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School fundraiser is just "junk-food marketing to kids," experts say

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School fundraiser is just "junk-food marketing to kids," experts say

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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In a week, NFL team devours dozens of eggs, hundred pounds of meat

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In a week, NFL team devours dozens of eggs, hundred pounds of meat

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Newsela | In a week, NFL team devours dozens of eggs, hundred pounds of meat

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Most NFL teams have nutritionists, who create specialized meal plans based on players' body composition.

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Food companies try to meet U.S. standards and earn "healthy" label

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Food companies try to meet U.S. standards and earn "healthy" label

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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Attempts to get kids to eat healthier lunches do not seem to be working

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Attempts to get kids to eat healthier lunches do not seem to be working

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Newsela | Attempts to get kids to eat healthier lunches do not seem to be working

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Attempts to get kids to eat healthier lunches do not seem to be working

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Attempts to get kids to eat healthier lunches do not seem to be working

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Newsela | Attempts to get kids to eat healthier lunches do not seem to be working

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Junk food, not just fast food, to blame for obese kids in U.S.

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Junk food, not just fast food, to blame for obese kids in U.S.

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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Dumping the veggies and grabbing some Pop-Tarts

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Dumping the veggies and grabbing some Pop-Tarts

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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Cereal companies update products to keep pace with healthier consumers

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Cereal companies update products to keep pace with healthier consumers

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Newsela | Cereal companies update products to keep pace with healthier consumers

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Cereal companies update products to keep pace with healthier consumers

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Cereal companies update products to keep pace with healthier consumers

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Newsela | Cereal companies update products to keep pace with healthier consumers

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Cereal companies update products to keep pace with healthier consumers

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Cereal companies update products to keep pace with healthier consumers

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Newsela | Cereal companies update products to keep pace with healthier consumers

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Dole hopes to appeal to kids by using Disney characters on its packaging

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Dole hopes to appeal to kids by using Disney characters on its packaging

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Newsela | Dole hopes to appeal to kids by using Disney characters on its packaging

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HealthJuices and smoothies may not be as healthy as many think, experts say

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HealthJuices and smoothies may not be as healthy as many think, experts say

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Newsela | Juices and smoothies may not be as healthy as many think, experts say

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In one gulp you get instant energy and lots of vitamins and minerals, say the ads for juices and smoothies. But experts warn that the drinks are high in sugar and calories and not so healthy.

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Military leaders fear America’s youth can’t make the cut

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Military leaders fear America’s youth can’t make the cut

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Newsela | Military leaders fear America's youth can't make the cut

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When the U.S. military decided in January to drop a long-standing ban against women serving in combat roles, it was not just doing it to be fair -- it was doing it to help solve a recruitment problem.

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Newsela | Hunger problems in U.S. could be fixed by replacing meat with plants, study says

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Newsela | Benefits and risks of biotechnology

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Issue Overview: GMOs and engineered food

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Issue Overview: GMOs and engineered food

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Newsela | Issue Overview: GMOs and engineered food

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From farm to lab to table, a tale of tomatoes and a top banana

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From farm to lab to table, a tale of tomatoes and a top banana

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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You'd be surprised how much confusion there is about basic food facts

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You'd be surprised how much confusion there is about basic food facts

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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WHO says removing trans fats from the food supply will save lives

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WHO says removing trans fats from the food supply will save lives

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Newsela | WHO says removing trans fats from the food supply will save lives

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The World Health Organization issued its plan to remove trans fats from the global food supply.

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Chefs compete to make tasty, nutritious school lunch for $1.25

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Chefs compete to make tasty, nutritious school lunch for $1.25

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Newsela | Chefs compete to make tasty, nutritious school lunch for $1.25

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Some top restaurant chefs competed to see who can make creative school lunches that students will want to eat. The biggest challenge: the ingredients can't cost more than $1.25.

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A cooking-as-medicine revolution is entering the health care world

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A cooking-as-medicine revolution is entering the health care world

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Newsela | A cooking-as-medicine revolution is entering the health care world

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Equal Eating: Should all students receive free meals at school?

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Equal Eating: Should all students receive free meals at school?

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Should all Vermont students receive free meals at school? New research says it could impact your child's education and well-being, and one Vermont district has implemented the program at all its schools.

Franklin Northeast Supervisory Union business manager Morgan Daybell says their board decided to expand the lunch program so all district students could eat for free. He says lunch participation is already up 10 to 30 percent in places like Bakersfield.

"It's still a bit of an experiment for us" Daybell said.

He admits there was some pushback from board members who were concerned about using local property tax dollars to fund these programs. Adding the three schools could cost up to $100,000. which sounds like a lot, but is actually only .3 percent of their district's $33 million budget.

Reporter Cat Viglienzoni: In your opinion, is that money well spent?
Morgan Daybell: It is. And I think the money that we're going to be getting through the program to expand it is well spent.

Most school districts would probably tell you that they would like to provide a free meal for everyone but it's just not in the budget. And that's why advocates are now pushing for data to back up claims that universal free meals are worth the money.

"There's very little research out there on the benefit of universal school lunches on school academics and school climate," said Bernice Garnett, an associate professor at The University of Vermont's College of Education & Social Services.

So Garnett launched a study in 2017 to look at just that. She surveyed more then 240 school staff around the state and is doing in-depth studies at two schools. She found universal meals contributed to:

- Greater access to food
- More local food in cafeterias
- Increased readiness to learn
- Less financial stress for students, families, and administrators
- Fewer visible income disparities among students
- Better overall social climate in schools

"It really created a culture of equity," Garnett said.

"We are committed to making universal school meals a reality in every school in Vermont," said Anore Horton with Hunger Free Vermont.

The group worked with UVM on the study and is already looking at how Vermont lawmakers could help each student get their meals at school. They have not done any estimates yet on how much it would cost state taxpayers and Horton knows any tax increase is a tough sell amid calls for budget cuts.

"It's not an easy conversation for school districts to have with their communities," Horton said.

But she says it's necessary because the finding in the study that surprised her most was the drop in bullying. Bullying, she says, stems from displaying a family's income in the school cafeteria. "They're set up to have some kids feel like they're the poor kids," Horton said.

And for those who send their kids to school with homemade lunches and who might be skeptical, Horton says there are a few reasons families might consider school meals: One, they are already helping fund lunch programs with their tax dollars. Two, the property tax increase to pay for the program would be less than the amount that family would spend to buy the meals themselves. And three, they won't have to worry about packing a lunch each day.

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equal eating: should all students receive free meals at school?

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Equal Eating: Should all students receive free meals at school?

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Should all Vermont students receive free meals at school? New research says it could impact your child's education and well-being, and one Vermont district has implemented the program at all its schools. Franklin Northeast Supervisory Union business manager Morgan Daybell says their board decided to expand the lunch program so all district students could eat for free.

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The global food problem isn’t what you think

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January 2 Gerald C. Nelson is a professor emeritus at the University of Illinois at Urbana-Champaign and a former senior research fellow at the International Food Policy Research Institute.
Providing food security to the nearly 10 billion people who will inhabit the globe by 2050 is one of the key issues of the 21st century. Given that reality, you might think the international community would at least be able to agree on how to define the problem.

Unfortunately, you would be wrong.

While a large part of the agricultural research establishment is focused on one aspect of the challenge - calories - another part of the scientific community is focused on a related but different one: adequate nutrient consumption.

To this point, the first group has driven the world's agricultural research agenda. But a new study I co-authored with a group of international scientists and recently published in Nature Sustainability suggests that calorie fundamentalism is leading us down a dangerous path.

Our group looked at both the question of how much food will be available during the next three decades and the question of whether this food will meet our nutritional needs.

