Download SPOTTING THE PROBLEM—DOES DIET PLAY A ROLE IN ACNE?

Nutridate
Volume 18 • Number 2 • May 2007
Spotting the Problem—Does
Diet Play a Role in Acne?
by Dr Neil Mann1 and Robyn Smith2
(1Associate Professor of Human Nutrition, 2PhD research student)
School of Applied Sciences, RMIT University, Melbourne
Acne is a common skin problem which affects 85 per cent
of Australians at some stage of their lives. It begins during
puberty, peaks at about 18 years and generally fades by the
mid-twenties. In some cases it can persist into middle age,
with 12 per cent of women over 25 years being affected.
Although acne is not life-threatening, it can have long-term
ramifications for sufferers, including diminished selfesteem, social withdrawal and emotional distress.
What is acne?
Acne is a complex disorder of sebaceous (oil-producing)
hair follicles of the skin, particularly on the face and upper
torso. These follicles consist of a sebaceous (oil-secreting)
gland, a hair duct and a hair strand. The final outcome
of this disorder is blockage of the duct, thus trapping
oily sebum under the skin, where it allows bacteria to
breed resulting in infection and inflammation. There are
four distinct phases of acne development, which can be
summarized as indicated (see Figure 1):
• increased production of keratin (a fibrous protein)
which blocks the follicle opening,
• a rise in hormones (especially androgens) which
stimulates the sebaceous glands to produce more of the
skin oil known as sebum,
Figure 1: F
ormation of an acne lesion in the sebaceous follicle.
Blockage of the duct by keratinised cells due to certain
growth hormones stimulated by over production of
insulin, followed by excess sebum production and
bacterial multiplication.
• increased number of bacteria in the follicle, and
• inflammation caused by the follicle rupturing under the
skin due to the build up of infection rich sebum.
These events lead to the formation of non-inflamed
comedones (commonly known as black heads and
whiteheads) and inflamed papules, pustules and nodules
(otherwise known as pimples).
STUDENT ACTIVITIES
1. What is acne? Refer to Figure 1 and the text preceding it to complete the following sentences:
• Hair follicle is blocked by . . .
• Sebaceous glands produce increased sebum due to . . .
• Bacteria within the hair follicle . . .
• The follicle ruptures under the skin due to build up of
infected sebum leading to the formation of . . .
2. Use a dictionary or the article to define each of the follow
terms:
sebaceous,
sebum,
keratin,
androgens,
comedones.
Does chocolate or any one food
cause acne?
For many years people have blamed chocolate for causing
pimples and a study performed in 1969 set out to test
this widely held view (Fulton, Plewig et al 1969). Sixty-five
acne sufferers ate either a chocolate bar or an identicalappearing (placebo) bar and had their acne assessed.
The researchers found that chocolate had a similar effect
on acne as a placebo bar. Therefore, they concluded that
chocolate cannot be blamed for causing acne. However,
other researchers, who later examined this work found
that the sugar and fat contents of the placebo bar were
virtually identical to that found in the chocolate (Mackie
and Mackie 1974).
This is a lesson important in all fields of scientific
investigation. Make sure you have a clear understanding
of the study control/placebo and its relevance. In this
case it raises the important question: if the ingredients
NUTRIdate is published and distributed by:
Warringal Publications PO Box 336 Fitzroy VIC 3065 • Telephone (03) 9416 0200 • Facsimile (03) 9416 0402
GPO Box 4611 Sydney NSW 1043 • Telephone toll free 1800 334 641 • Facsimile toll free 1800 629 559 • Website www.edassist.com.au
Subscription information: Full-rate subscription $60.00 per annum • ISSN 1320-9701 • Copyright 2007
of the two bars were similar, why would chocolate be
expected to aggravate acne more than the comparison
(the placebo) food? Despite its obvious flaws this study is
frequently cited as evidence that diet plays no role in the
development of acne.
case of acne. Since acne is highly prevalent in western
countries, the authors proposed that a western diet may
be a contributing factor. The diets of the two acne-free
societies consisted mainly of low glycemic index (GI) foods,
such as tubers, vegetables, fruits and wild forms of maize
and rice (which contain slowly digested and absorbed
carbohydrates) as well as hunted game.
