State and local officials push trans fat bans and menu labeling. Some restaurants, diners and manufacturers object.
By Jerry Hirsch 10:14 PM PST, December 16, 2008
Restaurants are being told to list calorie counts on their menus. Schools are banning bake sales, and cities are outlawing new fast-food restaurants in some neighborhoods.State and local governments, concerned about the growing cost of obesity and diabetes and the ever-higher cost of healthcare, are acting more like food police. And more regulations may be ahead.
Decades of federal inaction in fighting the nation’s obesity epidemic and regulating dangerous food ingredients such as artery-clogging trans fats are behind these local and state efforts, said Michael Jacobson, director of the Center for Science in the Public Interest.The Obama administration, with large majorities in Congress and headed by a president who made healthcare a centerpiece of his campaign, could launch a new era of food regulation, he said. “The Obama administration clearly believes strongly that government has a major role to play in many arenas, including protecting the public’s health.”Jacobson and other proponents of more oversight of what and how the nation eats want to see the Food and Drug Administration split into two agencies, with one focusing on food and the other on drugs and medical devices.
They say the FDA commissioner traditionally has been preoccupied with drug regulation and has allowed food oversight to flounder. Critics cite what they characterize as the agency’s weak, slow and inept efforts this year when melamine was found in contaminated infant formula in the United States and a months-long outbreak of salmonella poisoning in produce sent 286 consumers to the hospital.Greater regulation of food production, preparation and consumption — whether on the local or national level — is controversial.”The government might have good intentions, but can’t average citizens make up their own minds on what to eat? This is an example of nanny government,” said Bill Whalen, an analyst at Stanford University’s Hoover Institution.Despite some criticism from food manufacturers and restaurants, state and local officials are setting the pace and defining the agenda. New York City, Philadelphia and California have banned trans fats.Several local health departments — including Los Angeles County — want the federal government to reclassify salt as a food additive, a move that would pave the way for greater regulation.More than a dozen states and numerous cities are pondering legislation patterned after a new California law forcing chain restaurants to list calorie counts on menus. Los Angeles has a one-year moratorium on new fast-food outlets in a 32-square-mile area of South Los Angeles that is home to 500,000 residents. San Jose is looking at a similar proposal.A legislative and consumer backlash against trans fats has pushed big restaurant chains — including KFC, Burger King, IHOP, Applebee’s, Starbucks, Subway, Taco Bell and Denny’s — to begin to eliminate trans fats from their foods.Yum Brands Inc., the parent of KFC, Taco Bell and Pizza Hut, isn’t waiting for more legislation. It plans to add product calorie information to menu boards in its company-owned restaurants nationwide and to encourage franchise owners to do the same. The company said the calorie information would be phased onto menu boards starting this year and be completed by Jan. 1, 2011.It’s a big move by one of the largest purveyors of fast food. Louisville, Ky.-based Yum franchises or owns about 20,000 U.S. restaurants.So far, the local regulatory initiatives have gained momentum because of rising rates of obesity, diabetes and heart disease, said Amy Winterfeld, a health policy analyst for the National Conference of State Legislatures.”If Americans ate healthier food and were more active they would not be as obese and there would not be as many obesity-related healthcare costs,” Winterfeld said.Yet restaurant customers don’t always agree that legislating food rules or forcing chains to post nutritional information is the best way to tackle the problem.”They are going too far trying to regulate people’s lives and health. Soon they will be regulating portions,” said David Yochelson, an Encino attorney who dines out with his family several times a month.Policies such as the fast-food establishment moratorium in Los Angeles border on racism, said Joe R. Hicks, vice president of Community Advocates Inc., a Los Angeles civil rights organization.”It’s insulting. They are saying that if you live in Brentwood you have the ability to make choices for yourself but if you live in South Los Angeles you don’t,” Hicks said.
The restaurant industry calls the trend to legislate food choices a case of mistaken priorities.”With crime and budget-shortfall issues, why are city and state legislators focusing on trans fats and fast-food restaurants?” asked Jot Condie, president of the California Restaurant Assn.