With a depth and breadth that goes far beyond previous studies, we made assessments for 158 different countries of the current supply of macronutrients, such as carbohydrates, protein and fat, and micronutrients, such as vitamins and minerals needed for good health, cognition and productivity. We then forecast the country-by-country needs in 2050, when the global population will have increased by about 2.1 billion and when the economies of these countries will likely have expanded. Finally, to provide both best- and worst-case scenarios, we projected a future without climate change and one with extreme climate change.

Here's what we found:

Under even the worst conditions, there will be enough food, if we define "enough" as meaning sufficient calories, on average, for everyone - with 2,000 calories per day as the standard requirement. Of course, this doesn't mean everyone will actually get enough to eat; it doesn't mean that today either. Civil wars, poor roads and income disparities will likely produce hunger in 2050, as they do today. But helping these people is a question of access, not availability.

In fact, our research shows there will be more calories available per capita in 2050 than now. This is true in all five of the income quintiles into which we categorized the world's people and even in the face of our extreme climate change scenario. Here's why:

First, we found that the positive impact of income growth that is widely anticipated between now and 2050 overwhelms the negative impact of climate change. On average, people who need more food will be better able to afford it. Second, the post-World War II Green Revolution efforts to boost the productivity of staples such as wheat and rice have been so successful that we are now awash in carbohydrates. And because so much has already been invested in improving the productivity of these crops, solid yield gains will likely continue for the next few decades. The productivity enhancements have also made them more affordable relative to other foods that provide more of the other needed nutrients.

Our success with carbohydrates, however, has had a serious downside: a worldwide plague of obesity, diabetes and other diet-related diseases. The World Health Organization reports that in 2014, there were 462 million underweight adults worldwide but more than 600 million who were obese - nearly two-thirds of them in developing countries. And childhood obesity is rising much faster in poorer countries than in richer ones.

Meanwhile, micronutrient shortages such as Vitamin A deficiency are already causing blindness in somewhere between 250,000 and 500,000 children a year and killing half of them within 12 months of them losing their sight. Dietary shortages of iron, zinc, iodine and folate all have devastating health effects.

These statistics point to the need for more emphasis on nutrients other than carbohydrates in our diets. And in this area, our findings are not reassuring.

Micronutrient deficiencies are a problem today even in the world's richest countries and are widespread elsewhere. Our forecasts show these deficiencies are likely to continue under all scenarios and that climate change could make them worse in some regions.

Our findings thus point to the need for a course correction. While we prepare to adapt to climate change, which will likely produce major and somewhat unpredictable effects on future food supply, we must also prepare for the decades immediately ahead. We must shift our emphasis from food security to nutrition security.

A major effort must be made to increase the productivity - the yield per hectare - of nutrient-rich foods such as fruits, vegetables, nuts, seeds and beans. By enhancing their productivity, we'll make them more available and affordable. And we'll see the benefits in a diminished obesity crisis and fewer victims of micronutrient deficiencies.

Agricultural research, however, generally takes years to pay off. It's magic, but it's slow magic. We need to start now.
Read more: Patty Stonesifer: 1 in 4 D.C. children can't access affordable, nutritious food. This has to change. Post Opinions Staff: How we can combat climate change Jennifer Rubin: How to get a handle on hunger Francisco Toro: Venezuela's hunger crisis is for real Paul Polman and Daniel Servitje: The global challenge of food and nutrition security

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Opinion | The global food problem isn't what you think

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January 2 Gerald C. Nelson is a professor emeritus at the University of Illinois at Urbana-Champaign and a former senior research fellow at the International Food Policy Research Institute. Providing food security to the nearly 10 billion people who will inhabit the globe by 2050 is one of the key issues of the 21st century.

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Charts of the nutrients in a variety of foods--fruits, meats, vegetables, dairy, etc.

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Fruit Chart | Nutrient chart | Vitamins and minerals in common fruits

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Fruit chart: nutrition chart with pictures provides an easy cross-reference for vitamin and mineral content in fruits and vegetables.

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Changes to Dietary Guidelines Needed to Preserve Our Sanity

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Changes to Dietary Guidelines Needed to Preserve Our Sanity

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Since the most recent incarnation of the Dietary Guidelines for Americans was released by the USDA in December 2015, a debate has raged about the scientific process (or lack thereof) used to generate the nutrition policies that dictate how schools, hospitals, and other institutions feed people, and how people across the country think about food. In response to widespread criticism, the USDA sought public comment about the recommendations this month, and received thousands of submissions.

I have studied the guidelines in some depth and discovered countless inconsistencies, omissions, biases and errors within this 144-page document that cause me great concern--both as an American citizen and as a psychiatrist specializing in nutrition. [For my tragicomic critique of the 2015 Dietary Guidelines Advisory Committee report, upon which the guidelines are based, please see: US Dietary Guidelines Hazardous to Health?]

I am convinced that our national nutrition recommendations pose significant risks to brain health that our society cannot emotionally or financially afford. For this reason, I am sharing the commentary I submitted to the USDA here in hopes that it may help shed light on the controversies at hand, and suggest a healthier way forward.

TOPIC: How well do USDA Food Pattern variations meet nutrient recommendations for children and adults?

Thank you for this opportunity to provide feedback about the US dietary guidelines generation process. I am writing not to take issue with any one dietary pattern, beverage, supplement, or nutrient, but rather to question (and make constructive suggestions about) the overall process by which the DGAC generates our national nutrition guidelines. The current process, by its very nature, interferes with the ability to arrive at meaningful recommendations with the power to improve public health, and leads to increased risk for nutrient deficiencies in children and adults of all ages.

As a psychiatrist specializing in college mental health who has studied and written about nutrition for the past ten years, I have grown increasingly concerned with the decline in mental health in our country and am convinced that the decline in the quality of our national diet is playing a major role in this growing epidemic. I am concerned that our nation's dietary guidelines are part of the problem rather than part of the solution. Our current guidelines are convoluted, constantly changing, and so complex as to require 144 pages of explanation. This document confuses and frustrates even the savviest reader. We need guidelines that are clear, transparent, internally consistent, and easy to understand and implement. Approached properly, our national guidelines have the potential to serve as a source of knowledge and empowerment for all Americans striving to live long, healthy lives. It is my sincere hope that constructive, progressive change to the way the guidelines are generated would improve the public's trust in the process, as well as improve public health.

Our current process for generating the national dietary guidelines fails the American people in that it:

1. Views nutrition from the outside in rather than from the inside out.

Currently, the Dietary Guidelines focus on a few arbitrarily-chosen dietary patterns hypothesized to be healthy by DGAC committee members. In human clinical trials, when compared to the modern "Standard American Diet" which is high in processed foods, each of these diets represents healthy improvements. However, this does not mean that these patterns represent the healthiest diets possible, only that they are superior to the unhealthiest diet one can imagine. There are countless other patterns just as worthy of study which are dismissed or not considered at all, thereby generating mistrust in the process among people who follow different diets which they experience as healthy. One could argue that the very focus on dietary patterns is unhelpful, given the myriad patterns possible. Wouldn't it make more sense to approach questions about human nutrition from the inside out-by focusing on what the body needs to function properly and how it processes various foods, and using this information to determine which foods are best able to meet our common requirements? Truly valuable guidelines would go beyond recommending complicated, arbitrary patterns to educating and empowering people to make healthier choices within their chosen dietary patterns.

2. Prioritizes nutritional epidemiology over other scientific methods.

The vast majority of USDA guidelines are founded on hypotheses generated by epidemiological studies. Nutritional epidemiology is a notoriously flawed methodology, resting on inherently inaccurate food frequency questionnaires that generate weak, inconsistent, biased, and confounded associations. In stark contrast to cigarette smoking or infectious diseases caused by single agents-examples of public health problems which are well-served by epidemiological methods-there are simply too many variables in the modern human diet to properly account for with this approach.