In contrast, western teenagers typically eat a diet high in
refined, high GI foods, such as white bread, rice, potatoes,
soft drinks, sugar-rich foods and processed cereals and
snacks, which cause a rapid rise in blood glucose level
after consumption. The researchers proposed that the
difference in the GI of foods may provide the link between
diet and acne.
STUDENT ACTIVITIES
3a.Describe the obvious flaw identified in the 1969 study to
determine if chocolate caused pimples?
b.What is the implication that can be drawn from this for
future studies involving placebos?
No one food has ever been found to be the single cause
of a specific disease, such as, heart disease and diabetes,
which are undeniably accepted as nutritionally-related
disorders that are multifactorial and involve the whole diet.
So why should we expect one food item to be responsible
for acne? In the case of heart disease, we know that
several aspects of nutrition contribute to heart health, eg.
saturated fat, fibre, fish, antioxidants, etc. It is also more
than likely that a complex interplay of dietary factors
present in many foods contribute to acne. The question
is what are those factors and what are the main foods that
contribute these factors in the diet?
Modern man has tipped the glycemic
index scales
In westernised societies, large scale food processing,
such as (the refinement of flour, has been detrimental
to the nutritional quality of food. When grain is refined
into flour, dietary fibre, essential vitamins (particularly
B vitamins) and minerals are removed and the starch
present in the grain is made more accessible to intestinal
enzymes for digestion. This process of refining grains
impacts enormously on blood glucose level, in that the
starch (made of glucose molecules) is readily available for
absorption as minimal digestion is needed.
A perfect example of this is white bread and even
wholemeal bread. Similarly, root vegetables such
as potatoes, and grains such as rice and wheat have
been selectively bred over generations to be high in a
certain type of starch that is rapidly digested by humans
(amylopectin starch). All of these suspect foods have
a common feature, that is a high glycemic index. The
glycemic index (GI) is a system of classifying the blood
glucose-raising potential of carbohydrates. On a scale of
0–100, foods are ranked according to their ability to raise
blood glucose and the higher the number, the greater
the blood glucose response. High GI foods (GI>70)
are rapidly digested and produce high blood glucose
responses. In contrast, low GI foods (GI<55) are more
slowly digested and produce only a small rise in blood
glucose. See information below measuring GI of foods.
Differences in acne prevalence
worldwide
The reason that we began to suspect a diet acne
connection was the observation that the prevalence of
acne is much lower in rural, non-industrialised societies
than in modernised western populations. Although
ethnic/racial genetic differences may play a role in
acne, we also observed that people of similar ethnic
backgrounds exhibit different rates of acne when living
different lifestyles. For example, acne prevalence in
indigenous South American Indians is similar to that of
people of European decent when consuming a western
diet. But no acne is observed when these Indians
consume their natural historical diet, lacking refined
processed food staples. Thus genetic/racial difference
can be ruled out as a main affect in acne prevalence
(Cordain, Lindeberg et al. 2002).
Further support for a role of diet in the development
of acne can be found from observational reports of the
Inuit (Eskimo) people of North America (Schaefer 1971,
Bendiner 1974). Acne only emerged in the Inuit population
after the adoption of a western lifestyle. Acne was nonexistent among Inuit teens in earlier times when they
maintained their hunter-gatherer lifestyle. During this
time their diet was based almost entirely (80–100 per cent)
on meat and fish. However, when they adopted a western
lifestyle and were exposed to a diet high in bread, cereals,
confectionaries and soft drinks, acne became a common
and sometimes severe problem. Although the exact reason
for the development of acne is unclear, the Inuits blamed
the change in their diet. Interestingly, along with acne came
many other diseases already common in the West, such as
dental caries, obesity, diabetes and heart disease.
A more recent study suggested that presence of acne was
related to the type of carbohydrate in the diet (Cordain,
Lindeberg et al. 2002). Researchers observed more
than 1,300 teenagers from two non-westernised societies
(Kitavan islanders of Papua New Guinea and the Ache
hunter-gatherers of Paraguay) and found not a single
How is the GI of a food measured?
