Archive for the ‘Food Choices’ Category

Great tomatoes: memories or not?

Wednesday, June 29th, 2011

Here's what they look like in the supermarket

When I was a kid in Wisconsin, we used to have "beefsteak tomatoes" several times a week. Then I went off to college and medical school, then residency and fellowships and, eventually, the Air Force. At some point I realized I wasn't eating tomatoes as often and, when I did, they just weren't the same.

We raised our own back in large pots on the back patio two years ago, bought a few at farmers' markets and some vine-ripened tomatoes at a supermarket. The taste, in all cases was much, much better than the standard grocery-store tomato, but I hadn't thought much about the reasons.

Than a friend, knowing about my blog, suggested I buy a book called Tomatoland, written by Barry Estabrook. The back cover advance comments included one by Ruth Reichel who was Editor in Chief for Gourmet Magazine for ten years (it went out of business in 2009) and has been restaurant critic for the New York Times and the Los Angeles Times. She felt the original Gourmet article, "The Price of Tomatoes," (which was expanded to become the book) was the one she was most proud to have published during her tenure.

There are two basic themes to Tomatoland: one is that the "industrial tomato," grown in Florida and accounting for a third of all the fresh tomatoes grown in this country (and a much greater percentage of those available in the supermarkets from October to June) is bred for almost everything except taste. His detailed exploration of the Florida tomato, whose attributes are tightly controlled by a state tomato committee, explained what I had known for some time. They add little to salads except for color.

But here's what they look like when they're picked

That especially excludes taste and nutritional benefits. The one thing the modern industrial tomato has over its 1960-era predecessors is sodium; it has considerably less vitamin content and less calcium, according to Estabrook. He has won two James Beard awards, one for his blog http://politicsoftheplate.com. I went to that website and read a recent post which brought me back to the second theme of Tomatoland: the abhorent conditons endured by our migrant farm workers.

There are, according to that post, 400,000 of those low-paid laborers, 70% of whom are estimated to be undocumented. Florida had virtual slavery with crew bosses picking out and often holding workers in dismal settings (locked in a truck, for instance). That situation, has gradually improved in some aspects at least, in  large part due to the efforts of a worker coalition. But Estabrook's recent post said many of the migrant farm hands/pickers skipped working in Georgia this year after a new law mirroring Arizona's harsh legislation was put into place.

So Georgia was short 11,000 farm workers and the farmers were in danger of losing $300,000,000 worth of produce. The governor, who pushed for the new law a few months ago, is now offering those vacant farm jobs to unemployed probationers. The problem is the work is tough and often reuires experience, so the newly employed group is quitting in droves.

Read the book; it's an eye-opener.

 

 

So what should I eat?

Friday, June 24th, 2011

Medical research comes through for us

I was reading my morning papers yesterday, The Wall Street Journal (hard-copy edition) and the New York Times breaking news (on my Kindle). I came across a June 23, 2011, WSJ article titled "You Say Potato, Scale Says Uh-Oh." It detailed a recent research study online in a prominent medical journal. The premise was what you choose to eat will determine what happens to your weight over a four-year period.

The overall conclusion, once again, is picking healthier items for your diet leads to less weight gain. Most American adults gain a pound a year, but if they add a serving of French Fries on a daily basis, they'll gain more (3.35 pounds). The NEJM said the participants in three huge studies (a total of 120,877 U.S. men and women who were free of chronic diseases and non-obese at the start of the studies), gained most if the extra item was potato chips, and lost weight if it was yogurt. The list, after chips, in deceasing correlation to weight gain included potatoes, sugar-sweetened beverages and unprocessed red meat or processed meat.

Negative numbers were noted for the addition of vegetables, whole grains, fruits, nuts and then yogurt. Other lifestyle influences were examined. If one of the subjects exercised regularly, they lost weight; if they watched much TV, they gained pounds.

So what's new here? Huge studies over lengthy time periods + a few different conclusions.