Nutritional epidemiology is notorious for generating extremely weak, inconsistent associations between various foods and diseases. In fact, it has been determined that 80% or more of hypotheses generated by nutritional epidemiology are later proved false in clinical trials. By my count, of the 14 members of the DGAC, 9 are professional nutritional epidemiologists. Therefore, the majority, by virtue of their chosen professions, are likely to overestimate the value of observational studies. Fortunately, there is a wealth of high quality information to be found in other fields of science upon which to base our nutrition guidelines, including biochemistry, physiology, botany, anthropology, toxicology, and human clinical trials.

3. Places undue focus on isolated laboratory values rather than overall health.

An excellent example of how the over-reliance on epidemiological associations misinforms dietary policy is the focus on LDL. In medical school we were wisely taught to "treat the patient, not the lab test." It is gradually becoming clear that the relationship between cholesterol tests and cardiovascular disease is complex, and that unfractionated LDL levels are the weakest predictors of future heart disease ( compared to HDL and triglyceride levels). Tragically, our decades-long obsession with LDL reduction has distracted us from the search for root causes of cardiovascular disease such as inflammation, oxidation, calcification, insulin resistance, and endothelial dysfunction.

Focus on LDL reduction has also led to the strange and dangerous recommendation by the USDA to replace natural saturated fats with industrially-produced, refined seed oils, such as soybean and cottonseed oils. These modern oils tend to be extremely high in linoleic acid (LA), the essential omega-6 fatty acid necessary for mounting an inflammatory response to injuries and infections. Linoleic acid is readily obtained from both plant and animal foods, so there is no need to go out of our way to obtain more of it by consuming refined seed oils.

Furthermore, it is well-established in the scientific literature that an excess of omega-6 fatty acid competes with and reduces the availability of precious omega-3 fatty acids (namely, EPA and DHA). EPA generates anti-inflammatory molecules necessary for resolving and healing cellular damage. When EPA products are outnumbered by LA products, inflammation-the cornerstone of most chronic disease-predominates. DHA comprises 20% of the brain's fat content and is critical to cortical development and myelination, as well as to the structure and function of retinal photoreceptors, cardiac cells, and mitochondrial membranes throughout the body. EPA and DHA are far more challenging to obtain from most standard omnivorous diets in that they are found in seafood and pastured animal organs/fats and do not exist in plant foods. It is well-established that the human body converts very little, if any, plant-sourced omega-3 fatty acids into the EPA and DHA our bodies require, therefore we must consume pre-formed sources of these essential fatty acids directly from animal foods (or take supplements). Misplaced focus on LDL and unnecessary avoidance of saturated fat has resulted in guidelines that inadvertently contribute to depletion of DHA from our hearts and brains and EPA from our immune systems, setting the stage for widespread inflammation and chronic disease.

4. Displays clear evidence of pro-plant bias.

The most recent DGAC was too homogeneous in that plant-based dietary philosophies were over-represented at the expense of other viewpoints. Of the 14 DGAC members, 9 had conducted studies focusing on the health benefits of plant ingredients and/or plant-based diets, and two had written books promoting plant-based diets. Therefore, most of these researchers had staked their careers at least in part on the theory that plant foods are superior to animal foods. Pro-plant bias (whether conscious or unconscious) within the committee likely clouded its ability to objectively evaluate and compare the nutritional qualities of plant and animal foods, resulting in guidelines that imply we should limit animal foods and strive to consume large quantities of plant foods.

Thus, the committee found itself in the shameful position of explicitly recommending that up to 50% of our daily grain intake be in the form of enriched refined grains, despite overwhelming evidence that refined carbohydrates are exceedingly unhealthy. The rationale for this absurd position is that without these fortified processed foods the "healthy" dietary patterns put forth in the guidelines would be lacking in key essential nutrients that are difficult to obtain from plant foods, yet easy to obtain from animal foods, such as B vitamins. How did human beings obtain essential nutrients prior to the invention of processed foods? This is the kind of common-sense question not being asked as part of the current process.

The consumption of refined carbohydrates can lead to chronically elevated insulin levels, which promote inflammation, oxidation, and insulin resistance throughout the body, including at the blood-brain barrier. Insulin resistance, which now affects more than 50% of Americans, is a driving force behind many chronic diseases, including obesity, type 2 diabetes and Alzheimer's disease.

Additional problematic evidence of pro-plant bias is the lack of responsible acknowledgment of and warnings about risk of serious micronutrient deficiencies inherent in vegan diets unless properly and carefully supplemented. The 144-page dietary guidelines for 2015-2020 devote just a single sentence to vegan diets: "This [healthy vegetarian] Pattern can be vegan if all dairy choices are comprised of fortified soy beverages (soymilk) or other plant-based dairy substitutes." This simple statement sanctioning a vegan diet does not clearly state that plant-based dairy substitutes must be fortified with B12 and neglects the importance of proper supplementation of long-chain omega-3 PUFAs (DHA and EPA) and vitamin K2, which are not found in plant foods. It also includes no warnings about the risks of serious nutrient deficiencies which are more common among vegans than omnivores, including: B12, B2, iodine, zinc, EPA and DHA deficiencies.

5. Displays clear evidence of anti-meat bias.

As a psychiatrist I was curious to understand the reasoning behind the DGAC's conclusion that diets lower in red meat reduced risk for depression. There is clear evidence that the DGAC not only cherry-picked studies to support its stance against red meat, but that it misrepresented the studies it chose to review. I took the time to read every study the DGAC cited in support of its findings and was appalled to find that they did NOT support the notion that red meat increases risk for depression (!). My complete analysis of the studies concludes:

"In summary, 16 studies look at meat. One of them suggests meat increases risk for depression, six of them suggest that meat mixed with junk foods increases risk for depression, NINE studies specifically exonerate meat, including BOTH of the RCT's, and one of the RCT's found that eating MORE red meat was actually PROTECTIVE against depression."

Anti-animal food bias clearly prevented the committee from objectively and honestly evaluating all of the available science.

6. Fails to properly and critically evaluate the nutritional quality of whole foods.

The guidelines are inconsistent in taking bioavailability concerns into account when comparing the nutrient content of plant and animal foods. Just because a food contains a nutrient does not necessarily mean we can access it. It is well-known that many plant foods naturally contain compounds which interfere with our ability to digest, absorb, and utilize many essential nutrients from plant and animal foods.

For example, the committee assumes human beings need to consume whole grains and legumes to be healthy, yet there is no scientific evidence I'm aware of demonstrating a nutritional requirement for grains of any kind in the human diet. Whole grains are presumed to be healthy because of the plethora of studies demonstrating that diets including whole grains are healthier than diets including refined grains, not because there are any studies demonstrating that diets including whole grains are healthier than diets without any grains at all. When one looks closely at the components of grains, one finds very little in the way of nutrients (to the point that we go out of our way to fortify them) and significant amounts of anti-nutrients and natural toxins including phytates, lectins, and protease inhibitors not found in animal foods. Nutrition experts must do the hard work of studying not just nutrients within foods but all components within foods that affect our health.

Conclusion

My own health deteriorated following the USDA guidelines; it was only by abandoning the guidelines and starting from scratch to learn nutrition on my own, from the ground up, that I was able to restore my own good health.

To generate truly meaningful dietary guidelines, future committees must start from scratch as well. To continue to make modifications to an inherently flawed foundation composed of weak epidemiological associations, biased assumptions, and arbitrarily-chosen dietary patterns will not significantly improve the quality of the final product. We need a more diverse, less entrenched, more scientifically rigorous committee that openly declares its personal, professional, and financial biases. There is nothing inherently wrong with bias-all humans have their biases-it is in acknowledging them that we stay honest with ourselves and others about our blind spots.

If we choose as a nation to publish highly influential nutrition guidelines that dictate how our hospitals, schools, and other institutions feed people, then it is my sincere hope that future committees be comprised of individuals representing a diversity of (declared) nutrition philosophies-so that we avoid the appearance of dietary favoritism-as well as a diversity of scientific disciplines-even from outside of the nutrition sciences, perhaps even several representatives from non-biological sciences-so that we avoid the risk of building our guidelines on unrecognized assumptions about foods that may need to be questioned.