To measure the GI of a food it must be done in at least 10
human subjects and the mean result reported. The subjects
consume a drink containing exactly 50.0 gram of glucose
powder and their blood glucose level is monitored every
15 minutes for two hours after this. Measurement is done
using a glucose meter to test glucose level in a drop of
blood from a prick on the subject’s finger.
On another day the subjects eat a serving of the food
to be tested, that also contains exactly 50.0 gram
carbohydrate and the blood tests are repeated for two
hours. These glucose levels are plotted on a graph as
shown and the area under each graph calculated. The
‘area under the curve’ (AUC) for the food is divided
by the AUC for glucose and multiplied by 100—this is
termed the glycaemic index (GI).
Glycaemic Index (GI) = AUC (test food) x 100
AUC (glucose)
~~
Young males with acne were split into two groups and
prescribed a diet for three months. One group followed
the typical western diet of highly processed foods, such
as white bread, potatoes and snacks such as biscuits and
chips and soft drinks. The other group mirrored the diets
of non-westernised societies, including lots of fresh and
natural foods. The group that ate the diet which mimicked
the non-western diet was called the experimental group
and the group that ate the comparison diet was called the
control group.
1. Control group—this group was supplied with foods
with moderate-high GI values, which was typical of their
normal diet.
2. Experimental group—this group was provided with
foods higher in protein (eg. lean meat, fish, eggs etc)
and low GI carbohydrate type foods (e.g. whole grains,
nuts, basmati rice, etc).
The aim of the study was to compare the effects of the two diets on acne symptoms and hormones related to acne. All participants were supplied with the same facial
wash/lotion (no other creams or medications were
allowed) to ensure that diet was the only difference
between the two groups. The participants attended RMIT
University each month to have their acne measured by
a dermatologist. At the beginning and end of the diet
period, blood levels of hormones that play a role in acne were also measured.
Figure 2: Blood sugar levels over a 2 hour period following
consumption of either 50g pure glucose (red), or a test
food containing 50g carbohydrate (orange).
STUDENT ACTIVITIES
4. Name and describe the two case studies cited that link
lifestyle with acne.
5. Make a list of the low GI foods and the high GI foods
mentioned.
6. What does the study by Gordain, Lindberg et al 2002 propose
about the link between diet and acne?
7. Refer to figure 2 and the text in the article to describe the
difference between low GI and high GI foods and their
relationship to blood glucose levels.
Study results
Blood sugar levels and insulin
response
Both groups showed improvements in their acne during
the 12-week study. However, the reduction in acne was
significantly greater in the experimental group. At 12weeks, there was a 51 per cent improvement in acne
in the experimental group compared to a 31 per cent
improvement in the control group (see Figure 3). The
experimental group also reported improvements in their
self esteem, their social life and their emotional wellbeing.
The small improvement in the control group (a phenomena often observed called the placebo
effect) has been put down to natural improvement with
approaching summer, a tendency for some control subjects
to improve their diet unintentionally and the common skin
wash used being superior to their previous cleaning habits.
Sugar glucose is the body’s basic energy source and is
present in the blood, so it is readily available to all body
tissues continuously. This glucose mainly comes from
digestion of carbohydrate containing foods in the small
intestine. Both starchy foods and sugary foods contain
glucose. Once digested the glucose moves rapidly from the
intestines into the blood. As the blood glucose level rises
the pancreas produces a hormone called insulin whose
job it is to make cells throughout the body absorb this
glucose from the blood and use it for energy metabolism
(or storage as fat) in the cells. If blood glucose levels are
continuously and rapidly rising following the consumption
of high GI foods, then large quantities of insulin are
constantly being released into the blood.
This over-production of insulin is believed to affect many
other hormones and processes in the body, some of which
are linked to acne. For example, high levels of insulin may
cause androgens (the male hormones) to become more
active in both males and females. Androgens are known
regulators of sebum (skin oil) production. Insulin can also
promote growth of keratin in skin cells, which can cause
the follicles to become blocked. With a blocked duct the
excess oily sebum cannot escape onto the skin surface as
it should. It builds up in the duct and skin and bacteria
multiply rapidly in the duct using the sebum as food.
