"I Shall Not Want" - Audrey Assad

Have a Coke and a Mile (or Five)

Intent

My original intent for this post was to share a study wherein researchers labeled caloric values on sugar sweetened beverages in terms of physical activity expenditure requirements as opposed to actual kcals per serving. Not only was I fascinated by this concept, I thought it was a great idea. So good, in fact, that I shared my findings with a friend and, in turn, she offered another enlightening perspective that I'll share toward the end of the post.

Research

First published in February of 2012, the study, “Reduction in Purchases of Sugar-Sweetened Beverages Among Low-Income Black Adolescents After Exposure to Caloric Information” hypothesized that researchers could reduce purchases of sugar-sweetened beverages (SSB) among adolescents by providing easy-to-understand caloric information. Researchers claim that providing relative caloric information, such as converting calories into a physical activity equivalent, would not only impact the sales of SSBs to adolescents, but also reduce consumption of SSBs, which have been associated with adolescent obesity. They further claim that translating caloric values into “interpretable equivalents” (Bleich et al. 329) made information more accessible to low literacy and low nutritional-literacy populations.

The intervention provided caloric information of SSBs in four corner stores in West Baltimore, Maryland. Some inclusion criteria were that the stores had to be five or fewer blocks from a middle or high school (i.e. within walking distance), the population within the zip code was at least 70% Black, and each store had to sell water and diet soda in their respectable beverage cases. Researchers identified the following three “caloric conditions”: 1-providing an absolute caloric count; 2- a percentage of total recommended daily intake (i.e. percentage daily value); and 3-providing a physical activity equivalent, represented as the number of minutes jogging (Bleich et al. 330). Baseline data was collected at each corner store four weeks prior to the intervention and at two-week periods between each caloric condition (as they were rotated within the six-month study period). Researchers conclude that providing easy-to-understand caloric information, especially when translated into physical activity equivalents, may reduce caloric intake from SSBs among low-income, Black adolescents.

Lead researcher Sara N. Bleich of the Johns Hopkins Bloomberg School of Public Health, conducted a follow-up study wherein she and fellow researchers examined whether the effects (i.e. low-income, Black adolescents purchasing fewer SSBs, based on translating caloric information into relative term) were persistent.

Opinion

When I shared the findings of this study with my friend – an RN and very opinionated about health issues, particularly as they relate to SES – she had a myriad of responses but the one that struck me the most was this: If a kid [who doesn’t have a lot of money] walks into a convenience store, picks up a bottle of Coke and notices it will take 60 minutes to “work off” that beverage, then the same kid looks at a bottle of water, notices the PA expenditure compared to the Coke, what keeps the kid from choosing the bottle of Coke?  If the kid has two bucks and is getting ready to shoot hoops with his friends, he might think he’s getting “more for his money” similar to putting fuel in a car. Why would I drink water when I know I’m going to be playing ball for the next hour?

Admittedly, it took me a minute to wrap my brain around what my friend was saying as I had to really shift my way of thinking, not just in terms of nutrition but in terms of economics. Then, of course, it made perfect sense. Why wouldn’t an adolescent want more for their money? What has more impact: money or health? My knee-jerk response would be, given the fact the target demographic is both young, thereby seeking instant gratification, and lower SES, the answer is money.

 

Bleich SN, Herring BJ, Flagg DD, Gary-webb TL. Reduction in purchases of sugar-sweetened beverages among low-income Black adolescents after exposure to caloric information. Am J Public Health. 2012;102(2):329-35.

Physician's Prescribing Fruits and Vegetables

http://well.blogs.nytimes.com/2014/12/01/prescribing-vegetables-not-pills/?mabReward=RI%3A14&_r=1

I saw this article in the NY Times and was very happy to see New York starting such an awesome program!  The Harlem Hospital Center enrolled overweight/obese middle school children into an innovative program to increase consumption of fruits and vegetables.  The point of the program was not necessary to lose weight, but to instill healthier eating habits that would in turn cause weight loss, and it has worked.  The program was created by a non-profit organization that promoted increased access to healthy, fresh foods in "food desert" and limited economic areas.  The families in the program are given nutritional education, healthy recipes, and "Health Bucks" which are redeemable at local produce markets, to allow these families to purchase more fruits and vegetables.