A responsible committee would openly acknowledge areas of nutrition controversy and doubt to foster ongoing research. If we truly care about the health and well-being of our fellow human beings, we owe it to ourselves and others to stay curious and open-minded. We must take the time to learn and appreciate how the foods we choose to eat operate within the human body, to understand and be honest about the real risks and benefits of the diets we personally eat and professionally recommend, and to acknowledge the limitations of our knowledge. The healthier the process is, the healthier our nation will be.

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Changes to Dietary Guidelines Needed to Preserve Our Sanity

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Since the most recent incarnation of the Dietary Guidelines for Americans was released by the USDA in December 2015, a debate has raged about the scientific process (or lack thereof) used to generate the nutrition policies that dictate how schools, hospitals, and other institutions feed people, and how people across the country think about food.

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Walk into any grocery store, grab a few packaged products, and flip to the ingredients. You'll likely spot added sugars - lots of them - provided you can discern their dizzying array of names: sucrose, dextrose, barley malt, agave nectar, high-fructose corn syrup, treacle, to list just a few.

Why is our food saturated with all these sweeteners? When did they make their way into our yogurt, cereal, and oatmeal? How did they sneak into our salad dressing, soup, bread, lunch meat, pasta sauce, and pretzels?

And, most crucially, what forces are responsible for this deluge, which is making some of us very sick?

UCSF scientists are uncovering the answers to those questions. What they're finding is that the food and beverage industry pushes sugary products, while obfuscating the significant health hazards of added sugars. UCSF researchers are scrutinizing this influence, scouring the research to better understand sugars' link to disease, and fighting biased science by exposing industry tactics and educating the public.

The more we eat, the sicker we get

When Dean Schillinger, MD, was a resident at San Francisco General Hospital in the early 1990s, almost half his patients had HIV or AIDS. Today, he's chief of general internal medicine at the hospital, and a new crisis occupies him: Nearly half his patients have type 2 diabetes. Many grapple with its horrific toll, including blindness, kidney failure, amputations, heart attacks, and strokes.

"Our AIDS ward has become a diabetes ward," says Schillinger. "It happened in front of my eyes in basically one generation."

Startling statistics bear out Schillinger's experience: Since 1970, the incidence of diabetes has more than tripled (type 2 diabetes accounts for about 95 percent of that increase). In California alone, 11 percent of adults have diabetes and 46 percent are prediabetic. That adds up to over half the state's population. Another troubling fact: People of color and those at lower income levels are at higher risk of having type 2 diabetes and are getting it at younger and younger ages.

Nearly one in four teens has prediabetes, placing them at very high risk of acquiring full-blown diabetes within 10 years, in the prime of their lives. About one in two children of color born today will be diagnosed with type 2 diabetes during their lifetimes.

It's not the only disease that's reared its ugly head in recent decades. Nonalcoholic fatty liver disease - a buildup of extra fat in liver cells, which can lead to cirrhosis, or scarring of liver tissue - wasn't even a known diagnostic entity 30 years ago. Now almost one-third of U.S. adults have it. The disease is on track to become the leading cause of liver transplantation within five years. And doctors are treating the first generation of kids with fatty livers.

The dramatic spike in these diseases isn't caused by genetic changes, a common misbelief, says Schillinger. "Something in the environment has changed."

That "something" includes many societal shifts - such as sedentary lifestyles and larger portion sizes - as well as greatly increased consumption of added sugars, say Schillinger and others.

Americans eat far more packaged foods and consume more sugary beverages than we did 50 years ago. And sweeteners are almost impossible to escape: They're in three-fourths of packaged products. Liquid sugar, in the form of sodas, energy drinks, and sports drinks, represents 36 percent of the added sugar we consume. On average, Americans eat about 17 teaspoons of added sugars every day - substantially more than the U.S. Dietary Guidelines' recommended maximum of 12 teaspoons on a 2,000-calorie diet. That adds up to a whopping 57 pounds a year.

"Our food system is completely out of whack," says Laura Schmidt, PhD, MSW, MPH, a professor of health policy and the lead investigator of UCSF's SugarScience initiative.

A growing body of scientific evidence now links long-term overconsumption of added sugars to diabetes, cavities, liver disease, and heart disease. Much of this evidence focuses on a cluster of metabolic issues, known collectively as metabolic syndrome (MetS), that raises people's risk of developing chronic diseases. These issues include insulin resistance, elevated blood sugar, high blood fats (triglycerides), high cholesterol, high blood pressure, and a condition known as "sugar belly."

One of the main culprits in MetS is fructose. Fructose is found naturally in fruits and honey, but in processed foods and sodas it's been extracted from corn, beets, or sugarcane, stripped of fiber and nutrients, and concentrated. Nearly all added sugars, even healthy-sounding ones like organic cane sugar, contain significant fructose. Table sugar, for example, is 50 percent fructose. The most common type of high-fructose corn syrup, a concentrated, liquid form of added sugar, is about 55 percent fructose.

The problem with fructose is that the body can turn only so much of it into energy; the liver transforms the rest into fat globules called triglycerides, which in excess can wreak havoc. The liver releases some of these into the bloodstream, causing "sugar belly" (an especially dangerous form of body fat) and raising cholesterol levels (which are linked to heart disease).

Even worse, the triglycerides that stay in the liver affect insulin's ability to regulate blood sugar, a condition known as insulin resistance. This causes more fructose to be turned into fat and accelerates the amount of fat the liver releases into the blood. It's a vicious cycle - one too many Americans are trapped in.

With almost half of Californians and millions of others nationwide at risk of developing full-blown diabetes, "we are sitting on a ticking time bomb," says Schmidt.

Documents reveal scientific shenanigans

In 2007, Cristin Kearns, DDS, MBA, began an unlikely journey that would shed light on some of the forces that helped push us to this brink. Her foray began years before she became an assistant professor at UCSF, at a dental conference on the connection between gum disease and diabetes. One of the keynote speakers gave his seal of approval to Lipton Brisk, a sugar-laden tea. Aghast, Kearns chased him down and asked how he could possibly call sweetened tea healthy. "There is no evidence linking sugar to chronic disease," he calmly replied.

"I was speechless," Kearns recalls. "I literally had no words."

After all, she had seen how sugary drinks damaged her patients' oral health. Some had cavities in every tooth, and she knew tooth decay was the leading chronic disease afflicting kids.

Another speaker at the conference, this one from the federal government's National Diabetes Education Program, shared a dietary advice pamphlet that said nothing about sugar intake. "I found that strange," says Kearns. She had worked in an inner city clinic where many patients had diabetes, and it was clear to her that excess sugar played a role in their disease.

What was going on? Kearns couldn't let go of that question, so she went home and started researching sugar. Driven by a nagging hunch, she focused on the players behind the disconnect between her experience and what she heard from "experts." Up popped the website of the Sugar Association, a trade group that dates back to 1943; its members include Domino Sugar, Imperial Sugar, and other sugar producers.

The more Kearns unearthed about the Sugar Association, the more convinced she became that they were influencing science and federal policies.

The more Kearns unearthed about the Sugar Association, the more convinced she became that they were influencing science and federal policies. She quit her job to dig into archives all across the country. One day, she hit the mother lode: 1,500 internal Sugar Association documents related to a public relations campaign the industry had launched in 1976. The documents clearly showed the industry's plan to influence the Food and Drug Administration's regulatory review of the safety of sugar. "I couldn't believe I'd found it," she says.

Kearns came to UCSF as a postdoctoral fellow in 2013 to learn how to analyze industry tactics, drawn by the faculty's expertise combating the tobacco industry. In the 1990s, UCSF's analysis of thousands of tobacco industry documents showed that tobacco companies had known about the grave dangers of smoking for decades, but they withheld that information from the public to protect their profits.