This is infection and leads to redness and swelling called
inflammation.
Figure 3: Percentage change in the number of acne lesions
at each visit according to dietary group. The solid
line represents the decrease in acne lesions in the
experimental group and the dashed line represents
the control group.
Researching the diet and acne link
Nutrition researchers from RMIT University and
dermatologists from the Royal Melbourne Hospital
recently investigated the link between diet and acne.
~~
Figures 4a–d: Photographs showing improvement in acne
following the experimental diet. Photos 4a and
4c were taken before the diet and photos 4b
and 4d were taken after 12 weeks of the diet.
In each case some redness is still evident, as
inflammation resolves slowly. However infectious
lesions are gone and no new comedones have
formed.
a.
b.
c.
d.
In summary
This research showed that eating a healthy, well-balanced
diet with minimum amounts of processed foods helped
improve acne symptoms and reduce the psychological
impact of acne. The improvement in acne was also
associated with changes in hormones, providing further
support for the dietary connection. These results provide,
for the first time, evidence that diet may play a role in
acne. Hopefully, this study (and future studies like it) will
provide a clearer understanding on a topic that has been
surrounded by much controversy.
An added bonus of this type of dietary approach to acne
is that the diet itself has many other health benefits. It is
an excellent way to control weight as appetite is partially
suppressed, risk factors for heart disease including
cholesterol are lowered, and potential for later diabetes are
reduced, as fat is lost from the body and insulin sensitivity
improves. In many ways this type of diet is similar to the
now-proven weight loss diet developed by CSIRO scientists,
‘The Total WellBeing Diet’ and should not be confused
with the many unscientific fad-type diets promoted in
the media. Finally, this type of diet provides all necessary
vitamins and minerals needed for good health at levels
above those accepted as standard for teenagers in the
Australian Nutrient Reference Values.
STUDENT ACTIVITIES
8. How does blood glucose level effect insulin levels and, in
turn, the effect of insulin on hormones linked to acne?
9. After reading about the RMIT study and other case studies
mentioned in this article respond to the following:
a. Describe the diet you would recommend to people
wishing to reduce their incidence of acne.
b. State the facts from the RMIT study on which you have
based your recommendations.
• acne lesions
• insulin levels
• self esteem
• androgen
• social life
• keratin production
10.Describe the health benefits other than the reduced
incidence of acne, that a diet high in low GI foods and low in
high GI foods might deliver.
Figure 5: Percentage change in hormones at 12-weeks
according to dietary group. Fasting insulin and
adrenal androgen DHEA-S and FAI, the measure
of androgenic hormone activity have all significantly
decreased in the experimental group. These changes
are associated with decreased follicle blockage and
less sebum production.
30
Percentage Change
25
20
15
10
5
0
-5
-10
Insulin
Testosterone
Experimental group (n = 23)
Adrenal
Androgen
(DHEA-S)
F u r t h e r activities
Free
Androgen
Index
11.Investigate the GI index of some popular food products.
Make a list of food products which you can commonly eat
with a GI of 55 or less. These foods have low GIs and should
be eaten more frequently than foods with a high GI.
12.Investigate the CSIRO ‘Total Well Being Diet’ and explain
why it has delivered proven health benefits to its users.
Control group (n = 20)
With regards to the hormonal changes (see Figure 5), the
experimental group showed a slight reduction in insulin
levels, whereas the control group showed a significant
increase in insulin levels. The diets also had an affect on
androgen (male hormones) levels. The experimental group
showed a reduction in levels of an androgen produced by
the adrenal gland (DHEA-S), which is known to be active
in sebum production. The free androgen index, a measure
of androgen activity, also decreased in the experimental
group, whereas the control group showed an increase.
Growth factor activity also declined in the experimental
group, lowering the potential for keratin production in the
cells lining the duct, hence decreasing duct blockage.
