Not ready for a soda tax? Fine, I’ll come back later.

Tomorrow is my last day of my public health nutrition summer internship! It is definitely bittersweet. I am blessed to have had this experience, and proud of the work that I’ve done, but I am bummed to leave. I really look up to my supervisors and hope that some day I can make the kind of impact they’re making on public health through nutrition. I’m grateful that they gave me my own project to do, compared to many internships I’ve heard of that mostly consist of, to put it plainly, bitch work. I have also learned a lot about what is actually involved in public health work at a local level, and what it takes to carry out an initiative like changing the products offered in vending machines. 

In fact, I’ve been really lucky in that I got to intern in a city that is progressive when it comes to changing the food environment. It is much easier to change nutrition policy here than it is at the federal level. And speaking of which, I was informed today by Mark Bittman’s column that Representative Rosa DeLauro just introduced the SWEET Act to the U.S. House of Representatives, which would charge soda producers a penny per teaspoon of caloric sweetener (sugar or high fructose corn syrup), meaning roughly 10 cents per can of soda. 

Taxing soft drinks has been an idea on the horizon for a number of years now to attempt to reduce obesity and promote health. In fact, a number of localities and states now have initiatives in their legislatures to tax sugary drinks. This idea has been panned by many politicians and a lot of the public as well, and understandably so. I suppose people feel like they shouldn’t be punished for drinking soda, which they have the right to do in a free country. They think this is an overextension of the government’s power. What they don’t realize is that government policy that has been in place for decades already, though more subtly, determines what many of us eat. Take soda for instance. If corn (and by extension high fructose corn syrup) weren’t so heavily subsidized, soda wouldn’t be so cheap and abundant, and wouldn’t be so heavily consumed. For that reason, I see such a tax as barely leveling the playing field. 

Another complaint is that such a tax would unfairly target the soft drink industry, when no one food can be responsible for obesity; it’s just too much of every food, and not enough exercise. Well that’s not really true. Soda is the one food (if you can call it a food) that is independently linked to obesity. Reputable scientific research has found on numerous occasions that regular soda consumption, even half a can a day, is a risk factor for obesity, and the more you drink, the greater your risk. Besides, soda is also one of the only foods that boasts literally no nutritional value whatsoever. It is only empty calories; some would even argue, and I agree, they’re harmful calories because it’s all sugar. Furthermore, we’re not eating too much of everything, only the bad things like soda and other processed junk food and animal products. We’re eating far too few whole fruits and vegetables. 

Another complaint that I’d argue is legitimate is that we don’t know if it would work. That’s true. We don’t. People might replace soda with other empty calories. People might pay the extra 10 cents. But I feel that our nation’s health is so desperate at this point that it’s definitely worth a try. Be comforted by the success of Mexico’s recently implemented soda tax; consumption has gone down! Even if it the policy didn’t reduce soda consumption, which I doubt, the revenue would go to public health initiatives like subsidizing fruits and vegetables or bringing nutrition education to low income schools. 

All of my arguments seem futile at the moment, though, because there’s no way this bill is going to pass any time soon; there’s just too much opposition. But to me, the fact that the bill was proposed at all is a sign of progress toward policy more oriented toward health and away from industry. That’s one of the most important things I’ve learned this summer; you have to start somewhere. Remember, things like prohibiting smoking in restaurants once seemed ridiculous too–I’d say a 10 cent per can soda tax is far less drastic. 

What’s your view on a soda tax? And what will it take for Congress to pass one?

 

 

 

 

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Eating healthfully saves money? Who knew?

This Meatless Monday cooking venture was the most well-received so far this summer, at least by my dad and brother. I made three varieties of the ever-trendy flatbread pizza. I’m not quite up to making crust from scratch yet, so I used this multigrain lavash bread, which is very thin and the brand I bought is actually meant to make roll-up sandwiches. It turned to be the perfect base, actually. I brushed five flatbreads lightly with olive oil, and did three sets of toppings. 1: Fresh mozzarella, sundried tomatoes, fresh thyme, and fresh basil. 2: Fontina, sautéed mushrooms, fresh rosemary, and lemon zest. 3: Gorgonzola, apples, walnuts, caramelized onions, and fresh basil.