The fruits of her labor revealed the sugar industry's decades-long strategy to downplay sweeteners' potentially harmful health effects. She found strong evidence that the industry had manipulated science to protect its commercial interests, influence regulations, and shape public opinion. (The industry has disputed this assessment through public statements by the Sugar Association.)

One of her studies, published in JAMA Internal Medicine, showed that the Sugar Research Foundation, which later become the Sugar Association, recognized as early as 1954 that if Americans adopted low-fat diets, then per-capita consumption of sucrose would increase by more than one-third.

By the mid-1960s, however, researchers had begun wondering whether sugar might be related to heart disease. The Sugar Research Foundation paid three Harvard scientists today's equivalent of $50,000 to review the existing research on sugar, fat, and heart disease. Their analysis, published in the prestigious New England Journal of Medicine ( NEJM), minimized the link between sugar and heart health and promoted fat as the culprit instead.

"It was clearly a biased evaluation," says Kearns, who spent a year analyzing the communications between the industry and the researchers, as well as the studies included in the review. "The literature review helped shape not only public opinion on what causes heart problems but also the scientific community's view of how to evaluate dietary risk factors for heart disease," she says.

These tactics contributed to the low-fat craze, which began in the early 1970s and paralleled a rise in obesity, according to Kearns and Schmidt. Many health experts encouraged Americans to reduce their fat intake, which led people to eat foods low in fat but loaded with sugar (think SnackWell's cookies). The trend is an example of "how industry has deeply penetrated science in order to distort the facts about what's good for our health," says Schmidt, a co-author of the JAMA paper.

Another of Kearns's studies, published in PLOS Biology, showed that the industry also withheld critical scientific evidence. In 1968, the Sugar Research Foundation funded a research project on animals to illuminate the connection between sugar and heart health. Early results uncovered a potential link between sucrose and bladder cancer. Within weeks of obtaining conclusive evidence that sucrose elevates blood triglycerides by interacting with gut bacteria, the foundation ended the study. The results were never published. At the time, the FDA was deciding whether to take a hard stance on high-sugar foods. Kearns says if the results had been made public, sugar might have been more heavily scrutinized.

With thousands of documents still to analyze, and more archives being identified, she believes she has just scratched the surface of the industry's influence. "It's vast," she says. "I could be doing this for years."

Diabetes expert Schillinger has also been probing biases in sugar science. In a report in the Annals of Internal Medicine, co-authored with Kearns, he reviewed the 60 studies between 2001 and 2016 that looked at whether sugary drinks contribute to obesity or diabetes. Of the 26 studies that found no link, all were funded by the sugar-sweetened-beverage industry or conducted by people with financial ties to the industry. Of the 34 studies that found a link, just one was funded by the beverage industry; the rest were independently funded.

"It was by far the strongest relationship ... I've observed between conflicts of interest and science," Schillinger says.

Stop blaming yourself

Since sugar-related chronic diseases are largely preventable with changes in diet and physical activity, there's a tendency to point fingers at people for making bad choices and being lazy. Soda companies add to the cacophony by claiming their products can be enjoyed as part of a healthy lifestyle.

Such ideas are bunk, say sugar scientists.

"We need to stop blaming individuals for getting sick and start changing our crazy food environment," says Schmidt. "It puts an incredible burden on individuals. People's choices are very limited when 74 percent of our food has added sugar." And that burden falls most heavily on those without the time and money to purchase and prepare healthy foods.

Scientists and policymakers can change the environment by pursuing the same public health prevention strategies used to combat Big Tobacco, Schmidt says.

"It's easy to forget that back in the '50s and '60s, smoking was the norm," she explains. People smoked on airplanes, at work, in restaurants, even in hospitals. "You could buy cigarettes in our medical center vending machines," she says. "Public health officials changed the environment. They made it unpopular to smoke." They did so by amassing evidence of tobacco's dangers, warning people of its harms, advocating for taxation, pushing to get cigarettes moved behind counters, and calling for smoking to be banned from bars and public buildings, among other approaches. Eventually, the death rate for lung cancer plummeted.

"We're in the beginning stages of that kind of public health battle around sugar," Schmidt says. UCSF has already started implementing many strategies, including these:

1. Provide evidence-based information to lawmakers and the public.

UCSF's SugarScience.ucsf.edu website highlights the evidence about sugar and its impact on health. The site reflects an exhaustive review of more than 8,000 scientific papers published to date. Studies are rigorously reviewed, including for author bias and conflicts of interest.

In addition, the UCSF Industry Documents Library  - which houses tobacco industry documents - and the UCSF Philip R. Lee Institute for Health Policy Studies launched the first-ever food industry document archive in November 2018. It includes thousands of previously secret documents by food industry executives, including Kearns' stash, illuminating how the industry manipulates public health. It's open to journalists, academics, and the public.

2. Tax products that make us sick.

Schmidt is working on soda tax initiatives with policymakers in the Bay Area and around the world, from India to Africa to Mexico. "Taxes trigger what I call a virtuous cycle of policymaking," she says. Taxes gently discourage consumers from buying harmful products, while also generating funds that governments can pour into prevention - such as better screening for diabetes, construction of water refilling stations in low-income communities, and promulgation of public health messages.

The beverage industry, however, argues that such taxes make it harder for low-income individuals to buy groceries and unfairly single out soda. But this isn't the case if the tax proceeds are returned to low-income communities through programs promoting healthy food and clean water access, Schmidt counters. The industry has spent millions of dollars around the country over the past decade to defeat soda tax initiatives. In June 2018, the California legislature passed a bill championed by the soda industry banning California cities and counties from passing new taxes on sugary beverages for 12 years. UCSF's researchers say this significantly undermines the cities and counties from preventing diet-related chronic diseases through such taxation.

"That was a really bad week," says Schmidt. "These companies have us totally outgunned. It's like David versus Goliath." Such struggles are why it's essential for scientists to get evidence into the hands of policymakers and the public, she says.

3. Warn people of the harm.

Schmidt, Schillinger, and others at UCSF are trying to issue warnings, but the soda industry is thwarting these efforts, too. The researchers worked with local legislators to help pass, in 2015, the world's first ordinance requiring billboards advertising sugar-sweetened beverages to include a warning notice. "This was huge," says Schillinger. "A brilliant landmark for public health."

But the beverage industry challenged the ordinance, and an appeals court blocked it, saying it unfairly targeted one group of products. In January 2018, the appeals court said it would rehear the case.

Wake up to the influence

"We need the general public to become aware of what's going on," says Schillinger, who was a paid expert for the City of San Francisco's defense against the industry's lawsuit to block the billboard ordinance. That experience, along with his research and boots-on-the-ground care of patients, has convinced him the sugar struggle is a societal problem that needs many more stakeholders. "If this is just a medical issue versus industry, we will lose," he says.

"We need the general public to become aware of what's going on" with industry influence, says Dean Schillinger.

To that end, Schillinger co-created a social media campaign encouraging youths of color to voice their outrage in first-person, spoken-word pieces that reframe diabetes as a social and environmental problem, not just a medical one. Called "The Bigger Picture," the campaign has garnered nearly 2 million views and won numerous public health and film/media awards. Many health departments have adopted it for their own public messaging.

Schmidt points to other encouraging trends - soda taxes have been implemented in 33 countries, for example - but says we still have a long way to go to prevent the looming tsunami of sugar-fueled diseases.

"These industries know sugar sells, they know it tastes good, they know people want it. They're not going to stop doing what they do," she says.

But with science on their side, neither will UCSF's researchers. They'll continue to seek a sweet ending to the reign of added sugar.

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Sugar's Sick Secrets - UCSF Magazine - Medium

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Walk into any grocery store, grab a few packaged products, and flip to the ingredients. You'll likely spot added sugars - lots of them - provided you can discern their dizzying array of names: sucrose, dextrose, barley malt, agave nectar, high-fructose corn syrup, treacle, to list just a few. Why is our food saturated with all these sweeteners?

