Vegetables!

99% of the time when Sweetheart asks me what I want to eat, I answer, “Vegetables!” (I know… I guess this is why I do what I do.) He alerted me to this song, which I never knew existed before.

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I knew it!

In an article in The New York Times today, researchers show that sugar has a more profound effect on reward centers in the brain than the more commonly maligned fat. They have even shown how addictive sugar is with animal studies: mice demonstrate signs of withdrawal after large quantities of sugar that were previously available to them have been taken away.

This gives me even more motivation to engage in my annual January sugar-free cleanse. (And no, artificial sweeteners aren’t allowed, either!)

For more information on sugar, check out this and this.

NC-Toxic_Sugar1

Photo via

The Silver Lining

Could public health budget cuts be a good thing?

At the Large Public Health Department where I work, we’ve been going through a long period of belt-tightening. This year, for the first time in 5 years, employees got a “retention” raise. Our programs are having to cut corners and, in some cases, entire programs are disappearing. It has been a rough go for everybody.

The upside of all of this is that, as funding decreases, policy becomes the focus. Before, direct client services were often the goal of most of our programming. Now our efforts are shifting. Here’s an example: we had a tobacco cessation program that was wildly successful (94%, to be exact). Numbers like that are hard to come by, and no one wanted to mess with the program because of that. But let’s put those numbers in perspective. The program was client-focused, so maybe in a session, the worker would see 3-4 people. In the course of a month, maybe 30 or 40. Of those 30 or 40, 94% would quit smoking – so, we’ve successfully reached a total of 28-37 people. As with tobacco cessation programs across the country, ours has been forced by grant funding to shift their focus to policy efforts. Now, although they have a lower success rate, they are reaching thousands of people per month with the same amount of money. Doesn’t this make more sense?

Think about all of the greatest public health advancements. Clean water – and toilets! Vehicle safety. Hand-washing. Immunization. What all of these have in common is that they reach a large number of people and are fairly passive to adopt as practices. This is how public health works best, in my opinion. I’m excited to see policy get more recognition in the coming years.

Fat City

Photo © Karen Kasmauski

Photo © Karen Kasmauski

I recently read probably the best editorial about obesity that I have ever come across. It was a difficult read: uncomfortable, honest, brutal, no-holds-barred, and yet still, somehow, sensitive. The author, an Australian physician who works at a bariatric clinic, has seen it all. I posted the article on Facebook, but not without much deliberation. I don’t want to engage in what is known as fat-shaming. I don’t want to alienate anyone who struggles with their weight – and I understand that it can be a struggle. In the end, I decided that this article was simply too important not to post. I wish that everyone who is at all interested in health, medicine, obesity, nutrition, policy, law (etc., etc.), would read it.

Here are a few of what I think are the most thought-provoking selections from the article:

  • “I have heard people say thinness is beautiful and coveted because it is difficult to achieve and rare now, the way curves apparently appeal in times of famine…. Today when we look at those who are thin, part of what we see is a triumph of will over gluttony, so the beauty is a moral beauty; it has little to do with health.”
  • “I listened recently to a neurosurgical registrar describing the difficulty of finding a spinal fracture under 10 centimetres of adipose (fatty) tissue. Neurosurgeons love precision; one false move on the inside and you won’t remember your mum. The registrar’s voice was filled with a kind of shocked horror. She had to send the car-crash victim to the scanner mid operation, with a metal screw embedded in his neck so the surgeons could find their bearings beneath the mattress of fat. Post-op, none of the neck braces were big enough to fit. To immobilise the man’s spine the team used sandbags.”
  • “I had a friend who had been anorexic and spent her teenage years in and out of hospital, being fed through a nasogastric tube. She recovered in her 20s and managed to channel all of her intrusive obsessional thinking about food into athletics. One day she said to me that she didn’t understand why she could be hospitalised against her will for not eating enough, and yet there was no limitation on how fat you could get. It was completely unfair, she said, that you could be refused alcohol if intoxicated but roll into your local fish-and-chip shop 100 kg overweight and be served the equivalent of a week’s worth of calories for lunch.”

I also love the section on how our emotional state plays into eating, because it is so true and obvious, and yet so routinely overlooked. Give the article a read and then let me know what you think in the comments section.