The study's co-author, Dr. Walter Willet, the chairman of Epidemiology and Nutrition at Harvard's School of Public Health was interviewed on NPR New's program "All Things Considered." He commented that highly refined foods-sugar-added beverages and potatoes, white rice and white bread-were related to greater weight gain. The presumption is these foods are rapidly broken down into sugar, absorbed and then quickly removed by the action of insulin. So if you eat these things, in a short while you're hungry again.

high-protein Greek-style yogurt

Nuts have fat, but keep us satiated for a prolonged time. Yogurt was a surprise to the research group (we're talking about natural yogurt without added sugar) and the mechanism for its influence on weight is unclear, but may relate to the healthy bacteria included.

The bottom line may be just because some foods contain fat, doesn't necessarily mean they'll be fattening. On the other hand, foods that keep us satisfied for a longer time may help us control our overall calorie intake over the long haul.

 

 

 

E. coli and you

Saturday, June 4th, 2011

This is a "bug" you don't want

I've seen several articles in The New York Times and the Wall Street Journal in the past few days about diseases caused by an extremely toxic new strain of the common bowel bacteria, E. coli. More then 1,800 people in Europe have been infected with this food-bourne illness and some have died from an unusual kidney complication it can lead to.

The "bug" itself appears to be highly resistant to antibiotics and experts in the United States feel the wrong approach is being taken in Europe. One professor from Washington University is quoted as saying, "If you give antibiotics and the strain is (already) resistant, then you give that bacteria a competitive advantage..."

Here the recommended strategy is not to treat E coli infections with antibiotics at all. American doctors give IV fluids to help keep the kidneys functioning. They dialyze patients who develop acute kidney failure. On both side of the Atlantic physicians agree that people who develop bloody stools should be admitted to a hospital in an isolation room/ward. Otherwise a person who has an E. coli-caused diarrheal illness can easily infect others.

But dialysis can save your life

The rare, but deadly kidney disease that these food-bourne bacteria can cause is called hemolytic-uremic syndrome (HUS). The NIH PubMed website defines it as a disorder that usually occurs when an infection in the digestive system produces toxic substances that destroy red blood cells, causing kidney injury.

Hemolytic-uremic syndrome (HUS) often occurs after a severe gastrointestinal infection with E. coli bacteria (Escherichia coli O157:H7). However, the condition has also been linked to other gastrointestinal infections, including shigella and salmonella, as well as infections outside the GI system.

In America HUS is most often seen in children and is the commonest cause of acute kidney failure in them. Several large outbreaks in 1992 and 1993 were linked to undercooked hamburger meat contaminated with E. coli.

But in this case we're not talking about meat, but rather vegetables. In the past American outbreaks have been associated with contaminated tomatoes, lettuce and cucumbers.

So should we be worried? Thus far there have been only four cases identified in the US. Those people had traveled to the northern part of Germany recently and that's been identified as the epicenter of this E. coli outbreak. Germany has had 1,733 cases in the most recent count I could find. Initially Spanish cucumbers were blamed, but now it appears clear that Germany is the source.

The FDA is closely monitoring lettuce, cucumbers and tomatoes imported from Germany and Spain, but those countries account for <0.2% of our imported produce.

My family is about to start our 26-week season eating locally produced organic vegetables from Grant Family Farms, the CSA we joined last year. That improves my comfort zone enormously. I think the rest of you should consider farmers' markets, CSAs and other sources for vegetables that are grown relatively near your homes.

I've been saying that for a while; this outbreak just reinforces my thoughts on the subject.

Lies, damn lies and misleading labels

Friday, May 20th, 2011

Caveat emptor (let the buyer beware)

A while back I mentioned the Nutrition Action Healthletter that the Center for Science in the Public Interest puts out. The April edition has a fascinating article titled "10 Common Food Goofs" written by CSPI's PhD house nutritionist, Bonnie Liebman. I knew some of the concepts she mentioned, but certainly not all of them and her specific examples are superb.

The main thrust is we need to read labels and read them carefully. Yet even if we do so the food industry with the "help" of the FDA frequently misleads us. One examples had to do with portion size.  My wife, an extremely successful lifetime member of Weight Watchers (she's five foot nine and weighs 130 pounds), taught me this concept a while back. Her idea of an appropriate serving of meat is the size of a deck of cards.

I started from there and looked at what I ate. Twenty-six pounds ago my typical meat serving was 12-16 ounces, now it's six to eight ounces (I'm five foot eleven and now weigh 150 pounds). But Liebman takes the concept and moves it into areas I never thought my way through before.