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Number 3 turned out the best and was my absolute favorite. I also made a green salad with carrots, celery, and scallions to round out the meal.

Flatbreads are so easy, and pretty much universally liked. There are so many combinations of meatless toppings to choose from—you could eat flatbreads every week and not get bored. I think they’re a great way to ease yourself into plant-strong eating. Just make sure you go light on the cheese! Think of it as a condiment, not the base.

Here’s a quick reason to eat less meat and replace it with plant-based proteins: it can be a lot cheaper! Everyone thinks that eating healthfully will cost more, but it doesn’t have to. Replacing animal protein like red meat, poultry, and fish with plant proteins like tofu, canned beans, whole grains (i.e. bread, rice), and nut butters, will almost surely save you money. Make your regular chili without meat, for example, and use more beans and a bit of a grain like bulgur, and it will cost less. Make your sandwich with hummus and avocado instead of turkey and avocado. And have you ever noticed that the vegetarian options on restaurant menus are always the cheapest? If you haven’t, take a look and save some money! Try the stuffed eggplant instead of the steak, and you’ll avoid the extra expense and the potential health, environmental, and animal welfare concerns. You know guac is included at Chipotle when you don’t order meat, right? 😉

And here’s a quick reason to eat more fresh fruits and vegetables: even if they cost more per calorie than some meat and most refined carbohydrates, a healthy diet will save you  money in the long run. I would bet my life on that. Americans spend the smallest percentage of their incomes on food in the world! What’s more, we spend a smaller fraction of our incomes on food now that we ever have. We can certainly afford to spend a little more on fresh, sustainable, nutritious food now, so that we can spend less later on managing heart disease, type II diabetes, and cancer with drugs that don’t even cure us (see my recent post). 

What’s your favorite vegetarian combo of flatbread or pizza toppings?

How do you eat healthfully on a budget? 

Channeling Violet Beauregarde

I have something to confess.

I’m a gum-aholic. I chew it all day long. Whenever I’m not sleeping, eating, or working out, I’m always chewing a piece of Trident Tropical Twist. I go through at least a pack a day now. I buy multiple cases at a time.

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This has been going on for years, ever since I started trying to lose weight. A lot of people try chewing sugarless gum to keep them from overeating, and it totally helps some people, myself included.

 

I never thought of this as an issue until recently. Better to be constantly chewing 3-calorie sticks of gum than constantly snacking, right?

Then I became more aware of the problems of processed food and artificial ingredients, but I still made gum an exception to my worries. But recently I read a blog post about the dangers of chewing gum by the very well known Vani Hari, aka Food Babe. I have so much respect for this gal. She has led multiple successful campaigns to get food companies to not only be more transparent about their ingredients, but also to remove suspect ingredients from their products. I happen to think that she gets a little too zealous about the dangers of certain additives and GMO ingredients (see my posts on GMOs here and here), but she gets things done without having to change policy. It’s incredible! You should check out her work.

Anyway, she wrote this post about gum, and she cited the possible dangers of some of the artificial ingredients in brands like Trident, which, again, bothers me but not to the point of wanting to do anything about it. I don’t think the science has shown that there’s that much danger from the doses we’re exposed to generally of things like aspartame. Then again, I chew SO MUCH GUM. But what really freaked me out is this:

“Chewing gum messes with your bodies ability to produce digestive enzymes, a critical substance that helps you get all the nutrition from food you need into your bloodstream.

Every time you chew a piece of gum, you send signals to your brain that you are chewing actual food. Your digestive organs – the stomach and pancreas get ready to digest food by creating digestive enzymes your brain thinks you need. Now imagine doing this all time and every day by chewing gum that isn’t real food, you’re tricking your pancreas and stomach to produce digestive enzymes when they don’t really need to use them. Over time the digestive organs become overtaxed and stop producing the amount of enzymes they once did.”