References
Bendiner, E. (1974). ‘Disastrous trade-off: Eskimo health for white
civilization.’ Hospital Practice 9: 156–189.
Cordain, L., S. Lindeberg, et al. (2002). ‘Acne Vulgaris—A disease of
Western civilization.’ Arch Dermatol 138: 1584–1590.
Fulton, J., G. Plewig, et al. (1969). ‘Effect of Chocolate on Acne Vulgaris.’
JAMA 210(11): 2071–2074.
Mackie, B. and L. Mackie (1974). ‘Chocolate and Acne.’ Aust J Dermatol
15: 103–109.
Schaefer, O. (1971). ‘When the Eskimo comes to town.’ Nutrition Today 6: 8–16
~~
Falling in Love With Food . . .
Valuing the ‘Health’
Of Food, Families and
Friendships
by Aloysa Hourigan
Senior Nutritionist, Nutrition Australia (Qld)
Take a moment to think about eating your favourite food.
Think of the aroma, the taste and texture, and what event
or person you connect that food with . . . it could be
icecream with friends, fresh bread when you pass the local
bakery, the roast dinner your grandmother cooks or the
family barbeque.
Why do we eat?
Is it only to keep our bodies physically healthy? Think
about all the reasons why you eat food. It might be that
we feel hungry but it could also be the sight, smell or
remembered taste of a food that influences what we
choose to eat. From early in childhood we are left with
memories and experiences that relate to particular
foods. As we move on through life those memories can
still trigger certain emotions and feelings. When these
feelings occur we seek out the food that we associate with
that emotion.
This can be part of what Dr. Rick Kausman, author of
‘If not dieting, then what?’, describes as ‘non-hungry
eating’—and the good news is that there is no need to
feel this type of eating is wrong. Instead, Dr. Kausman
suggests it is a good practice to sometimes embrace the
idea of eating our favourite foods, for reasons other than
hunger. He suggests we choose just a small amount and eat
it very slowly, appreciating all its wonderful taste, smell and
texture and the memories that go with it.
When we take our time with food our senses are more
satisfied and the need for ‘more’ is less likely to be there.
A suggestion from Dr. Kausman is to try this the next time
you are looking for that ‘chocolate fix’—take just two small
squares of chocolate, eat one at a time, and keep each
square in your mouth for about a minute or two. Your
senses will be satisfied and it is unlikely that you will need
to reach for more.
What happens when we eat?
We smell and we taste, we share a meal with family and
friends, we stop and relax, we respond to emotions and
sometimes we celebrate a special event. Our senses, our
need to communicate with family and friends and our
emotions are all involved in the act of eating. When we eat
on the run, grab convenience food and make all our food
choices based on what is on the food label we might be
setting ourselves up to break our social bond with the act
of eating and to fall ‘out of love’ with food.
Throughout history the connection between food and
our happiness in life has gained a place in the writings
of philosophers, scientists and other historical figures. A
quote from the times of ancient Persia: ‘Pleasures may
be divided into six classes, to wit, food, drink, clothes,
sex, scent and sound. Of these the noblest and most
consequential is food.’ (Muhammad IBN Al-Hasan Al-Katib
Al-Baghadi). This quote reflects the importance and high
value that was placed on food and the way it contributes
to our enjoyment of life. Today, this connection is being
overshadowed by the intense concern about the nutrient
content of food and its relationship to physical health.
Scientists and consumers alike continue to put all their
energy into the search for the ultimate diet. The search is
for a diet that offers ‘superfoods’ to boost our health and
prevent ageing, quick fixes for problems of overweight,
and restriction of the variety of fresh healthy foods we can
eat. Most of this is based on very little scientific evidence
and the food industry and the media pick up the ‘cure all’
and ‘quick-fix’ messages to sell less healthy processed foods
and expensive food supplements. We are often throwing
away the benefits that savouring food and preparing it and
sharing it with others can bring.
