Health Education: calories

Showing posts with label calories. Show all posts

Information for Food Decisions

The <a href="http://www.health.gov/dietaryguidelines/2010.asp" target="_blank">Dietary Guidelines for Americans</a> recommend that calories be monitored on a daily basis.  The recommendation is based on the importance of consuming the appropriate amount of calories to prevent 'over fatness' - which appears to increase the risk for several diseases.    To be fair, clear and honest, many of us do not know our calorie needs - the amount that balances with our energy expenditure.  This lack of knowledge needs to be addressed, but is not the focus of this post (calorie needs are assessed on an individual basis).  For now, lets pretend that everyone does know their personal needs- and agree that for most of us its between 1800 and 2500 calories a day (NOTE: if you need 1800 calories a day and consistently eat 2500 calories a day, you will have excess fat!)    Presuming you need 1800 calories a day and you know this, and you obtain many of your meals away from home, to stay on target you need access to nutrition information at the point of purchase at those places .      I feel it is imperative that nutrition information be available everywhere  food decisions are made, but it is not.  The national menu labeling law (passed within the Affordable Care Act) amends an older law, the Nutrition Labeling and Education Act which excluded ready to eat foods, like those at restaurants- from nutrition labeling.  This oversight was a mistake and it took a new law to fix it.  The fact that the new law does not include all places that sell ready to eat foods, e.g., entertainment venues, is dumbfounding.  The FDA can fix this - they are responsible for the final rules.  It needs to be fixed now, not 20 years from now.  This is a real fight and certain industries and labeling advocates are battling it out - leading in some part to the delay of national labeling.    The Center for Science in the Public Interest is lobbying for the expansion of nutrition labeling and today they shared the picture below from a New York City cinema.  NYC has a much broader labeling law, however, the federal law will override state and city laws.  That means even the NYC policy will not include movie theaters, (or theme parks, bowling alleys, etc.) if the federal law doesn't include them.  Take a look at the numbers below and see how important this information is to the person trying to stay in their limits.  BTW, we should all try to stay in our limits, at least most days.     <table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3OqmQ95Iv9pIj7-5yy9nHMTph_vyyudNO1OImEUT0aYVCQaoZLqOv1n5dPaaCDA7KJ-w8UR8GQaCIV-8i5uzMMW65l_smjH-ALErhLsgpuHNQ5QsDFdbKjB1wx4Ddalvg1IXFqya6fc6U/s1600/cinema.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3OqmQ95Iv9pIj7-5yy9nHMTph_vyyudNO1OImEUT0aYVCQaoZLqOv1n5dPaaCDA7KJ-w8UR8GQaCIV-8i5uzMMW65l_smjH-ALErhLsgpuHNQ5QsDFdbKjB1wx4Ddalvg1IXFqya6fc6U/s640/cinema.jpg" width="640" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><h2>To take part in the campaign to expand labeling - click <a href="https://secure2.convio.net/cspi/site/Advocacy?cmd=display&page=UserAction&id=1425" target="_blank">HERE</a></h2></td></tr></tbody></table>Just a note, the Nutrition Labeling and Education Act is the one that mandated nutrition information and nutrition facts panels on the foods you find on grocery store shelves.

Information for Food Decisions

The Dietary Guidelines for Americans recommend that calories be monitored on a daily basis. The recommendation is based on the importan...

8:31 PM

What foods are healthy and how can you tell from a menu?