If that is true, I’m in big trouble. I can’t imagine trying to wean myself off gum-chewing all the time. I’d be really worried that I’d eat more just to give my mouth something to do.

I feel like a hypocrite, because this is exactly the type of problem I want so many people to overcome: stop consuming this thing that’s probably bad for your health, and at the very least is definitely not good for your health. I did it with food, for the most part. But how ridiculous would it be if I eat tons of fruits and vegetables but can’t absorb any vitamins by the time I’m 40 because I couldn’t give up chewing gum? That is, if the Food Babe is right. But what she said does make a lot of sense to me.

I’m really nervous now to read her post on microwave popcorn, because I indulge in that snack frequently as well.

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Remember Violet Beauregarde from Charlie and the Chocolate Factory? She pursued her obnoxious gum-chewing to a fault, specifically blowing up like a blueberry (or gum bubble). Maybe I better seriously consider chewing less, lest I end up like Miss Beauregarde.

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What do you think? To chew or not to chew?

Could good nutrition replace medicine?

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Look at all that beautiful fresh produce :). That’s a picture I took of a farmer’s market where I assisted at a nutrition lesson and cooking demo this week. 

I am becoming more and more convinced lately that a whole foods, plant strong diet can prevent any chronic disease, be it heart disease, hypertension, type 2 diabetes, cancer, and even dementia. If you give your body the tools it needs (namely carbohydrates, a limited amount of plant-based protein and fat, and all the fiber, vitamins, mineral and who knows what myriad of natural, miraculous substances whole fruits, vegetables, and grains provide us) and don’t feed it anything harmful (namely excess meat, dairy, eggs, and refined sugars and starches), all the scientific evidence says that it’s almost certain you won’t develop any of those nasty chronic conditions that can ruin your quality of life and shorten your life. I don’t know that good nutrition can prevent you from contracting communicable diseases, but I’d bet that someone who eats a healthy diet will be far better at fighting off HIV than someone who’s malnourished or who eats junk. 

In one respect it absolutely astounds me that most scientists and doctors forty years ago would not accept that diet had anything to do with chronic disease. But on the other hand, it’s really hard for people to accept ideas that go against the grain. If you had told me a year ago that Greek yogurt could be bad for my health, I would have flat out denied it. Now that assertion makes me uncomfortable, but I’m willing to accept it if the evidence is strong enough. 

Even though the general populace is beginning to accept that a healthy diet is critical in order to live a long, healthy life, the medical profession is still very much built around that old adage “a pill for every ill.” In all of medical school, students might get 20 hours of formal instruction in nutrition. Compare this to the 500 hours, more or less, of nutrition instruction that I will have received before hopefully getting certified as a registered dietitian. Knowing how important nutrition is to health, this is monumentally disturbing to me; relatively few people see dietitians ever, let alone from the beginning of their lives, but medical doctors, who are not guaranteed to have any expertise in nutrition, are our primary care providers from day 1. 

I’m not saying doctors are quacks. But I do think the establishment of medical education is WAY behind the times, or more precisely, behind the scientific evidence. Cardiologists know how to do drastic, risky, complicated, and costly heart surgery, but not how to prevent heart disease in the first place? How did we get here? Furthermore, in all of medicine’s and the drug industry’s quest for the miracle cure for any of these illnesses, all they’ve been able to do is treat the symptoms and perhaps prolong people’s disease-ridden lives. The death rates from chronic disease have not decreased, and for the most part patients are not being cured by drugs and surgery. 

The only miracle cure has been in food. Nature is a miracle, after all. Michael Pollan’s (my idol in food journalism) simple commandments, “Eat food. Not too much. Mostly plants.”, when adhered to closely, have been shown to promote a healthy weight, universally prevent, and very often reverse the progression of the chronic diseases up to the point of no longer needing drugs or surgery. Even better, the right diet works to prevent all of these diseases, with only positive “side” effects, like more energy, while pills and surgery have all kinds of side effects, some that are just as bad as or worse than the original illness. 