Nutrition Australia’s theme for 2007 is ‘Falling in Love with
Food—value yourself and your health’. It offers a message
about repairing the relationship between ourselves and our
food. At a time when we eat food mostly for its suggested
nutritional value, for the promise of a successful change in
body shape, or because it might be a magical ‘cure all’ we
might be forgetting about some of the other qualities of
food. Sharing meals can contribute to helping our life and
bodies to stay in balance.
STUDENT ACTIVITIES
1. Make a list using the information from this article and add
some thoughts of your own.
a. Why do we eat food?
b. When do we eat food?
c. What influences the type of food we eat?
Add to these lists as you work through the article.
2. Savouring favourite foods slowly is to be encouraged. Explain why.
Even when we have been able to work out how to
satisfy our senses with food, we still have to deal with
the influence of our eating environment. What food is
available, the time we have for eating and social factors
such as who we will share the food with, can all affect
our food choice. You might be able to think of times
when your family and friends have celebrated special
events like birthdays and anniversaries. There are often
many food memories that go with these occasions. Other
factors include the abundance of food, the attraction of
~~
immediate convenience foods, advertising messages, the
cost of food and the memories we have about enjoying
certain foods.
From when we are babies, the relationship between
food and the act of caring for those we love becomes
established. Babies often seek to be fed for comfort rather
than only hunger. Preparing food for families and friends
can be a way of expressing our care and love for them.
The pace of life today with respect to work, school and
family commitments often means people are left with
less time to do simple everyday things such as preparing
a meal, shopping for food and sitting down together to
eat. Advertising and the media encourage us to seek out
the ‘quick’ and ‘instant’ things in life—and one of these
is food. Another strong message is to ‘eat more’. Far less
value is now placed on the benefits of preparing and
cooking food at home. The skills of cooking are more at
risk of being lost with parents now less likely to pass on
these skills to their children. It is odd that while we are
all worrying about overweight and obesity, we forget that
we can have a say about how much and what we eat if we
prepare food ourselves.
Family mealtimes can have another useful role to play in
establishing and maintaining communication in families.
When we eat together we are more likely to communicate
and enjoy a more ‘connected’ feeling. Some studies in
the United States have identified that families who eat
together at least 3–5 times per week are less likely to
see their teenagers troubled by alcohol, drug abuse and
depression.
other things, been exploring this bond between food and
families. The data has shown a strong association between
families who watch television while eating the evening
meal and the level of overweight in their children.
Other findings from the data suggest a link between the
amount of time mothers spend watching television with
their children and their children’s snacking habits. More
hours spent by the mother watching television seem to
encourage more snacking in children. These findings
highlight the importance of how we eat and the eating
environment. Eating meals together has a greater positive
impact on health when the television is turned off and
families talk to each other. In another study in Colac,
Victoria, researchers showed a relationship between
excessive snacking, television viewing time and the
number of televisions in the house.
Making eating an event of its own, where we are conscious
of the taste of food and when we take time with its
preparation can influence how much we eat and our
satisfaction with the meal. Much previous research has
indicated that taking longer over meals (at least 15 to
20 minutes) and not having other distractions such as
television, while eating, allows us to feel more satisfied at
the end of a meal. This can help us not to overeat.
What all the above information suggests is that there
is value in taking time to prepare meals from fresh
ingredients and in sharing these meals with friends and
family. The value is not just for our physical health but
can also benefit our emotional and mental health. The
World Health Organization (WHO) defines health to include emotional, social and mental health along with our physical wellbeing. So the next time you eat,
aim to look after your total health, not just the physical
aspects. Let yourself enjoy the taste and texture of the
food, and let yourself benefit from the act of preparing
and sharing food with your families and friends. Allow
yourself to be ‘Falling in Love with Food’—and value
yourself and your health.
STUDENT ACTIVITIES
3. What is the value to health and wellbeing of taking time to
prepare and have meals with the family?
4. What is the link between watching television and:
a. incidence of overweight in children?
b. snacking habits of children?
5. Explain why the age-old rituals of preparing and sharing
meals together are under threat today.
6. Develop a set of ‘golden rules’ or ‘guiding principles’ for
today’s society to ensure that the 2007 theme for Nutrition
Australia, ‘Falling in Love with Food­­—value yourself and your health’ can be achieved.