To see the summary abstract of the study I refer to in this blog post, please click <a href="http://www.sciencedirect.com/science/article/pii/S0091743513002259" target="_blank">here</a>. The lead author is Lillian Sonnenberg.    The purpose of this particular post is to share the results of another menu labeling study that used the Multiple Traffic Light (MTL) system to help customers identify "healthier" items.  I have a concern and a point to make regarding overall menu labeling, the federal legislation and why my point probably won't make a difference, but first.. a digression.    Notice that in the above paragraph I put the word healthier in quotation marks.  I did this because in the research publication the authors assessed purchasing of items deemed healthier if they met criteria to be labeled as green. Two of the 5 criteria for a green label were low calorie (e.g., 500 or less for an entree) and low in saturated fat (i.e., < 2 grams).  The researchers also surveyed the customers before and after they introduced the labels.  The foods sold before and after the introduction of the labels were the same and the researchers knew if a person bought a green labeled food even during the time when no labels were posted.  When the researchers asked customers to answer a few questions after their purchase, the researchers also took their receipts.  Therefore, the researchers could match the survey answers with the items purchased.  A funny thing.. even customers who said that they always or almost always choose 'healthy' items were buying foods that were most often red (or unhealthy).  After the labels were placed, the 'healthy' eaters did only slightly better at purchasing green labeled foods.    The researchers point out that customers do not seem to know what determines a foods healthiness.  I am not at all surprised and to be fair, isn't 'healthy' subjective and likely to change with every news headline?  Instead, I think that the researchers could have defined healthy in their question. They might have asked how often the customer chose foods low in calories or low in saturated fat (but even here a person must possess some nutrition knowledge to know what constitutes low, which is why MTL labels are effective - green = low).  The researchers failed to mention another likelihood for why people who said they chose healthy items did not in fact buy them. It is possible that they said it because it was the socially correct answer, not because it was what they actually do.    Ok, now my main point.  Since the Affordable Care Act was passed with a National Restaurant Association supported nutrition menu labeling law included, new research has indicated that calorie disclosure alone (as per the law) is not sufficient to change selections.  Instead, menus using the MTL as the Sonnenberg et al study and many others have found, are more effective.  The law should be amended to incorporate these new findings, but it won't be  - nor will it be overturned - even if the ACA is.  I make both assertions for the same reason.  The National Restaurant Association is in large part responsible for the passing of the law - which in many ways is great.  It probably would not have happened without their endorsing it.  They will make sure that the law stays in place because it prevents states and cities from requiring restaurants to do anything different - it mandates a nationally standardized format that a restaurant chain can implement across its regions.  One law - one format.  And the format won't change (even if it isn't effective, or maybe for that very reason)  because if the MTL was used, the menus would be covered in RED and that would be bad for business.  (I think it would force restaurants to revise their recipes - in a good way-, but I just don't see this getting any industry support)

What foods are healthy and how can you tell from a menu?

To see the summary abstract of the study I refer to in this blog post, please click here . The lead author is Lillian Sonnenberg. The pur...