You would think that doctors, who arguably want to heal us, would take advantage of this miracle that is the whole foods, plant based diet. But how can you blame them when the whole field has been ingrained in this “pill for every ill” mindset forever?

Not only that, but the very powerful drug industry has a huge stake in this game. The money isn’t in getting people to eat their fruits and veggies; rather, it’s in finding the “miracle” pill that cures cancer. And as I’ve written about the food industry, the money often seems to determine the science. 

Maybe, if the American diet really changed drastically for the better, the drug industry and the medical industry would suffer financially. It’s definitely a possibility. But what good is it if even our doctors can’t take care of themselves because they don’t know how to eat right? What good is it if the medical profession isn’t putting a dent in the diseases that kill most of us and the drug industry is hurting us more than it’s helping us? Think about it–they make more money if we stay sick. 

You can probably tell I get pretty heated about this topic, but I’m really frustrated because the solution, to me, is obvious, if not easy. I believe that the health care system and the medical profession should be centered around good nutrition and prevention of disease, not drugs and treatment of symptoms. The transition would be rocky, certainly, but it would make for a much more effective and much less expensive health care system in the long term. (It seems that all of our food and health problems stem from thinking in the short term.) 

I’m not saying we don’t need drugs for things like bacterial infections (although industrial agriculture is making those drugs much less effective), and I’m under the impression that HIV patients’ lives have been able to be extended monumentally by certain drugs. But here in America the conditions that plague the overwhelming majority of us (this is not an exaggeration) can be traced to poor nutrition and can be prevented and treated by good nutrition. Pre-meds, doctors, researchers, patients, take note. Our primary care providers need to be trained in the foundation of health: what we eat. 

So what do you think? Could nutrition put the drug industry out of business? Should it?

 

Meat free today, maybe cancer free tomorrow

Once again, meatless Monday is upon us. My recipe of choice tonight was not only meat-free, but dairy-free and egg-free as well. Trying to mix things up ethnically as usual, I picked an oriental stir fry with tofu, lots of colorful veggies, peanuts, and a garlic sesame sauce. This is what it looked like in the pan:

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I am extremely proud to say that I made tonight’s dish ENTIRELY BY MYSELF, WITHOUT ANY HELP WHATSOEVER. And I got a lovely response from my family. And I thought it was quite tasty myself. And vegan! So there you go. I served it over brown rice, as in this photo of my partially eaten portion:

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I was talking to my dad as we ate about my growth as a “chef” this summer so far. While I’d say that I obviously still have a lot of room to grow, skills to hone, recipes to master, and instincts to develop, my confidence in the kitchen has increased fifty-fold. If cooking is the barrier for you to eating healthfully, know that it doesn’t take too long to become proficient. That being said, I have had my mom to help me along the way, so it probably would’ve taken longer without her. But if I can do it, anyone can. And frankly, it’s probably simpler to cook without meat! But that’s not the reason I’m giving you this week. 

So this week I’m reading The China Study, by T. Colin Campbell, PhD. The book summarizes the findings of a lifetime of research on the benefits of a plant-based diet and the harms of eating animal products. He’s a bit biased, but as I’ve said before, who isn’t? You have to weigh all the evidence together, which he claims and appears to do. But an awful lot of his evidence is correlational, and he frequently doesn’t explain what factors were controlled for, so I take it with a grain of salt. That’s not to say that I don’t believe him; I’m just saying if you questioned his claims I don’t think I as a reader would be able to defend them thoroughly using just the evidence he gives. But there is one phenomenon that he explains quite convincingly, and that is the connection between animal protein and cancer. 

