Download Health, Nutrition and The Modern Diet

Health, Nutrition and
The Modern Diet
Nancy R. Hudson, MS, RD
Director, Dietetics Program
University of California at Berkeley
Characteristics of the
Modern (US) Diet
More meals (about 50%) eaten away
from home
Often “grazing” replaces meals
Consumers prefer foods which can be
eaten “on the go”
Meals eaten at home are largely
manufactured, not home-cooked
Taste drives food choices
Other thoughts…
Cooking is going the way of other traditions
like building homes and furniture and sewing
clothing
People cook less in designer, well-equipped
kitchens than their grandparents did with a
stove, a refrigerator and a set of pots and
pans
Cooking is becoming a hobby, not a necessity
Changes in our Health
Due to all of the following factors:
Changes in diet
Advances in medicine and
pharmacology
Improvements in sanitation and food
safety
Changes in transportation
Positive Effects
We live longer than our ancestors – life
expectancy now 76.9 years
More of us achieve optimal growth
Fewer nutrient deficiency diseases
Decline in infectious diseases
Food supply is abundant – though not
always evenly distributed
Negative Effects
Obesity
Osteoporosis
Metabolic Syndrome
Diabetes
Some types of
cancers
Gastroesophageal
Reflux Disease
Cardiovascular
disease*
Strokes*
*Rates of these are
declining
Eating Disorders
Though not necessarily related directly to
the food supply, there is a relationship
to the marketing of foods and the mixed
messages of
Eat all you want
Thin is beautiful
BIG
“Fat”
Problem
The Guideline
Guidelines (until this month) were “eat
fewer than 30% of Calories from fat, no
more than 10% from saturated fat, at
least 10% from monounsaturated fat,
about 10% from polyunsaturated fat…..
and, by the way, limit cholesterol to 300
mg. each day
What the Public Heard
Fat is bad for you
Count fat grams, not Calories
Don’t worry about anything else
What Industry Did
Developed tens of thousands of low-fat
or non-fat foods
Found ways to make most of them taste
good
Marketed them as “healthy” food
choices
The Result
Some people limited their fat intake, but
continued to eat excess Calories
The fat that was avoided was the fat could be
seen, which was largely unsaturated
The “invisible” fat, mostly saturated and trans
fatty acids, continued to be eaten – tipping
the balance in favor of these unhealthy fats
Outcomes included obesity and poor serum
HDL/LDL ratios
New Guidelines
20-35% of Calories should come from
fat
Saturated and trans fatty acids are
unhealthy and should be limited
Mono- and polyunsaturated fats have
health benefits and are the preferred
dietary fats
It remains to be seen
how this new message
will be popularized
Problems with Nutrition
Education
The message is complex
Attempts to simplify the message can
actually lead to poor outcomes
Over-reporting of single studies
confuses the public
Too many “experts” out there – with
differing opinions
Headlines are often misleading
Problems with Nutrition
Education
The message is complex
Attempts to simplify the message can
actually lead to poor outcomes
Over-reporting of single studies
confuses the public
Too many “experts” out there – with
differing opinions
Headlines are often misleading
Some examples…
Historically, the “Sippy Diet” used to
treat gastric ulcers led to cardiovascular
disease
The low fiber diet, previously used to
treat diverticulosis, led to constipation
and worsened intestinal disorders
“Avoid red meat” can lead to copper,
iron and zinc deficiencies
More examples…
“Count fat grams” resulted in a disregard for
energy balance and obesity
“Eliminate fat” led to deficiencies diseases
related to EFA’s and some vitamins
“Eat organic” can lead to the exclusion of any
non-organic foods and, as a consequence, to
a variety of nutrient deficiencies
Problems with Nutrition
Education
The message is complex
Attempts to simplify the message can
actually lead to poor outcomes
Over-reporting of single studies
confuses the public
Too many “experts” out there – with
differing opinions
Headlines are often misleading
Nutrition Action
Healthletter (9/02)
“Fast Food 2002 The Best & Worst”
The Best
Wendy’s Mandarin Chicken Salad
Burger King Chicken Whopper Junior
Subway’s Low-fat Subs
McDonalds Fruit ‘n Yogurt Parfait
Burger King BK Veggie Burger
The Worst
Burger King Old Fashioned Ice Cream
Shake
Burger King Fries
Burger King Hash Browns
Burger King Double Whopper with
Cheese
Value Meals
As reported by USA
Today…
“Nutrition Watchdog
Praises
Fast Food Giants”
Two thirds of the column described the
“best” fast foods in detail
One third of the space was devoted to
the “worst”; it described only one of
those foods and merely listed the other
four
Nutrition/Food Policy
Should be based on science, not
emotion
Multiple constituencies need to be
included from the onset
The media is essential to the process
Needs to develop slowly, examining all
alternatives to prevent major errors from
occurring
Case in Point
Local food policy goal is to promote the
use of organic produce in schools and
hospitals
Propose to offset additional costs of
organic produce by cost-shifting, i.e.,
charging specialty restaurants more for
the product to subsidize its use in
schools and hospitals
Non-subsidized costs
Labor for placing separate food order from
additional vendor
Personnel to receive additional delivery
Cost of cleaning and preparation of produce
(non-organic is usually table ready)
Additional costs for processing accounts
payable
Product shelf life may be shorter
Less marketable appearance of some
products
Food Policy that has
worked
Iodization of salt
Fortification of milk with Vitamin D
Enrichment of cereals and grains
(including the recent addition of folic
acid to prevent neural tube birth
defects)
Industry-driven Change
The industry will change if consumers
demand it
It will also change if there is a marketing
advantage
Sometimes responding to the health
needs of the population has a long-term
advantage
It’s OK for industry to be profitable
Industry-driven Changes
that have worked
Fortification of orange juice with calcium
Removal of “lard” from General Mills’
Bisquick
Removal of “lard” from Nabisco’s Oreo
Cookies
Campbell’s Healthy Request Soups
Brands like Lean Cuisine and Healthy
Choice
Oil Change at
McDonalds
Not a panacea
Addresses the “type of fat” dilemma
Ignores the “amount of fat” dilemma
Many of my colleagues say it is not
enough
New oil has long-term potential to alter
the serum HDL/LDL ratio for the better,
for those who frequent McDonalds
Hidden Costs
New type of oil is more expensive (though
probably not significantly for such a large
user)
Oil has lower smoke point thus needs to be
changed more often, so both labor and raw
material costs increase
Since cooking oil cannot be discarded, the
recycling of more used oil also adds to the
total cost
The message of good
nutrition is not simple…
Adequacy
Balance
Moderation
Variety
Caloric Density
Get Moving!!!
In conclusion…
I believe that we are moving in the right
direction and that partnerships between
food and nutrition scientists, dietetics
practitioners, industry, and the
government will facilitate progress, not
inhibit it.