8:26 PM

Myths, Assumptions, Nuances and Obesity

I have been writing about health and wellness in one form or another for 13 years. During that time I have gone to graduate school twice.   My plan for the blog has always been to present information to the public that goes beyond the headlines. My goal is to educate the reader in the hopes that he or she will take new science and recommendations for better health into consideration.   These recommendations include consuming a quality diet, getting sufficient exercise, limiting sedentary activity and maintaining a weight lean enough to prevent diseases that are associated with adiposity - or over fatness. My understanding of research has improved over the years, especially the last few, but the science into the causes of obesity (adiposity) has been plagued with flaws.  Scholars far more experienced and critical than I, have begun to point out these flaws. I tell you this because I am sensitive to the fact that I may have perpetuated false claims in my own blog or given too much credibility and attention to tenuous claims.  This exactly opposite my goal.   Here I am speaking about diet quality and healthy weight. It IS still about calories and the sources of those calories, but it is much more nuanced.  By nuanced, I mean that numerous factors are independently and interdependently related to health and weight.   There are many problems with the methods used in obesity research and that makes it hard to pull together evidence that can suggest a solution.  Science has taught us a lot. We now need to use more precise measurement methods (e.g. with dietary recall, and body fatness), be consistent with our definitions (what is obesity?) and have more open minds about what the causes could be (is it really just too many calories ?). This was wonderfully explained by Herbert et al (2013) in a commentary published in the journal Mayo Clinic Proceedings.  The summary can be found <a href="http://www.mayoclinicproceedings.org/article/S0025-6196(13)00265-6/abstract" target="_blank">here.</a>  They give good advice for improving research.  I will apply this advice in my career. I will continue to talk about calories (food energy availability) and policies, but these are small parts of a very complex, multi -facted system. Let me quote from the Herbert article.  I assure you that I believe every word in this paragraph. <blockquote class="tr_bq">...obesity arises from the dynamic interplay of the external environment, inclusive of the social milieu, built environment and food energy availability, behavioral and development processes and a variety of genes and epigenetic effects that, in turn, control a myriad of metabolic systems and subsystems that regulate energy intake, energy expenditure and nutritional partitioning.   </blockquote>Now I will do my best to restate this in simpler terms: There are many factors both inside and outside of our bodies that work together to create a condition where obesity is likely.  As one factor changes one or more others reacts and these changes and interactions are continual (dynamic). The external environment can make it easy or hard to be physically active (built environment) and easy or hard to eat too many calories (especially nutrient poor ones) (i.e., food energy availability). These two factors are also impacted by social cues (preferences, norms, advertising, ' peer pressure' - i.e., the social milieu).  Behavior is what we do - exercise or not, choose certain foods or drinks, and development is the body changing over time.  Genes, or heredity, are usually activated by some interaction with the outside environment (epigenetics) and together impact how the food a person eats is processed by the body - whether or not one gets high cholesterol, or diabetes for example. That is a lot to process.  The simplest truth is that one should not eat too much, and a very complex set of circumstances determines if one eats too much and whether their eating too much causes a bad outcome (illness).   I would point out one last thing from the article.. the authors say that it is social and environmental factors, NOT genes, that have had the greatest influence. So here are 3 interesting links about calories. <a href="http://online.wsj.com/article/SB10001424127887324809004578635783927655580.html?mod=e2fb" target="_blank">Link 1</a> This is a story about peoples desire for calorie information and how some restaurants are starting to provide lower calorie meals.  It actually summarizes a lot of the research I have used in my literature reviews and in this blog.  I love how it mentions Dardens Restaurants use of nutritionists and calorie counts when creating new entrees.  Also, it points out some REALLY high calorie entrees ~ over 2000.  Oh one problem, the writer keeps referring to the national menu law as a proposed law.  The law is a law.  It has been passed.  The rule - how to follow the law, is being proposed.  <a href="http://projects.wsj.com/quiz/?uid=CALCOUNT&type=flat#mod=e2fb" target="_blank">Link 2</a>  This links to a 3 item quiz on which item has the lowest amount of calories... I scored 100. <a href="http://m.columbian.com/news/2013/jul/29/fruit-juices-and-smoothies-dangerous-for-your-heal/" target="_blank">Link 3</a>  This links to a story about smoothies and juices, both of which I personally avoid at all costs.

Myths, Assumptions, Nuances and Obesity

I have been writing about health and wellness in one form or another for 13 years. During that time I have gone to graduate school twice. ...

7:35 PM

Do calorie recommendations make a difference in calories purchased?