Campbell has pretty much convinced me that eating animal products increases one’s risk of developing all types of cancer. I learned in my intro nutrition class that prostate, breast, and colorectal cancer are most dependent on diet–lung cancer, for example, is still only linked to smoking. Regardless, I certainly believe that the more animal based foods and refined carbs and sugars you eat and the fewer whole, plant-based foods you eat, the greater your risk for all types of chronic disease. But in the specific case of cancer, he provides the following evidence:

  1. Observational studies out the wazoo showing highly significant associations between consumption of animal protein and cancer mortality.
  2. Controlled animal studies showing that 100% of rodents exposed to carcinogens on a 20% animal protein diet developed cancer, while NONE of the rodents on a 5% animal protein diet developed cancer.  
  3. Controlled clinical studies showing that cancer patients who switched to diets low in animal protein ostensibly halted and in many cases reversed the progression of their disease.
  4. A biologically plausible mechanism by which animal protein promotes development of cancer, which he tested and demonstrated in controlled studies.

So do with that information what you may, but wouldn’t you rather eat less meat than pay the myriad costs of cancer later in life? You can even lower your risk just by eating meat-free one day a week ;). 

 

 

Healthy vs. HealthiER

Here’s the latest from my public health nutrition internship! I’m pretty much finished assessing city-owned vending machines now, phew! I started working on my summary report yesterday morning, and in the afternoon went out with my boss to two Chinese takeout restaurants in a pretty poor part of town. These are not establishments that strive to provide a high-quality dining experience; rather, they seek to provide cheap, quick, convenient, tasty food. If these two places were representative of all the Chinese take out joints, they each have a small, dirty vestibule, a counter and glass window where you order and pay, and a kitchen behind it. 

Unsurprisingly, these restaurants provide a major source of salt in the diets of many low-income people in my city, and I would imagine in other cities as well. You can read my post on salt here, but at minimum know that a high salt diet is associated with high blood pressure, a condition which unquestionably puts one at higher risk for heart attack and stroke. The city’s public health department for which I work is collaborating with many of these Chinese takeout establishments to encourage them and give them resources to the reduce the amounts of sodium in their dishes. Many of them have responded very favorably and have begun to adjust the recipes of some of their popular dishes to include lower sodium ingredients, namely Chicken Lo Mein, pictured below, Shrimp with Broccoli, and General Tsao’s Chicken.

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We went to these restaurants to help administer a taste test and accompanying survey of a reduced sodium dish to customers and passersby. People’s responses were interesting; some noticed the sample had less salt, and some thought it was too salty. Most of them, when asked, said that buying lower sodium foods from restaurants was important to them. It gave me great nachas (a Yiddish word for a combination of joy and pride) to hear that the people most at risk for high blood pressure were aware of the importance of dietary changes, regardless of whether they would act on this knowledge. 

I also saw this from a much more pessimistic angle, though. For example, the General Tsao’s Chicken, even with less sodium, is not what I’d call strictly healthy. It’s breaded, fried meat in a sugary sauce, the nutritional equivalent of coating chicken fingers in soda. I do suppose that reducing the amount of sodium arguably makes it healthier than it was before, but that doesn’t make it a candidate for the whole foods, plant-based diet that I firmly believe is the way to go. Will this even make a significant difference in the lives or health of people who eat these meals? This campaign only affects a few dishes at each takeout place, and each still has a relatively high amount of sodium. 

This is one of those times where I have to keep reminding myself that however small, it’s a step in the right direction. I guess we have to pass healthier before we get to healthy. If it saves five people from dying prematurely from a stroke, then it’s worth it. And there’s definitely something to the salt reduction campaign raising awareness of the importance of diet to health and longevity; the more people who are aware, the more rapidly change will happen. That’s why I write this blog. Spread the word ;).

Cruelty free food! And I’m not talking about meat this time.

So I am reading yet another book about food issues, but this time with a bit of a different spin: Behind the Kitchen Door by Saru Jayaraman is about the (often miserable) plight of foodservice workers in this country.   