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Juice Displaces Milk and Fruit in High School Lunches

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Juice Displaces Milk and Fruit in High School Lunches

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Juice Displaces Milk and Fruit in High School Lunches

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To compare beverages and foods selected by high school students on days when juice was offered (juice days) and not offered (non-juice days) with the ...

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Sugar Science Healthy Beverage Initiative

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Added sugar is hiding in 74% of packaged foods

We tend to think that added sugar is mainly found in desserts like cookies and cakes, but it's also found in many savory foods, such as bread and pasta sauce. And some foods promoted as "natural" or "healthy" are laden with added sugars, compounding the confusion. In fact, manufacturers add sugar to 74% of packaged foods sold in supermarkets. So, even if you skip dessert, you may still be consuming more added sugar than is recommended.

How do I know if I'm eating added sugar?

Added sugar is hiding in foods that many of us consider healthy, like yogurt and energy bars. It is also added to savory foods, such as ketchup, breads, salad dressing and pasta sauce.

The U.S. Food and Drug Administration (FDA) requires food producers to list all ingredients in their foods. But added sugar comes in many forms - which is why it's so hard to find on the ingredients label.

There are at least 61 different names for sugar listed on food labels. These include common names, such as sucrose and high-fructose corn syrup, as well as barley malt, dextrose, maltose and rice syrup, among others.

While product labels list total sugar content, manufacturers are not required to say whether that total includes added sugar, which makes it difficult to know how much of the total comes from added sugar and how much is naturally occurring in ingredients such as fruit or milk. That makes it very difficult to account for how much added sugar we're consuming.

How much is ok?

Daily Added Sugar Limits Women: 6 tsp. (25g) Men: 9 tsp. (38g) Children: 3-6 tsp. (12-25g)

Unlike salt and fats that are added to foods, nutrition labels don't provide you with a daily reference value for added sugar.

However, the American Heart Association (AHA) recommends no more than 9 teaspoons (38 grams) of added sugar per day for men, and 6 teaspoons (25 grams) per day for women. The AHA limits for children vary depending on their age and caloric needs, but range between 3-6 teaspoons (12 - 25 grams) per day.

Even "healthy" foods can be high in sugar

With as many as 11 teaspoons (46.2 grams) of added sugar in some 12-oz. sodas, a single serving exceeds the AHA recommendation for men and is about twice the allowance for women and children. But sugar isn't only in beverages and sweet baked goods. Here are some healthy-looking items you might find in the supermarket that also have high sugar contents:

- One leading brand of yogurt contains 7 teaspoons (29 grams) of sugar per serving.

- A breakfast bar made with "real fruit" and "whole grains" lists 15 grams of sugar.

- A single cup of bran cereal with raisins, in a box advertising "no high- fructose corn syrup," contains 20 grams of sugar per serving.

- A cranberry/pomegranate juice product, also advertising "no high-fructose corn syrup" and "100% Vitamin C," contains 30 grams of added sugar per 8 oz. serving. Some of the sugar is naturally occurring, but some of it has been added.

Changing labels to help consumers

Americans consume 57 pounds of added sugar each year, on average.

Making healthy food decisions requires having complete information on the food label. When sugars are hidden unrecognizably in most packaged foods, it's a difficult choice to make.

To address this, the FDA is considering revising the current label design, including changing the way a serving size is measured and possibly adding a separate line item highlighting the amount of added sugar.

There is active discussion right now in public health circles about how to make nutrition labels easier to read and the need for clearer recommendations on how much added sugar is safe to consume. Stay tuned to SugarScience as we follow this discussion and interpret its impact for consumers.

, [1]Ng, S.W., Slining, M.M., & Popkin, B.M. Use of caloric and noncaloric sweeteners in US consumer packaged foods, 2005-2009. Journal of the Academy of Nutrition and Dietetics 112(11), 1828-1834.e1821-1826.

Retrieved from [2]U.S. Food and Drug Administration, . How to Understand and Use the Nutrition Facts Label. http://www.fda.gov/food/ingredientspackaginglabeling/labelingnutrition/ucm274593.htm

, [3]Sigman-Grant, M., & Morita, J. Defining and interpreting intakes of sugars. The American Journal of Clinical Nutrition doi:PMID: 14522745 78(4), 815S-826S.

Retrieved from [4]Food and Drug Administration, U.S. Agency Information Collection Activities; Proposed Collection; Comment Request; Experimental Study on Consumer Responses to Nutrition Facts Labels With Various Footnote Formats and Declaration of Amount of Added Sugars. Federal Register http://www.gpo.gov/fdsys/pkg/FR-2012-05-31/pdf/2012-13141.pdf

, Retrieved from [5]Johnson, R.K., Appel, L., Brands, M., Howard, B., Lefevre, M., Lustig, R., Sacks, F., Steffen, L., & Wyllie-Rosett, J. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation doi:10.1161/CIRCULATIONAHA.109.192627. 120(11), 1011-20. http://circ.ahajournals.org/content/120/11/1011.full.pdf

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We tend to think that added sugar is mainly found in desserts like cookies and cakes, but it's also found in many savory foods, such as bread and pasta sauce. And some foods promoted as "natural" or "healthy" are laden with added sugars, compounding the confusion.

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Too much fructose can damage your liver, just like too much alcohol

There is growing scientific consensus that one of the most common types of sugar, fructose, can be toxic to the liver, just like alcohol.

Fructose is the sugar that makes fruit taste sweet. For most people, there's nothing wrong with eating fructose in its natural state, in fruit.

But today, manufacturers extract and concentrate the fructose from corn, beets and sugarcane, removing the fiber and nutrients in the process. Getting frequent, high doses of fructose throughout the day, without fiber to slow it down, is more than our bodies were designed to handle.

Nearly all added sugars contain significant amounts of fructose. Typical formulations of high-fructose corn syrup contain upwards of 50% fructose, depending on processing methods. Table sugar and even sweeteners that sound healthy, like organic cane sugar, are 50% fructose.

What's unique about fructose is that, unlike any other sugar, it's processed in the liver. Small amounts of fructose, meted out slowly, are not a problem for your liver. Think of eating an apple - its sweetness comes with a lot of chewing that takes time. The apple's fiber slows down its processing in the gut.

But when we consume large amounts of fructose in added sugar, particularly in liquid form on an empty stomach, it slams the liver with more than it can handle.

As with alcohol, a little added fructose, consumed with fiber-rich foods, is OK. It's only when we frequently consume large quantities, in concentrated form, that fructose becomes a health hazard.

Liver damage is a looming health issue

For a long time, doctors mainly worried about life-threatening liver disease in alcoholics. But since 1980, there has been growing concern about two new conditions linked to fructose consumption from added sugar, as well as to obesity and other unhealthy dietary additives, such as trans-fats:

- Non-alcoholic fatty liver disease (NAFLD): This is characterized by excess fat build-up in the liver.

- Non-alcoholic steatohepatitis (NASH): This is characterized by fatty liver, inflammation and " steatosis," which is essentially scarring as the liver tries to heal its injuries. That scarring gradually cuts off vital blood flow to the liver.

About one-quarter of NASH patients will progress on to non-alcoholic liver cirrhosis, which requires a liver transplant or else it can lead to death.

Since 1980, the incidence of NAFLD and NASH has doubled, along with the rise of fructose consumption. Approximately 6 million individuals in the United States are estimated to have progressed to NASH and some 600,000 to NASH-related cirrhosis. Eating a lot of trans-fats, being overweight and not exercising also can contribute to NASH. Most people with NASH also have Type II diabetes.

What is alarming is that NASH is now the third-leading reason for liver transplantation in America. And it will become the most common if recent trends continue. Rates of NASH have doubled in America during the past 20 years alongside a dramatic increase in sugar consumption.

How do you know if you have a liver problem?

You should be concerned if you or your kids have a "sugar belly" or belly fat. If your waist is larger than your hips, you should ask your doctor for a blood test that checks for triglyceride levels.