<div style="-webkit-text-stroke-width: 0px; background-color: white; color: black; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; margin-bottom: 0px; margin-left: 5px; margin-right: 5px; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px;"></div><div style="-webkit-text-stroke-width: 0px; background-color: white; color: black; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; margin-bottom: 0px; margin-left: 5px; margin-right: 5px; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px;"></div>    I want to mention a few things from the study I cite below.  Here is the most important one. A conclusion statement in the summary is misleading.  The statement, "Posting calorie benchmarks had no direct impact..." implies that the benchmarks were posted on the menu or menu board, but they were not. The study did not assess the effect of posting daily or per meal calorie recommendations (i.e., the benchmarks) ON A MENU.  It tested the effect of handing someone a piece of paper with this information on it as they walked into a restaurant.  That is a huge difference.  The researchers do not try to say otherwise.  It is just the one sentence that is wrong.  Unfortunately, a lot of people will not read the study to find out the difference.  In addition, it is that conclusion that most of the popular press headlines are touting. <div><div>   This was not a study on whether or not menu labeling works.  The study tested the effect of telling someone how many calories they might need in a day and the effect of telling them how many calories they might need in a meal.  In other words, would  people given either piece of information purchase a lower amount of calories than people not given any information.  (This was tested in a situation where calories were listed on menus and in a situation where calories were not listed on menus. That condition did not make a difference.)</div><div>    The slips of paper they handed the customers did not seem to help.  But I caution you not to conclude that the information isn't helpful.  There is a big difference in a menu board disclosure and a piece of paper someone hands you.  Still, it fuels my argument for something more powerful and less mathy... traffic light labeling. </div><div>   There was something else I found interesting in this study.  The researchers asked the customers how many calories a doctor or nutritionist would recommend that they consume in a day.   Both men and women substantially UNDER estimated their own caloric needs, by 200 or 300 calories.. and YET, they ordered enough to far exceed their own estimated daily number.</div><div>E.g.,  a person who thought they needed 1100 calories for a whole day ordered 900 calories for their lunch.  Again, too much math.  Too much thinking at the point of purchase when other factors, like taste, cost, time, etc are more important.  (isn't it crazy that people think they need 1300 to 1600 hundred calories when our packages refer to a 2000 calorie diet AND people tend to actually consume 2000 or more a day  - more than most people need)</div><div>   STILL, the menu item calorie information should be available to every one every where.  Consumers have the right to know what they are eating. However, the best chance for changing the number of calories purchased may come when the restaurants start revising their recipes and the calories AVAILABLE to us become fewer.  Traffic light labels and lower calorie meals.. that's the ticket :) <div> (Also, note - the people in this study were all eating at McDonalds.. there might be something about McDonalds customers that is different than other restaurant customers) </div><div></div>Article cited: <div style="-webkit-text-stroke-width: 0px; background-color: white; color: black; font-family: Verdana, Arial, Helvetica, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; margin-bottom: 0px; margin-left: 0.5in; margin-right: 5px; text-transform: none; white-space: normal; word-spacing: 0px;">Downs, J. S., Wisdom, J., Wansink, B., & Loewenstein, G. (2013). Supplementing menu labeling with calorie recommendations to test for facilitation effects. American Journal of Public Health, e1-e6. doi: 10.2105/AJPH.2013.301218</div><div style="-webkit-text-stroke-width: 0px; background-color: white; color: black; font-family: Verdana, Arial, Helvetica, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; margin-bottom: 0px; margin-left: 0.5in; margin-right: 5px; orphans: auto; text-align: start; text-indent: -0.5in; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px;"><a href="http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301218" target="_blank">Summary</a></div></div></div>

Do calorie recommendations make a difference in calories purchased?

I want to mention a few things from the study I cite below. Here is the most important one. A conclusion statement in the summary is mi...

8:35 PM

Fat in food vs Fat on your body

I was frustrated by the research study on M&Ms. I was frustrated because it is 2013 and I thought we had learned that low fat is not the answer to our collective weight problem.    Studies that continue to focus on promoting low fat choices add to the confusion. As someone who has expertise in public health nutrition, health education and health promotion, I must try to clear this up.     Fat in food does not equal fat on your body.    Too many calories from any source does. When a person regularly consumes more calories than their body needs, the extra is stored as body fat.  (Note: Over indulging every weekend is regularly consuming too much.)  There are ways to increase your intake to build lean body mass but that is not the focus here. YES it is true that there are more calories in a gram of fat than there are in a gram of carbohydrate, protein or alcohol.   (9,4,4,7)   YES it is true that some foods are more nutritious than other foods.  It is recommended that we fill our plates with nutrient dense, not energy dense, foods      Foods that are especially important are complex carbohydrates (vegetables and many fruits), whole grains and so called 'healthy' oils or fats (like those in olive oils and salmon). Complex carbohydrates contain phytochemicals, flavinoids, and antioxidants.  These substances have been associated with reduced risk of many chronic diseases. And YES it is true that refined or simple carbs, like sugar, white flour (rice, pasta, bread) baked goods, sugary or starchy fruits with little fiber, and all sugar sweetened beverages have more calories than they do nutrients. AND Yes, it is true that some sources of fat just like some sources of carbs are believed to be harmful. (e.g., red and processed meats are associated with colon cancer).    The reason some foods are calorically (energy) dense is because they are full of sugar or fried in grease.      Too many calories from either  = fat storage.  ********************     And because its politically palatable to promote, physical activity as a solution to the country's obesity 'problem,'  I have to address that too.  Initiatives to build more parks and alert people to "take the stairs" are only going to work (for weight control) if two things happen.  TWO things. 1) people actually start using the stairs and parks, and 2) they stop eating too much It does not matter how many stairs a person climbs (Mayor Bloomberg), if he or she eats more calories than needed - weight loss will not occur if 'we' keep eating too much. There are people (fewer than the drug/genetic companies would have us think) who fall outside these generalities.  In other words, some people do not gain weight no matter how much they eat and others do not lose weight not matter how much they restrict.  These are very unusual people and I suspect you are not one of them.  Disclaimer: I am not a nutritionist or a dietitian who can give individual diet advice.   I share information based on research and public health recommendations. <div> </div>