Even if teenage children do not exchange many deep
inner thoughts with their parents over the evening meal,
the preparation and sharing of that meal gives parents
an opportunity to express some level of care and support
to their child. Providing food is an act of nurturing
and caring. The mealtime gives both parents and
children the opportunity to at least observe each other’s
mood, whether you are happy or distressed. Family
discussions over meals, even if heated at times, provide
an opportunity for children to give their opinions.
Adolescence is a time when it is important for young
people to be more responsible for themselves and express their thoughts and feelings as individuals, even if at times their views might be different from of
their parents.
The Nepean Longitudinal Study of Young People at
the Children’s Hospital, Westmead (NSW) has, among
References
Fletcher, N., ‘Charlemagne’s Tablecloth’, Weidenfeld & Nicolson. 2004.
Garnett, S., ‘Findings of The Nepean Longitudinal Study of Young People’
Paper presented at the Nutrition Australia AGM, 2005, Canberra.
Proceedings of the National Dietitians’ Association of Australia
Conference, 2006
Kausman, R., ‘If not dieting, then what?’, Allen & Unwin. 1998.
~~
Media Watch
by Dorothy Carey
meals, not just one token meal. Peter Bush said the
chain had made changes over the past few years
to try to offer healthier options, including the
introduction of salads and recently starting to use oil
that is virtually free of trans fats.
$330,000 Buys Maccas The Tick
Of Approval
The cynics might call it nothing more than a public
relations exercise, but the fast-food giant that has
repeatedly been chided for contributing to the
obesity epidemic now says it wants to be part of the
solution.
It has also reduced the sugar in its buns by 50 per
cent, participated in obesity summits around the
country and introduced nutrition labeling.
That, says McDonald’s, is the rationale behind
coming up with nine meals that have, for the first
time, been given the tick by the National Heart
Foundation.
‘Our mantra has been that we want to be part of the
solution to the obesity problem.’ Mr Bush said. ‘This
is really a consistent part of the journey that we’ve
been on.’
The meals include salads, McNuggets, even a burger
or two. But no, you can’t get fries with that.
Deakin University professor in population health,
Boyd Swinburn, a former medical director of the
Heart Foundation in New Zealand, said the situation
was a ‘clear win-win’.
VicHealth chief executive Rob Moodie questioned
whether the program was a marketing ploy that
would help McDonald’s sell more Big Macs by simply
getting more people through the golden arches. If
that were the case, he said, the Heart Foundation
should feel ‘duped’.
‘It potentially has significant public health interests
and it potentially has commercial interests,’ he said.
‘McDonald’s has come under a fairly intense amount
of fire around childhood obesity . . . but it sees a
commercial opportunity in trying to have healthier
options, it sees that that will help its bottom line.
Beyond the PR, this has much more substance to it
than a lot of other things they have announced.’
‘If, on the other hand, this actually led to changing
of consumption patterns, then hooray!’ he said. ‘If
there’s any sense that they’re going to simply sell
more junk food on the basis of improving their
market-ability and reputation and using it as a
smokescreen, then I would be very concerned.’
Carol Nader—The Age, 6 February 2007.
The meals will be available from February 28 in 747
McDonald’s restaurants across Australia.
STUDENT ACTIVITIES
1. Read The article. Make a list of all the positive points raised
to support McDonald’s getting the Heart Foundation’s tick
of approval. Beside each point made, see if you can provide
a counter argument.
2. How much does McDonald’s pay to the Heart Foundation
for the right to use the tick of approval?
3. Explain what costs are involved for McDonald’s and for the
Heart Foundation.
4. What changes have McDonald’s made over the past few
years to offer more healthy food choices?
The fast-food chain has had to make significant
changes to its recipes and is paying $330,000 a year
to earn the Heart Foundation’s tick of approval.
The foundation, a not-for-profit organisation, says
the money goes towards the cost of testing the meals
to make sure they meet standards and auditing the
restaurants.