One example is Fat Free Coffee-mate. Nestle's Original variety has a label that states it's free of cholesterol, lactose, gluten and trans fat and the Nutrition Facts label claims 10 calories, and zero cholesterol, sugar or salt.

There's a catch though and that's serving size. The FDA and the food manufacturers have decided to round down if you use just one absolutely level teaspoon as the serving size. That's not what most of us do when we use a coffee creamer.

If I do have a cup of coffee I almost always add a creamer and I don't measure out a level teaspoon. I usually don't pour the Coffee-mate, but I certainly use more than the "serving size." Liebman says if you drink a 12-ounce mug of coffee and pour in two tablespoons of Coffee-mate, you've actually added 50 calories and 1.6 grams of saturated fat, more calories and nearly as much saturated fat as if you'd added a similar amount of half and half.

There are nine other examples in her article, but the drift is the same. Serving sizes of a variety of foods, e.g., ice cream, aren't what the label may lead you to think. Contents may include only tiny amounts of what the label raves about (added fruits and veggies) or may have added vitamins that are best obtained from foods, e.g., not from expensive water that also contains added sugar and therefore calories.

On the other hand there are code words, "natural" and "made with real fruit" are two that Leibman mentions. We either don't know the code or need a magnifying glass to read the micro-print that explains it. The word "Natural," except for meats and poultry, is one of the vaguest terms in advertising. And Organic doesn't mean calorie-free.

Bottom line: read labels with extreme care. Better still, stick to unprocessed foods without labels.

 

 

The great potato war

Tuesday, May 17th, 2011

Time for a switch?

I was reading The Wall Street Journal this morning, starting as usual with the "Personal Journal section which headlined the story of a successful prolonged cardiac resuscitation: "96 minutes without a heartbeat."But then the front page caught my eye with an article titled "Spuds, on the Verge of Being Expelled, Start a Food Fight in the Cafeteria."

Searching back-files, I found recent discussions at the US Senate Agriculture's Appropriations Subcommittee hearings. The Department of Agriculture plans to not allow money in the WIC program budget to be spent on white potatoes and not surprisingly senators from Maine and Idaho protested.

Medical articles I found stated that potatoes dominate our vegetable consumption, especially among adolescents who favor them fried. Another study, this one among young preschoolers, showed 70% of 2 to 3 year old kids eating some form of vegetables daily, with french fries and other fried potatoes being the most commonly consumed vegetables. An article in Nutrition Research from April 2011 stated that white potatoes, including French fries, did contribute "shortfall nutrients' and, when consumed in moderate amounts, could form part of a healthful diet.

So what's the rub? Well to begin with if you're only eating French fries, or worse still baked potatoes with lots of cheese, butter and other toppings, you may not be eating any other vegetables and you're getting a lot of "unhealthy diet" items.

Then there's the question of which potato is better. The "Tufts University Health&Nutrition Letter" recommends trying sweet potatoes instead of white potatoes, saying they have huge amounts of beta-carotene  (if you eat them, as I do, with the skin) and larger quantities of vitamin C, folate, calcium and manganese than their pale cousins.

The article in the WSJ that I started with mentions "Maine Potato Candy," mashed white potatoes rolled in coconut and dipped in chocolate and even potato doughnuts, One school food-service director is quoted as regularly serving hash browns , mashed potatoes, "Maine fries," a baked potato bar and even potato puffs for various school meals.

The proposed USDA guidelines, on the other hand, would limit starchy vegetables (not just white potatoes, but also corn, peas and lima beans) to no more than one cup per week. As expected the potato industry and their elected representatives launched a campaign to defend their product, even calling the white potato a "gateway vegetable" that can introduce kids to other vegetables.

The fracas apparently started when the Institute of Medicine, part of the National Academy of Science, recommended that WIC money shouldn't be used to buy white potatoes. One food-service director, up in Caribou, Maine, said she tried serving sweet-potato fries, but her students "just don't like them." She'said to have noted they cost more and most of it goes in the trash.

I love sweet potatoes, but I started eating them early in life and I think that's the key. If those two and three year-old kids get introduced to sweet potatoes, in whatever form, and then after a few years get baked sweet potatoes (without all the toppings...we use salsa), by the time they are teenagers they'll eat them without any qualms.