Fat in food vs Fat on your body

I was frustrated by the research study on M&Ms. I was frustrated because it is 2013 and I thought we had learned that low fat is not...

7:53 PM

What's Good for the Goose

Okay, not the goose, but the dog or cat.     I recently heard a pet food commercial, which inspired this blog post.  I did not catch the product name and wasn't able to find it by searching keywords on the Internet, but that matters less.     The gist of the advertisement is that many of the foods we give to our pets provide nutrients in the wrong proportions.  Specifically, I recall the spokesperson talking about protein and salt.  She suggests that pets need to have a balanced diet with the right proportions of nutrients.  This will ensure their health.     I am pretty certain that the majority of pet owners, certainly those that consider themselves pet lovers, will at the very least, check the labels of the product they currently buy - and most likely, they will consider switching brands.  They will do this for their pets.  Their pets will have no choice but to eat the 'healthier' food.  The pets will feel loved.  :)    The great irony is that the majority of pet owners are themselves consuming too much protein and salt - as well as calories, sugar and probably fat.  This out of proportion consumption steadily rose over the past 30 years and has contributed to the substantial number of Americans (~70%) who are over weight.     We know that we are consuming too many calories, sugar, fat and too much salt - but it will take legislation - LAWS - to make us stop.  Isn't there some great irony in that?  Perhaps instead of fighting it, we should consider ourselves pets who need someone to feed us - for our own good, of course.

What's Good for the Goose

Okay, not the goose, but the dog or cat. I recently heard a pet food commercial, which inspired this blog post. I did not catch the pro...

7:52 PM

Decision Making Models

For one of my classes this past week, I read some research articles on school vouchers and school choice.  Within this framework, there was a discussion about the use of information.  Here it was using information to decide where to send a child to school.  This goes beyond choosing to move into a good school district, because not everyone has the power to do that.  Voucher programs are one way that parents who cannot live near a school that they like can still have some options.     When voucher programs are available the decision making model assumes that parents will use information about the schools in the program to choose one that meets their personal values and educational expectations or preferences.  For example, a parent may be interested in student teacher ratio, the size of a class, the size of  a school, the cost (tuition not covered by the voucher), the location, the academic history, the percent of students who graduate, the level of education of the teachers.. and so on and so forth.  A parent may even prioritize their list of preferences. In addition, what a parent feels is a quality of a good school, say student teacher ratio, is not likely to change from day to day or within present company, or when they are feeling blue.  It is  a time consistent and rational preference or value.     The research on school vouchers tends to show that just having a choice increases a parent's satisfaction with their child's school.  Choice is important.  Research also shows that children of motivated parents do better (regardless of school or choice).  But important for me, research also shows that a lot of the information needed to make a decision is not available, or is not readily available.  This leaves less assertive, familiar or formidable parents unable to go about getting the information.  Heck, they might not even know what makes a school a good school because their educational experience was itself limited.  They lack criteria to judge or select/     In reading all of this, my mind went constantly to decision making at the point sale and food. (I have no children, the school voucher issue is not my battle!).  Many people do not know what information is the most important (calories, sugar, fat, sodium, etc) needed to make a decision nor where to find that information.  People who have determined that low calorie, healthier foods are their preference, may still change their mind according to circumstance.  Food decisions are quite often irrational and not time consistent.    This is more reason for menu labeling that is simple and in your face.  Restaurant and similar establishments (ones that sell FOOD) should provide calorie info, (and I think sat fat and sugar info), put those numbers in a circle that is green, yellow or red and remind people that what they eat today can effect their health tomorrow.