The national manager of the Heart Foundation’s tick
program, Susan Anderson, said it was a world first
for McDonald’s to change its recipes to meet tough
nutrition standards. She said the meals would keep
the tick only if the new food combinations were not
changed. For instance, salads had to be included in
most meals to meet the required vegetable intake.
Going further
5. Carry out an inquiry activity in your class or school to see
how acceptable the approved McDonald’s meals are for
students. Which of the meal choices would students select.
What percentage of students would still choose the standard
meal with fries?
6. For discussion. Should fast food companies be required to
meet nutritional standards?
7. Given the increasing health problems associated with
overweight and obesity in childhood, suggest other
initiatives that could be implemented in fast food
restaurants to improve the nutritive value of the foods.
8. There have been a lot of articles in the media about fast
food restaurants changing to trans fats for cooking. Find out why the change will be a healthier option for consumers.
‘The key thing here is we know that 2.7 million meals
are sold at fast-food restaurants every day. It’s been
right on our radar to make sure that we’re trying to
improve the meal offerings in these outlets,’ she said.
Ms Anderson said the Heart Foundation wanted
McDonald’s to offer lots of options for healthier
~~
Media Watch
by Dorothy Carey
Are Vitamin Pills
Really As Healthy As
The Claims?
The arguments against using supplements such
as vitamins, minerals and anti-oxidants used to go
something like this: they were unnecessary, they
preyed upon people’s fear of getting sick and, at the
end of the day, they amounted to little more than
expensive urine.
Most skeptics saw them as innocuous enough
because people were not doing themselves any
harm, other than lightening their wallet.
However, concerns that some supplements may
be dangerous were fuelled last week when Danish
researchers warned that too much of vitamins A and
E and beta-carotene could increase the risk of death,
possibly by interfering with the body’s essential
defensive mechanisms.
‘There are a lot of concerns now with these
supplements about what we consider is safe. We
assume that because vitamins and minerals are
found in food, they must always be safe—but that
may not be the case,’ he said.
But the alternative medicine industry believes the
findings from the Danish study are alarmist and
based on high doses not marketed in Australia.
One of the biggest manufacturers of vitamins,
Blackmores, said people who took anti-oxidants
should dismiss the flawed research. The Australian
Self-Medication Industry labeled the findings
dubious and based on products that were controlled
by US regulators who had different rules to the
Therapeutic Goods Administration.
Cathy O’Leary—The West Australian, 6 March 2007.
STUDENT ACTIVITIES
1. List the ‘old’ arguments that are stated in the article against
using dietary supplements.
2. Give reasons why these old arguments are being challenged.
It raised an emerging theory that far from helping
rid the body of dangerous free radicals, anti-oxidant
supplements may be unwanted interlopers.
It is not the first time researchers have suggested
that natural remedies—like prescription drugs—can
have side-effects. Last year, an elderly man died
from acute selenium poisoning after reading on the
internet it could treat his prostate cancer.
Other studies have also identified risks, including
high doses of vitamin A supplements increasing a
pregnant women’s chances of having a baby with
a birth defect, and large doses of vitamin C tablets
increasing the risk of developing kidney stones.
The Australian Medical Association WA’s vicepresident Richard Choong said most people
have a reasonable diet and did not need vitamin
supplements.
3. Explain the ‘new’ information relating to the action of antioxidants.
4. Is it reasonable to assume that because minerals and
vitamins are found in food, they must always be safe? Justify
your response.
5. What is the response to this research from the alternative
medicine industry?
Going further
6 a. What are the functions of vitamins A, E and betacarotene in the body? Use texts to assist you with this.
b. Explain the relationship between beta-carotene and
vitamin A.
c. List the foods with the highest concentrations of each of
these vitamins.
d. Use tables of nutrient composition of foods to identify
the best sources of these vitamins in your diet.
7. Discuss reasons why the manufacturers of dietary
supplements may not want to accept the results of the
Danish study.
General Editor: Dorothy Carey, Nutrition Consultant and Writer
Student activities prepared by: Peter Wright, Assistant Principal, Koonung Secondary College
Editorial Board: Dorothy Carey, Colin Hobbs