This program is stemming off of the already existing food stamps program, however is pushing the consumption of fresh, health produce instead of allowing people to buy whatever they want.  It also is addressing the obesity epidemic through change, and not promoting diet and exercise that is likely to fall on deaf ears.  It follows along with a lot that we have learned throughout the semester, especially how small changes can lead to big differences.

The program found that 90% of families were shopping at farmers markets, and 70% understood more about the benefits of fruits and vegetables.  Spreading awareness and enthusiasm for healthier eating can be a major success in battling obesity.

Recent Yahoo Story

I really don't have time to comment much about this story I've just encountered when I went to check my e-mail on Yahoo about a half-hour ago but it's annoyed me so much I feel I have to at least bring it to everyone's attention.

So the story headline is "This is what happens when  you drink 10 coke's per day," which sounds like it would be really great because it follows the same guinea-pig style that was used in the McDonald's one month diet that came out a few years ago and caused McDonalds to stop offering Super-sized portions. The man in the video goes on a one-month diet where he forces himself to consume 10 cans of regular coke soda per day.

The video actually starts off really well in the sense that the man talks about how crappy he feels and how he doesn't have much of an appetite and is gaining weight exceptionally fast... but then -for anyone with a nutrition background away- he starts to go sour.

He states that one of his friends commented that they were surprised he was gaining so much weight when he was eating less fat than his normal PALEO diet. He says, "I'm Paleo, I eat a lot of fat, I eat a lot of protein...I'm doing this because I want people to know that I'm gaining weight--it's not because of the fat you're eating, it's not the amount of fat I'm eating that's making me gain a pound a day. Because I'm not hungry and I'm not eating as much fat. The change is I'm eating sugar. It's sugar that makes you gain weight."

He continues to say, "It's raised insulin level that makes you gain weight, not the fat...but it's so hard to get out of your mind that fat makes you fat."

And finally, later he says, "I'm surprised at how much weight I've gained in the last few days, and that's because my insulin level has been higher (how is he measuring this???) my fat cells have been qued to store fat, ITS NOT THE ADDITIONAL CALORIES IN THE COKES (oh really?) it's because I'm storing fat because I have a raised insulin level."

So I don't know who this guy is, but he's sure making a lot of public claims that aren't completely supported by the evidence. For one thing, absolutely added calories from the sugar are going to be stored as fat and excess energy. You ARE gaining weight from the calories. Please don't demonize grains. For another, having a high fat diet certainly will also cause weight gain and that's a negative without even knowing what this man's fat lab values are before during and after his 'experiment.'

Plus, there is a big difference between the sugar he's consuming in liquid form in his coke can than, say, a whole wheat piece of high fiber bread. Especially on the way it changes insulin levels and glucose peaks.

Anyway, I really don't have time to get into this because of finals but those are just some of the first things that pop into my head from watching this. You can find the link here and watch for yourself (don't get mad I've already warned you)

Thanks
Erica Houghton, RD

Oh and 10 cans of coke per day is 1,380ish calories
In one month he should gain FROM THE CALORIES (38,640) about 11 pounds. He gained twice that in his 'experiment.' If only he hadn't basically told the public fat doesn't make you gain weight and only sugar tells your fat cells to store energy.

Link: https://www.yahoo.com/health/its-not-news-that-soda-is-bad-for-us-but-it-is-104089767387.html

Anti-Obesity Campaign

https://www.youtube.com/watch?v=xUmp67YDlHY

The way the obesity epidemic is portrayed in this anti obesity campaign made me so upset and frustrated that I’d like to share this with all of you! The video focuses on food and reinforces the myth that obesity is caused by only one thing - eating too much. 

As we know obesity is a combination of genetic, environmental, psychological, social and many other factors that are yet to be determined. It is important the complexity is recognized so someone doesn’t make assumptions just based on eating behavior. This leads to weight bias, as shown in the video.

The parent shames on their child for hiding binge-eating foods in the video by yelling “you can’t do this!”. This is exactly what shouldn’t be done; yet this video is promoting these negative attitudes and behaviors. Children who are teased and victimized are vulnerable to depression; anxiety, low self-esteem and poor self-esteem, which can take a huge toll on emotional well being. This additional increase in vulnerability to unhealthy eating behaviors may reinforce additional weight gain.  