Decision Making Models

For one of my classes t his past week, I read some research articles on school vouche rs and school choice. Within this frame work, ther...

8:05 PM

National Menu Labeling Update

Funny that I should be the one posting an update on menu labeling when I regularly troll the internet searching for the updates myself.  The rule to post calorie information on restaurant menus and menu boards was adopted in 2010 when President Obama signed the Patient Protection and Affordable Care Act (PL 111-148). Section 4205 of PL 111-148 has not been enacted because the FDA hasn't issued the final rule.  The final rule will explain how the restaurant and vending industry are to go about getting that nutrition information to us - in a standardized, effective and reasonable manner.    Recently the FDA commissioner, Margaret Hamburg was quoted as saying that the menu labeling issue had become "thorny." The National Restaurant Association  is not the cause of the delay.  They supported the legislation that made its way into the law (to protect themselves from a plethora of differing city and state policies).      The latest snag comes from the pizza industry.  I read about the industry concern in a news brief from PizzaMarketplace.com. It told about a recent trip that executives from the nations largest pizza chains (e.g., Dominos, Pizza Hut) took to DC.  They went to talk to members of the Domestic Policy Council.  I had not heard of the DPC before I read the article.  You can read about the council <a href="http://www.whitehouse.gov/administration/eop/dpc" target="_blank">here</a>.    The pizza group made some good arguments.  They did say that they were not trying to get out of providing the information (that would be bad PR, yes?).  They are trying to find the best way to provide customers with nutrition information.    Some of their argument centered on the issue of made-to-order 'ness'.  For example, the toppings that can go on a pizza, the number of slices one makes from a pizza and how both of those things can differ by restaurant.  To supply calorie information for all the combinations would be incredibly expensive and space intensive.          The group also expressed concerns about the public having to do math in order to figure out the amount of calories in the particular slice of pizza they ordered.  For example, the restaurant could post the calories for a basic 12 inch cheese pizza and tell the customer to add 50 for sausage, 50 for pepperoni, and 20 for onions (etc ).  Then they could instruct the customer to divide that total pizza calorie number by however many slices they cut the pizza into to get the total number of calories in one slice of the pizza they ordered... well that would be too burdensome. Heck it was too much of a sentence even!.     I believe it was implied in the comments that some customers were not capable of basic math.  It is true that the calculations are a problem.  This is mostly because we (health educators, etc) have learned that when customers have to do math - they won't.  It takes too long OR they don't know how.  Maria Topliff (quoted in the news piece and representing a Chicago pizza chain), asked if instead of having the customers do it, we would ask the 16 year old behind the counter to do math.  She indicated that this would be a bad idea.  [this really points to a need for a dialogue on the lousy math skills of Americans.  Maybe we ought to do it this way so people will learn to add and divide!]      Ms. Topliff is right though.  There is great variability in a pizza restaurant.  I liked her idea of an onsite meal calculator - or even an on site IPad.  In fact, I think that might be a very good idea in this technological era.  It would be a lot cheaper for the restaurant and easier to update.  However, from menu labeling research we learned that people need to see the big picture (calories) at the same time they are reading the food choices.  Her idea doesn't do that.  It may be a necessity for pizza places, but I would not recommend that we allow non-pizza chains the same option.

National Menu Labeling Update

Funny that I should be the one posting an updat e on menu labeling when I regu larly troll the inter net searc hing for the updates mysel...

7:18 PM

Obesity Studies... What is a Cause?