A sugar belly occurs when the liver detects more fructose than can be used by the body for energy. That excess fructose is broken down by the liver and transformed into fat globules ( triglycerides), some of which are exported into the bloodstream and selectively deposited around your midsection and internal organs. Just as people who drink too much get a "beer belly," those who eat or drink too much fructose can get a "sugar belly."

Fat cells that accumulate around your midsection send out disruptive hormonal messages that upset your body's normal chemical balance. Scientists are actively studying how these hormonal imbalances become implicated in a wide variety of diseases, including heart disease, stroke, diabetes, cancer and Alzheimer's disease.

Why am I only hearing about this now?

Scientific evidence on fructose and the liver is relatively new, but it is a major area of laboratory and clinical research in our best universities and medical centers.

The goal of SugarScience is to bring you the latest research, getting the most critical information out of universities and into public awareness as quickly as possible. Getting you the news on fructose toxicity could change your health and the health of your kids. It's a good example of why we're here.

[7]Lazo, M., & Clark, J. The Epidemiology of Nonalcoholic Fatty Liver Disease: A Global Perspective.. doi:10.1055/s-0028-1091978 Seminars in Liver Disease

[10]LindbÃ¤ck, S.M., Gabbert, C., Johnson, B.L., Smorodinsky, E., Sirlin, C.B., Garcia, N., & Schwimmer, J.B. Pediatric Nonalcoholic Fatty Liver Disease: A Comprehensive Review. doi:10.1016/j.yapd.2010.08.006 Advances in Pediatrics

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There is growing scientific consensus that one of the most common types of sugar, fructose, can be toxic to the liver, just like alcohol. Fructose is the sugar that makes fruit taste sweet. For most people, there's nothing wrong with eating fructose in its natural state, in fruit.

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Food myths debunked: Whole milk may be healthier than skim

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Dr. Mark Hyman, author of "What the Heck Should I Eat," joins Megyn Kelly TODAY to bust myths about food, such as the widespread belief that chicken is healthier than red meat, or that skim milk is healthier than whole milk. He also says that fresh fruits and vegetables are NOT necessarily more nutritious than frozen.

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Confronting the Confusing World of Nutrition

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Confronting the Confusing World of Nutrition

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Confronting The Confusing World Of Nutrition

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Scientific Studies, and Other Useful Resources to Help You Defend Yourself Against the Most Common Myths and Outdated Nutritional Arguments:

Science is a beautiful thing, its truth is not based on opinion. Real science holds no place for tradition, dogma, or conjecture. When discussing science, one must differentiate between what is simply a myth, and what has been substantially proven. Honestly, science doesn't really give a damn what "you believe. " Science just is.
"It's easier to fool people than to convince them that they have been fooled" - Mark Twain
The subject of nutrition has become a push button topic that evokes passionate arguments, not unlike that of politics and religion. The current obesity and diabetes epidemics have catapulted the topic of nutrition to the forefront of discussions. For the first time in the history of our country, the overweight to obese population has taken over as a majority, and still most are flummoxed as to why. Doctors are still telling patients to "eat less and move more," while fearing saturated fat and cholesterol. Dietitians are still praising the benefits of "heart healthy grains," and teaching us how to count calories. The general population just blindly falls into step with the 40 year old, outdated dietary guidelines that caused this mess in the first place.

It's not surprising that people argue so vehemently in defense of their nutritional beliefs. They likely learned what they know from someone they trust or respect, like a doctor, professor, parent, or healthcare professional. It's not completely their fault. Much of the misinformation that is currently accepted as undeniable truth has been so imbedded into our collective thought processes over the past 40 years, and it is unlikely to be unlearned overnight. If you're interested in learning more about the origins of these falsehoods, this article goes into much greater detail: Click Here

In this modern age of advancement, nearly every modality of science has advanced by leaps and bounds. Technology, communication, and industry have surpassed our wildest dreams in many aspects. Why then is it so perplexing that nutritional science might advance over the course of decades? This is a mystery that continues to confound me.

What follows are some of the more common misconceptions in the world of nutrition. You may have been challenged on these topics before. Although knowledge is power, some people need a little more proof in order to prompt their rethinking process. So for each of these myths, I have provided not only links to scientific studies, but I have included investigative articles, book recommendations and shareable videos as well.

This is completely false, different sources of calories go through different metabolic pathways in the body and activate different stimulus in regards to hunger, hormones, and brain function.

An optimally healthy, or detrimentaly dangerous food item is not simply measured by its high or low caloric values. Several calorie sources such as added sugar and vegetable oils, can cause harmful effects on metabolism that have absolutely nothing to do with their caloric value.
Let's play science says. Studies:
Here are some links to some great articles that break down the debunking of the calorie myth in a more understandable format:
Book Suggestion: Good Calories Bad Calories - Gary Taubes Watch: Shareable Video
Even though fat has more calories per gram than carbs and protein, it is not any more fattening. Foods that are naturally high in fat tend to satiate and reduce appetite. While carbohydrates and excessive protein both initiate an insulin response that promote fat storage.

The studies consistently show that diets that are high in fat (but low in carbs) lead to much more substantial and sustainable weight loss than diets that are low in fat and high in carbohydrates.
Let's play science says. Studies: Book Suggestion: Eat Fat Get Thin - Dr. Mark Hyman
It is a myth that it is best to eat many, small meals instead of several bigger meals. The studies show that it doesn't have any effect on health, body weight or increased metabolism. In fact, a case can be made that allowing your body to constantly remain in a feeding state can be counterproductive if weight loss is your goal.
Let's play science says. Studies: Book Suggestion: The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate Day, and Extended Fasting - Dr. Jason Fung & Jimmy Moore
Even though sodium restriction can lower blood pressure, it does not appear to reduce the risk of heart disease or death. Several studies show that if you restrict sodium too much, it can increase risk factors for disease. There is no real science behind the 1500-2300 mg per day recommendation. Sodium is an essential electrolyte that is necessary to sustain life.
Let's play science says. Studies: Book Suggestion: The Real Meal Revolution: The Radical, Sustainable Approach to Healthy Eating - Prof. Tim Noakes Watch: Shareable Video
There are two types of polyunsaturated fats, Omega 3 and Omega 6. It is true that Omega 3s reduce the risk of heart disease, but the same is not true for the Omega 6s. Even though the Omega 6s (soybean oil, corn oil, etc.) can lower cholesterol, the studies show that they actually increase the risk of heart disease. Recent studies have shown that dietary cholesterol is not a detriment to your health. Therefore, the advice to increase polyunsaturated fat, without regards to the type, is likely contributing more to the cause of heart disease than preventing it.
Let's play science says. Studies: Book Suggestion: Trans Fats, The Hidden Killer In Our Food - Judith Shaw
Though it is true that the consumption of processed meat is associated with an increased risk of disease, the same is not true of unprocessed red meat. Though it may form harmful compounds if it is overcooked, unprocessed red meat is harmless. The answer is not to avoid red meat, but to make sure not to burn it. It should also be noted that the association between unprocessed red meat and cancer is highly exaggerated. Large review studies show that the effect is very minuscule in men and nonexistent in women.
Let's play science says: Studies: Book Suggestion: Always Hungry?: Conquer Cravings, Retrain Your Fat Cells, and Lose Weight Permanently - Dr. David Ludwig
This is simply not true. Since 2002, low-carb diets have been studied extensively, and over 20 randomized controlled trials have been conducted that attest to their safety. They consistently lead to improvement in regards to common health markers as compared to the typical low-fat diet. They result in more sustainable weight loss and improve most major risk factors for disease, including triglycerides, HDL, and blood sugar levels.