Or so I think.

What should I eat today? It depends who you trust.

Friday, May 13th, 2011

I ate out last evening and splurged a bit (I had one glass of Riesling, split an calamari appetizer, ate two-thirds of a Thai entree and split a favorite dessert, sticky rice with mango). So today my weight is up a little, but still within my allowable range.

Watch out for scam artists

But that sent me to my stack of recent articles on healthy and unhealthy eating and in particular to one from the April 2011 edition of the Nutrition Action Healthletter put out by the Center for Science in the Public Interest (CSPI). I have four of their articles sitting on my work desk amidst others I found on the internet or in a medical journal.

The one that caught my eye was titled "10 Common Food Goofs: "Fool me once..." and written by Bonnie Liebman. She is the Director of Nutrition for CSPI, got an MS degree from Cornell and has worked since 1977 for the CSPI almost from its inception.

I was going to ping off her article, but then got caught up after Googling Liebman, in following the Web trail back to a harsh critique of CSPI coming from an organization called The Center for Consumer Freedom (TCFCF)

I personally respect CSPI, but my intellectual curiosity kicked in and I wanted to know if the criticisms, calling CSPI the "undisputed leader among America's 'food police,'" came from a valid source. It took a bit of hunting, but what I found was interesting.

The non-paper trail for TCFCF leads to an interesting character, Richard Berman, a high-paid lobbyist for the restaurant and beverage industry. I don't know his actual salary, but he traded in one very fancy house for another even fancier one in the past decade and a half. One ABC article said his business got $1.5 million back in 2004 from TCFCF.

His internet overview of CSPI slams its director, Michael Jacobson, an MIT-trained PhD microbiologist. But when I followed up on Jacobson's reputation, I found the Center for Disease Control (CDC) had given him its 2010 Foundation Hero's Award.

Berman, on the other hand, was noted in the 2006 ABC article I found online, as one of a growing group of lobbyists who've set up non-profit front groups to push their corporate messages. The Center for Media and Democracy was quoted as saying groups have filed complaints with the IRS against such smear tactics. A former IRS division director was quoted as saying, "If someone sets up a website claiming the moon is made of green cheese and they go through some elaborate proof of that, the IRS isn't going to say that's too absurd. It's a form of free speech."

So I'm going to stick with CSPI's publications and ignore Berman's industry-favoring slant. I found it interesting that one of the websites I found in tracing Berman's roots is titled activistcash.com.

I think my bottom message is don't believe all that you read. Check up even on sites and publications you normally have confidence in.

That was a divergence from my usual blog posts, but I thought it was worth my time and hopefully yours too.

 

New proposed food advertisement rules with hedging language

Friday, April 29th, 2011

And here we go again

In response to the hue and cry about childhood obesity, an Interagency Working Group was set up, under the direction of our Congress, between the FTC, the FDA, the CDC and the Department of Agriculture . Their tasking was to "develop a set of principles to guide (note that word) industry efforts to improve the nutritional profile of foods marketed directly to children ages 2-17" and also to support healthful food choices.

After I read a short Wall Street Journal article on this proposal this morning, I found the original government release from yesterday online and a commentary in The Atlantic online written today by Dr. Marion Nestle, a named chair professor in the Department of Nutrition, Food Studies and Public Health at NYU and a visiting professor at Cornell. I have her 2006 book, What To Eat and consider her a trusted and knowledgeable figure in the field.

Let's start with the Interagency proposal, titled "Food for Thought." It mentions the major sources of calories for youngsters are cookies and cakes, pizza and various sugary drinks. When and if they eat veggies, half of those are chips and fries. Their parents are becoming concerned about childhood obesity as well they should be; one in three kids is overweight and headed toward an increased risk of all the diseases associated with obesity, hypertension, asthma and diabetes among them. They won't, on average, live as long as their folks do.

So, given that issue and the fact that the food industry spends huge amounts to markets these unhealthy food choices to kids, what does this august group come up with?

A voluntary program that should (note the word choice) be followed by the year 2016. Strange I think that's five years from now.