It isn't often that I refer you to an article in full that has been written by someone else, or in this case, a couple of someones.  You can trust that I am doing it for a good reason.  The article published in the NY Times addresses a point often made here.  Headlines and research should be interpreted carefully.      I believe that these two journalists get it exactly right (one hails from Union College - yay).  I only have one or two things to add, but I really think you should read the article first... click <a href="http://www.nytimes.com/2013/03/10/opinion/sunday/does-this-ad-make-me-fat.html?partner=rss&emc=rss&_r=0" target="_blank">HERE</a>.   Okay - I feel like you didn't listen to me.  The article is about junk food advertising and soda sizes causing obesity.   Read it <a href="http://www.nytimes.com/2013/03/10/opinion/sunday/does-this-ad-make-me-fat.html?partner=rss&emc=rss&_r=0" target="_blank">HERE.</a> OK. The only big problem I had was with the journalists' assertion that we do not know what causes obesity.  Of course we do.  A lot of people eating more calories than they need (and the number they need is personal).  There are reasons that people eat more calories than they need and some of those reasons are ones that I want to study.  I want to use the exact type of research design that the journalists advocate.  But, I do not think randomization into conditions will always (or ever) be possible.  Lagged interventions, or lagged policies may allow me to make good inferences. By this I mean, if one state adopts a public health policy before a similar state does, I can compare the two states on the outcome (calories purchased, BMI, etc). Most of the time,  my work will speak to associations, relationships, correlations and that is ok. I hope I  can get to cause, but I won't pretend that I did when I did not.      I would reword some of the journalists language about the studies they referenced.  It is true that advertisements do not cause weight gain - but they may entice people.  Ads may lead people to establishments where they over consume. Once inside the restaurant, is there any hope?  Maybe.  It is possible that putting the number of calories per item on a menu might encourage people to chose an item with fewer calories.  Having to put calorie numbers on a menu might encourage the restaurant owner to offer more low calorie items.      Having less billboards, less fast food places, higher prices on nutrient poor foods, removing sodas from WIC and SNAP benefits...Polices like these might reduce consumption of foods that are very high in calories... but at the end of the day.. it will always be about a choice that a person makes.  If that choice includes too many calories.. weight gain is likely to follow.    (ps if you think that the government wants to manipulate you and the food industry doesn't, you are woefully naive)

Obesity Studies... What is a Cause?

It is n't often that I refer you to an article in full that has been written by someone else, or in this case, a couple of someones....

7:52 PM

Holy Memphis Calories Batman

Mom and I were enjoying a healthy dinner that I prepared (shiritaki noodles Mexican, kale and baby corn) when a Hardees commercial aired.  As best I remember, the screen was mostly filled with the picture below  - but it showed a man with his hand on the sandwich and then taking bites of it.  He looked very happy.  We both said, "Oh my gosh!"  And Mom said something about there being French Fries inside the bun, but they turned out to be onion rings.  When I showed her the picture she pointed out the pulled pork which I thought was just BBQ sauce.  Then she said, "there's a burger too?!" Of course I looked up the information on the website and this is what I found.  First of all, there are three versions.  A 'little' one, a 1/3 burger and a monster burger.  The calorie, saturated (unhealthy) fat, and sugar grams are provided for each below, in order of size.  Sugar grams, you say?  Yes, me too.  I guess it is from the sauces. <table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcK6t_ASDfDzTy25y7_gsDzIiWrUyGzqF75J3uUxwFhLd70vYURNqX_9nc7yTBWNBcukqv2A2KYdqMD-Ob5i-wnwn6uUR-LhC7wxiXr9yCvmufapFUahqHxwHROD9CyiZXn_NfX_3Y5sIR/s1600/hardees.JPG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="295" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcK6t_ASDfDzTy25y7_gsDzIiWrUyGzqF75J3uUxwFhLd70vYURNqX_9nc7yTBWNBcukqv2A2KYdqMD-Ob5i-wnwn6uUR-LhC7wxiXr9yCvmufapFUahqHxwHROD9CyiZXn_NfX_3Y5sIR/s400/hardees.JPG" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Ger full nutrition information <a href="http://www.hardees.com/menu/nutritional_calculator#" target="_blank">here</a>.</td></tr></tbody></table>   Calories  710     Saturated Fat  14g      Sugar 28g   Calories 960     Saturated Fat 19g      Sugar  31g      Calories 1000     Saturated Fat 23g      Sugar 31g BTW, Mom did not finish her dinner because she said she was too full - her dinner had LESS THAN 200 calories and no saturated fat... that is what I call Volumetrics :) - well, Barbara Rolls, PhD calls it Volumetrics, but you know what I meant.  Low calorie, high nutrient density.  Its a healthy, yet filling, way to eat.