State Sen. Alex Padilla (D-Pacoima) disagrees. The author of the menu-labeling legislation believes government has a legitimate interest in food-related health issues because of how poor diet affects health and, by extension, state and federal budgets.”As long as we have an obesity epidemic and a health crisis in our communities there is a role for government to play. The debate comes over how much is too much and how much is too little,” Padilla said.Menu labeling gives people the information to make healthful eating decisions, he noted, but it doesn’t tell people how to eat or limit options.
Jacobson said there was already evidence that increased food regulation was paying off.Just two years ago Harvard University medical school researchers estimated that artificial trans fats — from partially hydrogenated oil — caused 72,000 to 228,000 heart attacks annually in the United States.Jacobson said that number was already dropping as cities and states started to ban trans fats and restaurants and food producers moved to remove them from their offerings.In July, California became the first state to require restaurants to cook without trans fats. The law requires restaurants to use oils, margarines and shortening with less than half a gram of trans fats per serving by Jan. 1, 2010, and applies the standard to deep-fried bakery goods by Jan. 1, 2011.Menu labeling is another trend. Some health advocates believe that if people see the amount of calories, fat and salt in meals before they order them, they gravitate to more healthful selections.Gov. Arnold Schwarzenegger signed legislation in September requiring chain restaurants in California to display calorie counts with each menu item. It was the first state law of its kind in the nation but won the support of the California Restaurant Assn. because it standardized requirements and preempted local ordinances in Santa Clara and San Francisco.The new law applies to restaurants with 20 or more locations in California, about 17,000 eateries. Beginning July 1, they must provide brochures with the number of calories and grams of saturated fat for each item. Starting Jan. 1, 2011, all menus and menu boards will have to include the number of calories for each item.Other cities have different approaches. New York requires the posting of calories, whereas Seattle requires listing calories, sodium, saturated fat and carbohydrates.Although many cities and states like the local autonomy, the National Restaurant Assn. is pushing federal legislation that would end local rules and increase flexibility, said Dawn Sweeney, CEO of the group.[email protected]
But this is a pretty interesting article on the “Top 10 Natural Products” http://abcnews.go.com/Health/ColdandFluNews/story?id=6467771&page=1
An “obesity tax” of about 15 percent on non-diet drinks is among the taxes and fees ina $4 billion tax plan that Gov. David A. Paterson plans to introduce on Tuesday to close the now $15 billion budget deficit.
By DAYLE HAYES
The best gift is often one that you would most like to receive yourself. With active gifts, you can add even more to the enjoyment by actually sharing your present with those you love. When you enjoy physical activity together, you’ll be sharing all the benefits of fitness.
Eight energizing gifts to share the joy of fitness
During this stressed-out, food-centered time of year, we could all use some simple pleasures, especially when they include “side effects” like weight management and stress reduction.
1. Start an active family tradition during the holidays.
Many active traditions – walking around to see holiday lights or sledding in the park – cost nothing. Others – a shiny new toboggan or bikes for the family – are well worth the cost, since they promote family togetherness, and physical health.
2. Make an active holiday date with friends.
Here is a no-cost idea for difficult economic times. Skip the usual gift (or cookie) exchange among friends or coworkers. Instead, find fun, active ways to celebrate together, like a downtown holiday stroll or a photo “safari” in a local park.
3. Give a coupon for future physical activity and fun.
Certificates for future needs also make inexpensive (and always appreciated) gifts. Possible coupons include dog walks, snow shoveling and yard work. Or make dates to share active fun: dance lessons, X-country skiing, or winter walks.
4. Support local businesses with fun outdoor activities.
Winter brings plenty of opportunities for outdoor fun and gift-giving. Stuff someone’s stocking with day passes for an ice skating rink, Nordic ski center or downhill ski lift. If you’re an expert, include an offer for personalized instruction.
