A and D and folate."

My first reaction?  Of course Americans have good levels of vitamins A and D and folate!  We drink gallons of milk (which is fortified with vitamins A and D), and eat copious quantities of refined grain products (which are fortified with folic acid).

Fact: The FDA mandated that, starting in January 1998, all enriched flour be fortified with folic acid.  This mandatory fortification, which includes foods like enriched bread, flour, cornmeal, rice, pasta, cookies, cakes, crackers and snack foods, was implemented to reduce the number of brain and neural tube defects (like anencephaly and spina bifida) in newborn babies.  These defects are more likely to occur when mothers consume less than 400 micrograms of folic acid a day.

And fortification has worked: the rate of birth defects due to folate deficiency has declined since 1998.  Hooray for governments that treat the entire population instead of just targeting the group at risk!  Right?

Um.  Maybe not.

While I am glad that our government health organizations (CDC, FDA, USDA) have helped decreased the rate of certain deficiency diseases, it seems that this approach has not been ideal for the prevention of chronic diseases, not to mention the promotion of optimum health.

For example, the recommended dietary allowance (RDA) of vitamin C -- 90 mg/day for adult men and 75 mg/day for adult women -- is based on the prevention of survey, a disease that occurred most frequently in the early part of the second millennium (1400's to 1700's) among sailors on seafaring ships who did not have access to fresh fruits or vegetables for months at a time.  Symptoms of scurvy include general weakness, anemia, gum disease, and skin hemorrhages.

Human beings are one of the few animals who cannot synthesize vitamin C from glucose and, therefore, must eat foods to obtain it.  Good sources of vitamin C include a medium orange (51 mg), a small grapefruit (39 mg), a raw sweet red pepper (94 mg), and a small papaya (95 mg).

Today, survey is most frequently seen in elderly people and alcoholics.  In other words, people who exist on a diet devoid of fresh fruits and vegetables.  Hardly a diet to promote optimum health.

I wonder, when the CDC measures the levels of our biochemical indicators, are they basing the results on the RDAs?  Are the reports really proclaiming "Hooray, most people have enough serum vitamin C to avoid scurvy!?"

I hope not.

I worry that, in an age of nutritionism (thank you to Gyorgis Scrinis, via Michael Pollan, for the new term!) we are so focused on getting enough of each particular nutrient, that we forget to eat real food.  A processed food that has been enriched with the latest "wonder nutrient" is much more attractive to the average American consumer than an apple sitting quietly in the produce section with no Nutrition Facts label to boast how much fiber it contains and no packaging to brag about the various phytonutrients inside.  When, in fact, most processed food has been stripped of its original wholesomeness and filled and coated with FDA-approved adulterants: sugar, salt, fats and chemical additives.

What am I getting at?  Maybe if Americans started eating real food again, the government would not have to mandate the fortification of processed food and then congratulate themselves when they find a measureable increase in serum levels.  Yes, levels of vitamins A and D and folate are up, but so is the incidence of diabetes and obesity.  This is a big disconnect for me.  I wonder, how can we be so happy that serum levels of specific nutrients relevant are good when the health of the overall body is so lacking?

I predict that if Americans made therapeutic lifestyle changes (i.e. exercised more) and started eating a whole foods diet, the rates of chronic diseases would plummet (as Dean Ornish and Mark Hyman have both shown)...and the need for fortification would be nil.

Leftover guilt

I was shocked to learn in today's Wall Street Journal that Americans throw away tens of tons of food every year (almost 34 tons in 2010, according to the Environmental Protection Agency).  The article, which focuses on consumer guilt and ways to transform leftovers into something desirable, explains that food waste ends up in our landfills and incinerators.

While I agree that Americans need to become more conscientious food shoppers, I realize that avoiding food waste is not always possible.  For that reason, I would like to introduce and discuss another way that we can prevent the 33 tons of food from entering our landfills: composting!

Composting is the easiest way to turn food waste (and yard waste) into a rich, dark soil.  And it can be done by almost everyone!  If you live in a rural area, you can section off a part of your property to use as a compost pile.  If you live in an urban area, you can use a composting bin.  The Environmental Protection Agency has a great website, which provides basic information about how to start composting, including lists of what can, and can't be composted, and the laws and regulations depending on where you live.

You can also check your local government.  Many cities (like Falls Church, VA) compost leaves in the fall and provide it to citizens in the spring (one to three years later) to use as yard mulch.  Some, more progressive municipalities may already have food composing as well!

free compost mulch nourishing my tomato plants

In addition to reducing your waste footprint, one of the greatest benefits of composting is that, once your compost is mature, you can use it to fertilize your garden and grow vegetables for you and your family!

Different kinds of hungry

I am not usually hungry when I wake up in the morning.  But I force myself to eat, following the recommendation of countless dietitians to get my metabolism going.

It's a common dieting mistake.  Some people skip breakfast, thinking they will consume fewer calories and lose weight when, in actuality, they are suppressing their metabolism (i.e. burning fewer calories) by failing to break the fast (break-fast) from the night before.  Once the stomach has food in it, the digestive system starts nourishing the body and, in response, the body becomes more active (i.e. burns more calories).

In addition to suppressed appetite in the morning, I experience many levels of hunger throughout the day.  I wonder if others experience a similar fluctuations in their hunger...

There is the "it's almost lunch time" hunger when my stomach is empty and growling because I ate breakfast 5 hours prior (more than enough time for a meager bowl of cereal to be broken down into molecular bits).  This hunger is usually accompanied by a slight headache, the kind I usually get when my blood sugar is low.  So I eat, and I feel better.

I tend to have a snack in the mid-afternoon, around 4pm.  This prevents my blood sugar from getting too low at the end of the work day, but it also mutes my hunger signals.  By the time I get home and it's time to make dinner, I am in a bind.  My stomach is not growling enough to motivate me to cook a huge meal, but I know if I do not eat a balanced meal of protein and vegetables, my blood sugar will soon tank and I will become a cranky person (which I try to avoid, for the sake of my housemates).

Then, there is the "ravenous hunger" I experience after long-duration exercise.  For example, the other night I biked 19 miles after eating only two slices of peanut butter and honey toast for dinner.  By the time my biking partner and I returned to the house, I was so hungry I ate a large plate of cheesey lasagne, a tall glass of juice, and 2 more slices of peanut butter honey toast.  I probably consumed 700-800 calories in 20 minutes.  And it felt SO good!  (To replace the calories burned on the hour+ long bike ride).

I find that, the less I exercise, the fewer "hunger signals" my stomach sends my brain.  There are days when I am unable to exercise (bound to my office chair during the day, teaching in the evening) and hunger is almost non-existent.  These are the days I find it most challenging to eat my daily recommendation of fruits and vegetables -- the less hungry I am, less less delicious food tastes.  And the less delicious food tastes, the more I gravitate toward sugary, fatty foods to stimulate my dulled taste buds.

Winter squash: good source of beta-carotene

Sugar is also my food of choice when emotional hunger strikes.  Sometimes it's surving a long and challenging day at work that has me craving a chocolate reward.  Other times a handful of cookies helps me fill up the emptiness of feeling lonely.  This type of "hunger" is not biological in nature, but is a powerful motivator to eat.

Some would say that emotional hunger is a dangerous beast.  "Watch out for emotional hunger, it leads to weight gain!"  However, despite the wild fluctuations in my hunger, I have no problem maintaining a healthy weight.  Perhaps it is "normal" to experience different types and levels of hunger throughout the day...  But I wish I was ravenous hungry more often.  Food tastes so much better when the hunger is biological.