Holy Memphis Calories Batman

Mom and I were enjoying a healthy dinner th at I prepared (shiritaki noodles Mexican, kale and bab y co r n ) when a H ardees com mercial ...

7:42 PM

Eat like you mean - WHAT Exactly?

Organizations that represent bowling alleys and movie theatres are trying to get the establishments exempted from the National Menu Labeling law.  They do not want to post the calorie content of the items they sell on the menu boards (next to the names and prices).  The photo below was taken at a Florida bowling alley.  I really am curious about the caption.,,. eat like you mean what exactly?       At the concession stand of this bowling alley there was a poster advertising a burger combo that you could modify by adding cheese or bacon to the french fries or onion rings, in addition you could add another whole burger - make it a double - for ONLY 2$.  My thought as I stared at this poster was,  I bet if I asked them to keep the extra burger AND the french fries but give me a salad -  they would charge me an EXTRA 5$.      YES ?! - and this is  exactly what the barber meant (<a href="http://yourhealtheducator.blogspot.com/2012/11/food-pushers.html" target="_blank">old post</a>) when he said, "they keep pushing the bad stuff on us, all the time, everywhere." <table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh53Pg3qptb8nFFKmObSxBLGQbHSBDy6248Cy3tLW9-EmWs9g5O1Hs2fyj7O_AkO16w39yD8jeU6K7b6CA4OQqklCVmNggwhIjS_HrxKNCCdVMZhamKvd59GIFYQ4IPCHykvdFg_-hihJFe/s1600/alley+food.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh53Pg3qptb8nFFKmObSxBLGQbHSBDy6248Cy3tLW9-EmWs9g5O1Hs2fyj7O_AkO16w39yD8jeU6K7b6CA4OQqklCVmNggwhIjS_HrxKNCCdVMZhamKvd59GIFYQ4IPCHykvdFg_-hihJFe/s1600/alley+food.jpg" width="640" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Like you mean to spend your older years with chronic disease and disability, of course</td></tr></tbody></table>

Eat like you mean - WHAT Exactly?

Organizations that represent bowling alleys and mo vie theatres are trying to get the establishments exe m pted from the National M e nu...

7:49 PM

Myths about snacking

This brief post is my reaction to the worst billboard EVER. The billboard is along a busy multi lane road in Greensboro NC.  It shows a man with an odd look on his face - possibly the ad makers were going for a look of surprise.  The man is only shown from about the chest up.  I have only driven by the billboard a few times and was mainly focused on driving, but I believe the man is at a table and is eating chocolate chip cookies (with a glass of milk).   The caption over the scene of the surprised looking man is, "snacking between meals is guaranteed to lead to weight gain."    NO IT ISN'T.  Eating more calories than one needs to maintain their weight is what leads to weight gain (99% of the time).  It doesn't matter when you eat those calories or what you call them (meals or snacks) - too many calories are too many calories. As far as the quality of calories goes, yes, we are more likely to over consume when foods  are energy dense, like sweets. But it has nothing to do with 'snacking' unless the snacking puts a person over the amount of calories their body needs.    The billboard message I'm highlighting is NOT a public health communication.  It is an advertisement.  It is an ad for a weight loss center.      My research and promotion focus is prevention of overweight and I find a lot of treatment venues to be misleading and in some cases, they promote complete untruths.

Myths about snacking

This brief post is my reac tion to the worst bil lboard EVER. The billboard is along a busy multi lane r oad in Greens boro NC. It shows...

7:00 PM

Health Education