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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.