The recommendations, now subject to public comment (read that as efforts to soften them by the food industry) appear reasonable on first glance. They include foods that "provide a meaningful contribution to a healthful diet" and note those food components that should (same word again) be limited (added sugars, sodium, saturated fats and trans fats).

Marion Nestle's comment notes a prior attempt that never saw the final "rules" being implemented, and voices concern that the principles are still voluntary with no agency set up to track compliance and that five years seems far too long to institute these kind of changes. She thought the 2010 proposals weren't strict enough and noted the sodium level mentioned in the 2011 version was actually slightly increased, presumably to allow inclusion of more junk foods. She does congratulate the FTC for its courage.

Well I'll be a little blunter. I'm not holding my breath that these changes will happen short of massive public protest.

Even though 17 major companies are making some changes by reformulating foods and decreasing their markets efforts to kids, I think those will be glacially slower than they should be if we're going to help and even save the upcoming generations.

So it's time for all of us to weigh in on this issue. Start a campaign, talk to friends, write a blog...do something.

 

 

Good fish, bad fish: a cautionary tale

Monday, March 21st, 2011

This fish is in trouble

I've learned something about fish food poisoning these past few weeks. Perhaps I knew about it  in medical school, but that was a long time ago. We love fish, consider it a treat, eat it several times a week and, once in a while, partake of other marine creatures. I like mussels as long as they're cooked,  and will eat sushi, but never raw oysters.

So four people we know have had apparent fish-related food poisoning recently. They didn't eat at the same place or the same fish. That got me curious and I started to hunt down types of food poisoning related to eating fish and other marine critters. I found two that aren't the usual bacterial- or viral-caused forms (I'll write about those another time).

So what happened in the first instance was at a play when a close friend got suddenly and violently ill. He collapsed, was "out of it" for perhaps thirty seconds (I thought cardiac arrest or major stroke), then sat up and vomited copiously over himself and his spouse. Then he seemed weak, but otherwise normal. I went with hin to the ER where he was monitored for cardiac rhythm changes for four hours, got blood work and had a brain scan. All those were essentially normal, but he vomited four more times in the ER and once more as I was driving him home.

Over the next two weeks he had a cardiac workup with an echocardiogram, a stress test and a 24-hour Holter monitor for rhythm disturbances. All those were negative. He was previously reasonably healthy for his age of 72 and had no history of any seizure disorder.

A few other tests are pending, but then I spoke to a friend who had suffered a similar illness and heard of two others in the community. I went hunting for odd forms of food poisoning as none of these folk had diarrhea and none had sequelae of their short-term illness.

I finally heard the term scromboid fish food poisoning. All four had eaten fish and several had eaten shellfish.

Scromboid turns out to fit better than other diagnoses. It's typically associated with the consumption of fish, especially Scombridae fish like tuna or mackerel. It has a rapid onset, is marked by abdominal symptoms and or prostration, headache, palpitations, or flushing., sometimes tachycardia (rapid heart beat) and low or high BP and usually is self limited. It is caused by a toxin which is not inactivated by cooking and may be associated with spoiled meat.

The CDC says it's the most common chemically-related food poisoning in the United States., but at that only causes 5% of the food-related illness reported. It's much less nasty than ciguatera, the other fish related illlness I found. That one is also toxin-related, heat-resistent, can cause somewhat similar symptoms, but can lead to months ort even years of problems.

After reading of these I'll still go back to our favorite fish restaurant; they had no other patrons with similar symptoms. Scromboid seems to be relatively uncommon & mild in retrospect. On the other hand some speculate that ciguatera caused the migration of the Polynesians between 1,000 and 1,400 CE.

If you do eat fast food, you may want to buy this book

Wednesday, March 16th, 2011

My writing mentor, Teresa Funke, sent me an email after reading one of my posts recently. She mentioned that her family has a book titled Eat This Not That! Her three kids love reading the book and pointing out choices, especially wrong ones, that she and her husband make. They've purchased several editions of the book over the past few years.

Well I had to buy the book and easily found it in our favorite locally owned bookstore, Old Firehouse Books (that's right; it's in an old fire station). This is the 2011 edition and costs $19.99.

The authors (major and minor) are David Zinczenko, the editor-in-chief of Men's Health and a co-writer, Matt Goulding, who's said to be a New York Times best-selling food author and has cooked and eaten his way around the world. I Googled the second author and found he also has a book called Cook This Not That! Since we already do lots of healthy heart cooking I won't buy that other book.