This coincides somewhat nicely with my meatless monday adventure this week: eating out vegetarian! I have been thinking lately that I really wanted to try going meatless in an Indian restaurant, because there is such a strong vegetarian tradition in India, and I had never tried any vegetarian dish besides a samosa. 

As an appetizer we ordered some samosas dressed up in tamarind, yogurt, and chickpeas, which was delicious. Then, pictured below is Black Lentil Dhaal, Aloo Ghobi (my favorite spiced potatoes and cauliflower), basmati rice, and peshawari naan, which is stuffed with ground up cashews and raisins and spices. Everything was delicious; the naan was especially pleasing. The feast was certainly satisfying for not having any meat, and barely any dairy. 

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Give the vegetarian dishes a try the next time you enjoy Indian cuisine. Funnily enough, the book’s author is also ethnically Indian. 

Now this was one of many, many times I have eaten in a restaurant. If you’re like most Americans, you eat out multiple times per week. But not until I started reading Behind The Kitchen Door did I stop to consider the employees in any restaurant. You figure they’re hired to serve you and that’s all you need to worry about, right? If you only knew. 

Whether or not the oppression of restaurant employees in and of itself deserves our attention, I bet it would interest you to know that the treatment of those employees directly and indirectly affects the quality and safety of the food they serve us. Do I have your attention now?

Here are the most important truths I’ve gleaned from Behind The Kitchen Door that anyone who eats in restaurants should know:

  • The federal minimum wage for tipped workers (servers, bussers, runners, etc.) is just $2.13. That means that after taxes and before tips, restaurant workers essentially make nothing if the state minimum wage isn’t higher. If their tips don’t make up the difference between that and the regular minimum wage ($7.25), the employer is supposed to make up the difference; however, they often don’t. This is illegal, and it’s called wage stealing. Another ridiculous practice that falls under that category is not paying workers overtime, also a regular occurrence in many establishments. An astounding proportion of restaurant workers cannot afford to eat. Something doesn’t add up here. 
  • There is no federal law requiring restaurants to give their employees paid sick leave. This means that if a worker stays home horribly ill, he doesn’t get paid, so many sick workers feel compelled to work while sick. This is compounded by the fact that the hourly wages without tips are so low that many couldn’t scrape by even if sick leave were paid. As a result, sick servers and cooks are often handling our food. The book lists several no-fun outbreaks that happened because an employee felt they had to go to work while sick to be able to survive and/or support their family. This legal loophole, to put it lightly, is a surefire way to cause food poisoning–as if salmonella infected eggs weren’t bad enough. 
  • There is, with several notable exceptions, almost universal racial discrimination in hiring and promoting. The “front of house” jobs (servers, hosts, managers) go disproportionately to white employees, while the “back of house” jobs (bussers, prep cooks, dishwashers) go disproportionately to people of color. Experienced Black and Latino dishwashers and bussers are frequently passed over for promotions to server and manager positions in favor of less experienced white workers. 
  • There is similar discrimination against female employees, and sexual harassment is far too common. Why is it that the majority of foodservice workers are women, but the majority of higher paid restaurant positions are held by men?
  • People like me (and you, hopefully) are getting more and more interested in where our food comes from and the nutritional quality and its environmental implications, but so few of us consider the lives of the people who prepare and serve our food. Jayaraman’s argument is that we cannot have a sustainable food industry if the industry oppresses these workers. The industry’s infamous, never-ending push for cheap food has horrifyingly led many restaurants to treat employees without respect, and sometimes like slaves. 

Of all people, I certainly have health at the forefront of my mind when eating out. But cruelty involved in the process of getting food to my plate has become an extremely important concern as well. If I boycott cruelty in the raising of animal products for consumption, then I certainly have to protest cruelty towards the humans putting the food on my plate. Next time you eat out, take notice, ask questions, let management know that fair treatment of employees is important to you as a customer. This useful guide grades restaurants based on how well they treat their employees.

So what surprised you the most about my little exposé?  What are you going to do about it?