5. Warm up someone from head to toe for outdoor fun.
Consider a small gift that makes a big difference during winter activities. Hats, scarves, mittens, gloves, or socks – especially in bright, fun colors – are an inexpensive way to help someone look good and feel comfortable during their time outdoors.
6. Purchase a “two-fer” at a fitness center, gym, or yoga studio.
Watch for holiday specials at local fitness facilities or worksite wellness programs. You can often pick up good deals on two-for-one classes or personal training sessions. Invite a family member or friend to have fun getting fit with you.
7. Order an interactive game or fitness/dance/yoga DVD.
While interactive video games do not provide the same fitness benefits as the real sport, they do get gamers off the couch and moving. Instructional DVDs are generally less expensive and may be more beneficial, especially if they are really fun!
8. Wrap up a simple fitness gift for everyone on your list.
Fun gifts to encourage physical activity are available for every age and interest. Visit a toy department or athletic store for ideas, such as Nerf and Koosh games, balls of all sorts, jump ropes, yoga mats, small weights, and water bottles.
Registered dietitian Dayle Hayes is a consultant to school districts and other groups across the U.S. and co-chair of Billings Action for Healthy Kids. Contact her at [email protected]
November 2008 Issue
Healthy Living Through the Holidays
By Rita E. Carey, MS, RD, CDEToday’s DietitianVol. 10 No. 11 P. 40
Because it’s so easy to overeat during the holidays and derail health and fitness goals, RDs should arm their patients (especially those with diabetes) with tips for resisting the season’s temptations.
The holiday season poses some common challenges to Americans’ health and wellness. This time of year, people struggle with weight gain, and people with diabetes will likely also struggle with blood sugar control. Dietitians and diabetes educators can help patients recognize the challenges inherent in the holiday season and assist with developing plans to deal with them.
Holiday Weight Gain: The “Gift” That Keeps on Giving
Research suggests that on average, individuals gain less than 1 pound over the six-week period from mid-November to early January.1 Although this amount of weight gain may seem trivial in the short run, its long-term impact on health may be substantial. The problem with holiday weight gain seems to be related to our inability to lose the pounds we have added over the course of a year; thus, we accumulate more of them as the years roll by. One of the first studies examining holiday weight gain found that in a study group of approximately 160 people, most gained an average of 1.4 pounds over the course of a year.1 About one half of the weight gain was observed over the six-week holiday period, and participants did not lose that weight but added more in subsequent months. Researchers concluded that adult weight gain occurs slowly, mostly during the fall and winter months, but adds up over the years.
Research also suggests that body composition changes may occur among some populations during the holidays, adding to the risk of future weight gain. A small study published in Nutrition & Metabolism in 2006 that examined college-aged students’ holiday weight gain concurrently measured changes in body composition. This study documented an insignificant overall weight gain during six weeks (pre-Thanksgiving to post-New Year’s) in this population but found a significant increase in body fat and concomitant decrease in fat-free mass. Participants demonstrated weight gain over Thanksgiving (the obese/overweight group gained an average of 1 kilogram of body weight, while the normal body mass index [BMI] group gained an average of 0.2 kilograms), but most had returned to their preholiday weight when they returned for a follow-up after New Year’s. (The authors noted that participants knew the focus of the study was holiday weight gain, which may have influenced outcomes.)
However, although body weight did not increase overall, the percentage of body fat did increase, irrespective of BMI. Over the short holiday period, researchers measured a significant increase in trunk fat mass in all groups and a significant decrease in leg and arm muscle mass. The authors noted that “this is particularly worrisome given that excessive accumulation of trunk fat is related to a host of comorbid conditions such as cardiovascular disease, type 2 diabetes, and early mortality” and “as most individuals judge overall health based on their body weight, these subjects would not consider themselves at higher risk of developing future disease.” This study also suggests that those at highest risk for seasonal weight gain are those who are already obese.