But let's go back to the book that I did purchase.

So what does this book do? Remember, I rarely eat fast food at all and if I do it's because we're on a trip and didn't bring sandwiches (we almost always do for shorter road trips, but the second or third day out, we may have to find a place to eat). My favorite choice then is Subway since I can pick a simple "sub" and not goop it up. Plus I know what the calories are in the sandwich since they're listed.

But the book is interesting. It lists the "20 Worst Foods in America,' for instance. It tells what's really in a "Chicken McNugget" (seven ingredients in the meat and twenty more in the breading). It has a Top Swaps section telling which burger, wings, pasta, ribs, fajitas, chicken, fries, salad, pizza and ice cream is better than its competitor. It focues on some specific food choices (bad ones, according to the book) and tells why (e.g., a Taco Bell Mexican Pizza has 64 different ingredients; Skittles have more sugar per package than two twin-wrapped packages of Peanut Butter Twix and a whole range of additives that help bring about all those colors; many of those were apparently linked in a Lancet article to hyperactivity and behavioral problems in children).

The bulk of the book fits the title, side by side comparisons of food choices from different fast food restaurants. They're interesting and may be quite useful to those of you who partake on a regular basis of such fare.

I have some real caveats however. Many of their "Eat This' selections still have way too much salt and sometimes more fat than I'd be interested in eating. The book touts losing weight without exercising or dieting. That's not my style at all. Nonetheless it's both a good read, and according to Teresa, a nice way to introduce kids to making food choices. The book rates and, in some areas, grades a wide variety of foods.

Overall I'd give it a C+, but you may rate it higher, even if you only eat fast food occasionally.

 

 

Fish, fish and more fish

Tuesday, March 15th, 2011

Sardines by the dozen

I've been looking at three articles  on which fish we should be eating. One came from a newspaper, one from a health.usnews.com website and the third from the Environmental Defense Fund website.

One of the dietary changes we've heard repeatedly over the last few years, besides eating more fruits and veggies and less red met, is to eat more fish. We're fortunate to have a wonderful restaurant here that's simply titled "Fish." We eat there fairly frequently, especially before attending plays (but that's another story). We also cook fish at home at least once and usually twice a week.

So which kind of fish should we be eating? That leads to the questions of sustainability, heart health and contaminants. To those, based on a recent experience, I'd add the risk of toxins (I'll write a blog post about that some other time).

The article from the Wall Street Journal (March 2, 2011) focused on salmon, talking about Wild Alaskan, Wild Pacific, Farmed Atlantic and Closed Tank-Framed varieties. The Farmed Atlantic salmon raised many enivronmental concerns and both Seafood Watch and Greenpeace decry salmon farming, stating it takes three pounds of  wild-caught fish to produce one pound of salmon.

The Wild Alaskan salmon got kudos from Seafood Watch, although another group noted that 40% of "wild" salmon caught in the state's waters were actually raised in hatcheries. Wild Pacific slamon raised sustainability concerns from some groups, but not all.

Confusing, huh? Well then I turned to the online health.usnews.com piece. This had three distinct sections: the AHA wants us to consume more omega-3s and recommends mackerel, lake trout, herring, sardines, albacore tuna and salmon as good sources. Yet in the contaminant section it's noted that albacore tuna, high on the food chain, carry the risk of mercury and PCBs.  There's debate as to the risk for most adults, but pregnant women (or those who are at risk of pregnancy) should clearly avoid this fish choice.

And farmed salmon, high up on the list of omega-3s, is tough to raise in a sustainable fashion.

The Environmental Defense Fund suggests we eat wild salmon from Alaska, pink shrimp from Oregon, talapia from the US, farmed rainbow trout, alabacore tuna from the US or Canada, yellowfin from the US. The EWG website led me to a Mark Bittman article (New York Times November 16, 2008) where Mark lauds wild-caught fish; he finds the flavor better and the environmental concerns lessened.

So what are we to do? I'd suggest eating more fish, trying to eat some fatty fish, eating less farmed fish and reading more about the issues involved. I may try more sardines.

The real question is whether there will be enough wild fish for all.