More on School Lunches

I was inspired to write this post by an article I read in the current issue of the Journal of Nutrition Education and Behavior. The article was a viewpoint highlighting opportunities for nutrition educators and researchers in light of the new National School Lunch Program (NSLP) guidelines. The abstract can be accessed here. I’ll do my best to distill it in an effort to give a brief overview of the updated requirements.

Photo credit: USDA

Photo credit: USDA

In 2010, new regulation updated the nutrition standards of the National School Lunch Program. These standards brought the NSLP up to speed with the 2010 Dietary Guidelines for Americans. Implementation began in the 2012-2013 school year. Here’s a summary of changes by food group:

  • Meals now have a calorie minimum and a calorie maximum, whereas previously only the minimum boundary was in place. This original one-sided limit harkens back to the inception of the NSLP. The legislation was signed into law in 1946. Section 2 of the act describes the purpose of the program: “It is hereby declared to be the policy of Congress, as a measure of national security, to safeguard the health and well-being of the Nation’s children and to encourage the domestic consumption of nutritious agricultural commodities and other food, by assisting the States, through grants-in aid and other means, in providing an adequate supply of food and other facilities for the establishment, maintenance, operation and expansion of nonprofit school lunch programs.” (P.L. 108–269, July 2, 2004) Yup, that’s right. It originated as a market opportunity for commodity foods. It was also put in place partly to ensure that young men were fit for military service (the “as a measure of national security” language – remember, this was just after the end of WWII). That, coupled with the fact that obesity and related conditions were not relevant health issues in the ‘40s, explains the lack of an upper limit on calories.
  • Fruits and vegetables are now classified as 2 separate meal components rather than falling under the same heading. The previous requirements were that a school had to offer a fruit or a vegetable. Under the new guidelines, students must select at least ½ cup of fruits or vegetables or a combination of ¼ cup fruit and ¼ cup vegetables. Additionally, schools have to serve a variety of vegetables throughout the week and have requirements for dark green and red/orange veggies, beans/peas/legumes, starchy vegetables and “other” vegetables. This helps to combat the tendency of schools to serve the cheaper, less nutrient-dense starchy vegetables (read: French fries) at every meal. (Unfortunately, the tomato sauce on pizza still counts as a vegetable.)
  • In the updated legislation, schools were originally required to comply with daily and weekly minimum/maximum ranges of meat and meat alternatives. (Before this, there was no maximum.) This has been a challenge for districts, as many suppliers do not carry age-appropriate portion sizes of these meal components. As a result, there is now “some flexibility” in the maximum amount – i.e., there is no maximum. (Do I hear “lobbying”?) The new legislation also allows beans/peas/legumes and tofu to count as a meat alternative when they are not counted as a vegetable, giving more opportunity for non-meat protein sources.
  • The updated legislation also originally required that grains, like calories and meats, had a daily and weekly minimum and maximum range. Again, this has changed due to pressure. There is now, as before the updates, no maximum for grains.
  • Milk now has to be skim or 1%, and can only be flavored (e.g. chocolate milk) in the skim version. Previously, 2% and whole milk were also offered, and there were no constraints on flavoring. The original idea was to ban all flavored milk, but – likely due to pressure from the dairy industry – this was thrown out.
  • As in the original legislation, districts must serve meals with 10% or less saturated fat and 0g trans fat/serving. There is no limit on total fat intake.
  • Other highlights:
    • The only foods allowed as seconds with no additional charge: fruits and vegetables.
    • Water must be available in the lunch room.
Photo: USDA

Photo credit: USDA

These changes sound pretty good to me. It makes you wonder, then, about Iowa Congressman Steve King and Kansas Congressman Tim Huelskamp’s determination to repeal them. In a 2010 blog post on The Hill, King and Huelskamp announced their introduction of a bill that would repeal the USDA standards. They wrote “If they have found a way to invade the lunch tray of the youngest members of our society, what’s next? The new regulations are a one-size-fits-all encroachment of our liberties.”

This kind of rhetoric frustrates me to no end. How can a politician argue for civil liberties within a program subsidized by the government? Don’t get me wrong. I’m all for civil liberties. But if our government is subsidizing the National School Lunch Program, don’t we have a duty to taxpayers to make sure we’re only subsidizing it once? The alternative is subsidizing it twice – once in the form of a meal and again in the form of healthcare down the line. Yes, we have found a way to invade the lunch tray of the youngest members of our society – by providing it. Let us, at the very least, ensure that it is healthful.