Environmental Contributions to Weight Gain
How do the holidays increase people’s risk for adding on pounds? In a 2004 Annual Review of Nutrition article, Brian Wansink, PhD, author of Mindless Eating: Why We Eat More Than We Think, identified a number of environmental factors that can lead to overconsumption during social gatherings and celebrations. Long eating duration (as is typical at parties and other social gatherings), easy access to foods (leftovers from holiday meals, visible snacks and treats laid out at home and at work), multiple distractions while eating, the availability of large stockpiles of foods, an increased variety of foods, large portions, and the social norms that condone overeating all likely contribute to holiday weight gain.
The relatively easy access to a large variety of foods during the holidays may be one of the biggest contributing factors; according to Wansink, the level of effort needed to access and consume food is one of the strongest influences on consumption. The distractions inherent in holiday socializing (conversations, media, and events) also encourage increased consumption, likely by making it more difficult to notice satiety signals. Interestingly, studies indicate that meals eaten with one or more other people may increase the quantity of foods people eat by 33% to 96%.2,3 Apparently, holidays present a number of environmental conditions that can cause us to eat more than we need or intend.
The Role of Exercise
People generally exercise less often during cold-weather months, and this seasonal variation in exercise frequency may also contribute to both holiday and annual weight gain. Expending fewer calories while taking more in over the holidays will undoubtedly lead to weight gain during this relatively short period of time. In addition, some evidence indicates that seasonal exercise fluctuations may contribute to long-term weight gain in a less obvious manner.
A very large study published recently in Medicine & Science in Sports & Exercise assessed whether the weight people accumulated during periods of diminished activity could be equally lost after they resumed usual activity levels. Researchers collected data from a population of runners (n = 54,956) who participated in the National Runner’s Health Study between 1991 and 1993, with follow-up data collected in 2000. They found that runners who regularly ran less than 32 kilometers per week (men) or 16 kilometers per week (women) who reduced or stopped running for a period of time could not lose the amount of weight they gained during inactivity if they resumed exercise at their normal rate. The study authors also mentioned that reduced abilities to lose weight after inactivity may be related to the loss of fat-free mass.
Blood Glucose Control
Impaired glycemic control among people with diabetes during the holidays may mirror both holiday and annual weight gain patterns in the general population. Evidence suggests that like body weight, hemoglobin A1C levels rise during the holiday season and, similarly, are unlikely to return to preholiday levels later in the year. Thus, as weight slowly increases from year to year among the general population, A1C levels may also slowly rise over time and seem to rise more significantly during the holidays in individuals with diabetes.
A study conducted in China and published in 2004 in Diabetes Care found that subjects’ A1C levels increased 0.198% during the holidays (December 20 to January 20 and January 28 to February 28) but decreased only 0.009% over the course of the subsequent year. Although China has a different holiday season from the United States, the holidays considered here cover approximately the same amount of time and occur during the winter months, as they do in the United States.
What to Do?
Weight gain, elevated blood glucose levels, and increased A1C levels are inherently interrelated. Monitoring for gradual weight gain via frequent weighing during the holidays may be a good first line of defense against rising A1C levels. Carefully tracking intakes and postprandial blood sugars is also helpful for preventing both weight gain and hyperglycemia. A small study published in 1998 in Health Psychology found that participants who recorded meal and snack intakes most consistently over a 10-week period actually lost weight while those who were less consistent gained weight.
Making changes in the home, work, and eating environments will reduce the number of opportunities individuals have to overconsume. Wansink offers several ideas to change a person’s environment to eat less. (See sidebar for some ideas summarized in Mindless Eating.)
Maintaining a regular exercise program is also important. Considering the research on runners, educators should let patients know that reduced activity during the holidays (secondary to inclement weather, busy schedules, or other distractions) may make any weight gained during this period increasingly difficult to lose. Maintaining a consistent exercise program year-round appears key to long-term weight maintenance. Individuals should also know that the amount of exercise required to maintain weight loss over a period of years is likely larger than is generally recommended. After studying 24-month weight loss maintenance in 201 overweight women, Jakicic et al concluded in a 2008 Archives of Internal Medicine study that 275 minutes per week of regular physical activity was necessary to maintain a 10% loss of body weight. This amount of exercise translates to about one hour of activity five days per week uninterrupted for two years.