The video also skews the way the epidemic should be looked at and adds to the common myths. It reveals polarized  “black” or “white” thinking. After watching this a viewer might feel that if they made a feeding mistake with their child they are hopeless for life. It can also make viewers think some foods are “good” while others are “bad”.

The video definitely draws attention to the obesity issue but in order to have a positive effect on childhood obesity, there shouldn’t be shocking, stigmatizing and promotion of dissonant thinking. It is not constructive for weight loss and has exactly the opposite effect! This video is a prime example of what we need to change in society. We need positive attitudes, compassion, mindfulness, modeling and less shame!

Fad Diets in the News

If you are from Cleveland, OH or are a basketball fan, LeBron James return to the Cavs has been the talk of the town for months. If you are unaware, LeBron lost a significant amount of weight during his off season; about 67 pounds. This diet plan he followed was classified as the LeBron James Diet-- a new fad diet to add to the list! A quick breakdown of the diet: Allowed: lean proteins, fruits, vegetables, healthy fats/oils, Not Allowed: grains, refined sugars, alcohol, processed foods and dairy. It a nutshell, its very similar to the paleo/atkins diet.

I was approached by a local news station, WOIO, in Cleveland to help cover a story on the LeBron Diet. Two workers at the news station followed this diet to the best of their ability for one month. In total, they lost around twenty pounds. The role I had in the story was I walked around the grocery store with each participant discussing the diet as well as discussing the pros and cons of the diet. My main concern with helping was I did not want the news station to cut of major keys/important facts I mentioned. I also did not want to sound like I was promoting the diet. Here are a few quotes taken from the article that I was happy they included and did not distort my wording and opinions:

"Nutritionist Pelat admits this kind of diet will knock the pounds off quickly for most people. But, she is adamant about it not being the way to go for anything long term."

"She's concerned about a number of things, including eliminating certain food groups like dairy and grains. They provide nutrients we need like vitamins and even fiber."

"She also points out that going under 1200 calories a day, which could easily happen with this diet, is simply too restrictive and tough on your body. That's why she believes LeBron did the diet in his off-season when strength and energy weren't so crucial."

The news station did a great job at highlighting and stressing how I was not promoting the diet and included tips for following a well-balanced diet more so than following the LeBron (fad diet). I thought this situtaiton fit perfectly into our fad diet lesson. Below is the link to the news story and the article.
http://www.19actionnews.com/story/27406361/health-alert-the-lebron-diet-plan

Just another example of how cognitive distortion can happen-- if LeBron James follows this diet it must work! What they aren't telling you is he was under strict care of doctors and dietitians to monitor his food intake and to make sure he was getting all the right nutrients as well as had a personal chef to prepare his meals. Things most of us do not have and don't think about when beginning or trying fad diets.

How Our Environment Affects The Way We Eat

http://www.huffingtonpost.com/2014/09/17/slim-by-design-environment-mindless-eating_n_5737688.html?utm_hp_ref=healthy-living

As nutrition students and professionals in the field we realize there are many factors involved in a healthy lifestyle, and environment plays a huge role in that process.  The article published in the Huffington Post reinforces the significant role our environment plays on what and how much we eat on a daily basis.  Food psychologist and behavioral economist Brian Wansink, P.h.D. and director of The Food and Brand Lab at Cornell University, provides tips in improving food behaviors in various environments.

Interestingly enough, 80% of eating decisions are made within 5 miles of where a person lives.  The grocery store, kitchen, office/work place are the main places where we eat.  Wansink suggests chewing gum before doing grocery shopping to help with cravings and hunger for snack foods.  Also he suggests shopping for the healthiest foods first and eating a healthy snack before shopping can help with the temptation of convenience foods.

In the Kitchen Wansink recommends keeping a fruit bowl out on the counter instead of chips and cereal.  In one study chips and cereal on the counter space were associated with women weighing 21 more pounds than their neighbors.   At the workplace he suggests not eating at the desk because it is associated with eating unhealthy foods and/or later in the day.  When at a restaurant he suggests ordering the entree you want and allowing yourself to have 2 other items.  These items could be an appetizer, alcoholic beverage, or a dessert for example.  People that practice this rule tend to eat 21-23% fewer calories.  These are basic concepts that provide good reminders of everyday environmental triggers that can affect our eating patterns.  

~Amy  DerGurahian