The study suggests that the amount of activity needed to sustain substantial weight loss is about twice the current public health recommendations (30 minutes of activity five days per week).
Some Observations From Real LifeMany people manage to make it through the holidays with stable weight and blood glucose levels. Some people who attend our local, monthly diabetes support group offer the following words of wisdom to those seeking to stay in good control:
• Don’t go to a dinner or a party hungry, especially if there is a buffet.
• Remind yourself how you would like to feel at the end of the night. Do you want to feel light and energetic or full and sluggish?
• Allow yourself to drink alcoholic beverages twice per week, but don’t drink more than two.
• Work sweets into your daily carbohydrate plan. You may want to subtract a few grams from your plan during the holidays because sweets generally spike blood sugar levels more than other carbohydrates.
• Pay attention. Keep track of how many times you start to eat something because you see it, not because you are hungry. If you find you are often eating when you are not hungry, you will likely gain weight.
More Vegetables and Less Fat
Barbara J. Rolls, PhD, has done some of the most intriguing research on Americans’ eating habits in recent years. In her book Volumetrics: Feel Full on Fewer Calories, Rolls wrote that it is the volume of our meals, not the calories or macronutrient composition, that most significantly impacts satiety. She explained that by increasing the volume of food at meals and snacks (usually by adding vegetables and other foods with considerable water content) and decreasing the calorie density (eg, by reducing fat), individuals can feel sated with meals containing fewer calories. One may apply a similar strategy to preparing meals and snacks during the holidays. A holiday meal that includes a large variety of vegetable dishes and a small number of meat and starch-based dishes will likely help guests choose more of the higher volume, lower calorie dishes.
Need a tasty holiday spread for bread or a dip for crackers or vegetables? Try Chef Molly Beverly’s Red Pepper Spread, which has significantly fewer calories and less fat than butter and most sour cream- or mayonnaise-based dips.
Staying healthy through the holidays need not be a Sisyphean task. Taking the time to work with clients on strategies to get them around their biggest challenges, teaching them how to change their environment and habits, and encouraging regular exercise can help them prevent weight gain and hyperglycemia. Preventing seasonal weight gain and hyperglycemia has long-term benefits, and patients should be made aware of this as well.
— Rita E. Carey, MS, RD, CDE, is a clinical dietitian and diabetes educator at Yavapai Regional Medical Center and the Pendleton Wellness Center in Prescott, Ariz.
• Do not leave serving bowls and platters on the table. Keep second servings a safe distance away.
• Decide how much to eat prior to the meal or event.
• Model the behavior of the person in the room or at the table who seems to be eating the least or most slowly.
• At buffets and receptions, avoid having more than two different foods on the plate at the same time.
• Wrap tempting foods in foil or in nontransparent containers.
• Place lower calorie, nutrient-dense foods toward the front of the refrigerator and cupboards. Make higher calorie, easy-to-eat snack foods and entrées more difficult to reach.
• Use smaller plates and bowls. Use smaller serving utensils.
• Stockpile healthier foods instead of high-calorie foods.
• Reduce the visibility of foods that are easy to eat.
— Source: Wansink B. Mindless Eating: Why We Eat More Than We Think. Bantam Books; 2006.
1. Yanovski JA, Yanovski SZ, Sovik KN, et al. A prospective study of holiday weight gain. N Engl J Med. 2000;342(12):861-867.
2. de Castro JM. Eating behavior: Lessons from the real world of humans. Nutrition. 2000;16(10):800-813.
3. de Castro JM, Brewer EM. The amount eaten in meals by humans is a power function of the number of people present. Physiol Behav. 1992;51(1):121-125.