Sidenote: Dietitians and other health care professionals often mistake the word ketosis for the word ketoacidosis simply because they have the same root word keto. Both words represent metabolic states, but that is all they have in common. One is dangerous, the other is not. For these people, might I suggest they seek some continuing education credits.
Let's play science says. Studies: Book Suggestion: The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable - Stephen Phinney & Jeff Volek
This is a myth. Saturated fat raises HDL (which some call the "good") cholesterol, and changes LDL particles from small and dense to large, buoyant (benign) LDL particles, which does not increase the risk of heart disease. This has been intensively studied in the past few decades, and studies consistently show that saturated fat, as well as dietary cholesterol, are not contributers to risk for coronary heart disease.
Let's play science says. Studies: Book Suggestion: Cholesterol Clarity: What The HDL Is Wrong With My Numbers? - Jimmy Moore & Dr. Eric Westman, MD
The low-fat diet has been put to the test in several huge randomized, controlled trials. It does not cause any weight loss over a period of 7.5 years, and has literally no positive effect on the prevention of heart disease or cancer. The low-fat diet is a huge failure, and likely a contributor to the development of many metabolic disorders. All major studies show that it doesn't work for sustainable weight loss.
Let's play science says. Studies: Book Suggestion: The Obesity Code: Unlocking the Secrets of Weight Loss - Dr. Jason Fung
It is often claimed that a high protein intake can cause harm to the kidneys, but this is false. Even though it is important for people with pre-existing kidney disease to reduce their protein intake, the same is not true for people with healthy kidneys. Studies show that protein consumption has no detrimental effect on kidney function in healthy people ... even in the case of bodybuilders who often eat large quantities of protein rich foods.
Let's play science says. Studies: Book Suggestion: Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet - Jimmy Moore & Dr. Eric Westman, MD
There is no evidence that people benefit from consuming low fat dairy in place of full fat dairy products. In fact, the opposite is true. Low fat dairy is higher in sugar which makes this misguided advice seriously questionable. Full fat dairy (especially from grass-fed cows) contains important nutrients like Vitamin K2 and butyrate, which are often scarce in the average diet. High fat dairy products are actually associated with a lower risk of obesity. In countries where cows are largely grass-fed, people who eat the most high fat dairy products have a drastically reduced risk of heart disease.
Let's play science says. Studies: Book Suggestion: The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet - Nina Teicholz
Although it is true that protein can cause calcium loss from the bones in the short term, this effect does not persist in the long term. In fact, studies consistently show that protein actually improves overall bone health in the long term. Moderating protein intake is often advised in low-carb and ketogenic diets because of glyconeogenesis, not for the purposes of bone health or thwarting osteoporosis.
Let's play science says. Studies: Book Suggestion: New Atkins for a New You: The Ultimate Diet for Shedding Weight and Feeling Great - Dr. Eric Westman, Stephen Phinney, Jeff Volek
Cholesterol contained in eggs do not raise the LDL cholesterol in the blood. It does, however, raise HDL ( considered by some the "good") cholesterol. Eggs actually improve the overall blood lipid profile. Recent studies show that egg consumption is not associated with heart disease. Whole eggs are among the most nutritious foods available on the planet.
Let's play science says. Studies: Book Suggestion: Why We Get Fat: And What to Do About It - Gary Taubes
There is nothing empty about the effects that sugar has on your body. When consumed in excess, sugar can lead to harmful effects on metabolism, and cause insulin resistance, fatty liver disease, and various other metabolic disorders. Studies show that in the long term, high consumption of sugar is strongly associated with the risk of obesity, type 2 diabetes, heart disease, and even cancer.
Let's play science says. Studies: Book Suggestion: Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease - Dr. Robert Lustig Book Suggestion: The Case Against Sugar -Gary Taubes Watch: Shareable Video Should you find yourself motivated to research a particular topic, bookmark the links attached to the following clickable banners. These are some of the finest research resources on the internet:

For the Latest Videos & Articles Pertaining to Optimal Health and Ketogenic Nutrition, As Well As Encouragement, Advice & Great Ketogenic/Low Carb Recipes ...Everyone's Welcome in the Facebook Group: WELCOME TO KETO COUNTRY

I'd be lying if I didn't admit that this song has been playing in my head all day. (It's quite the earworm) Let's Play Science Says by elim Hall:

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Scientific Studies, and Other Useful Resources to Help You Defend Yourself Against the Most Common Myths and Outdated Nutritional Arguments: Science is a beautiful thing, its truth is not based on opinion. Real science holds no place for tradition, dogma, or conjecture.

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"A calorie is a calorie" violates the second law of thermodynamics

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"A calorie is a calorie" violates the second law of thermodynamics

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The principle of "a calorie is a calorie," that weight change in hypocaloric diets is independent of macronutrient composition, is widely held in the popular and technical literature, and is frequently justified by appeal to the laws of thermodynamics. We review here some aspects of thermodynamics that bear on weight loss and the effect of macronutrient composition. The focus is the so-called metabolic advantage in low-carbohydrate diets - greater weight loss compared to isocaloric diets of different composition. Two laws of thermodynamics are relevant to the systems considered in nutrition and, whereas the first law is a conservation (of energy) law, the second is a dissipation law: something (negative entropy) is lost and therefore balance is not to be expected in diet interventions. Here, we propose that a misunderstanding of the second law accounts for the controversy about the role of macronutrient effect on weight loss and we review some aspects of elementary thermodynamics. We use data in the literature to show that thermogenesis is sufficient to predict metabolic advantage. Whereas homeostasis ensures balance under many conditions, as a general principle, "a calorie is a calorie" violates the second law of thermodynamics.

Great Weight Loss

Macronutrient Composition

Weight Loss Diet

Isocaloric Diet

Metabolic Advantage

The recent awareness of an epidemic of obesity coincides with, and may have contributed to a dramatic increase in the popularity of a variety of low carbohydrate diets. This rapid switch in dietary habits of a significant part of the population, and the virtual revolution in the food industry, is unusual in that it stands in direct opposition to long-standing recommendations of the majority of the nutritional and medical establishment (e.g. [, ]). Despite isolated examples, such as a recent editorial by Walter Willet pointing to the need to understand low carbohydrate diets [], there is still little real acceptance by nutrition professionals or health organizations. One aspect of these diets that has been especially controversial is the so-called metabolic advantage - the idea that more weight may be lost calorie for calorie compared with diets of higher carbohydrate content.

We recently reviewed the literature on metabolic advantage []. We showed that there is a sufficient number of reports in the literature to establish the existence of metabolic advantage and we tabulated results from ten or so studies demonstrating that low carbohydrate diets can lead to greater weight loss than isocaloric low fat diets. The reports we cited have frequently been met with the criticism that the data could not be right because they would violate the laws of thermodynamics ([, ]). An example is the recent demonstration of metabolic advantage in a small, pilot study [] which, despite its preliminary status, was extremely well controlled. Three groups were studied: A low carbohydrate group (LoCHO = 1800 kcal for men; 1500 kcal for women), a low fat group (LoFat, 1800 and 1500); a third group also consumed a low carbohydrate diet but an additional 300 kcalories were provided (LoCHO+300, 2100 and 1800). The order of average amount of weight lost was LoCHO = 23 lbs, LoCHO+300 = 20 lbs LoFat = 17 lbs. This work received a good deal of attention in the popular press. Media reports, however, included comments of experts that "It doesn't make sense, does it?" "It violates the laws of thermodynamics. No one has ever found any miraculous metabolic effects." ([]). If this is an accurate quotation, it is odd indeed. Miraculous, or otherwise, a metabolic effect was found. In the absence of an identifiable methodological error, experimental data has to be accepted and numerous investigations, in fact, serve as precedents for Greene et al.'s findings (Reviews: [, ]).

In our previous review of metabolic advantage [] we showed that there is, in fact, no theoretical violation of the laws of thermodynamics, and we provided a plausible mechanism. In general the pathways for gluconeogenesis that are required in order to supply obligate glucose (e.g. to brain and CNS), in combination with increased protein turnover, could account for the missing energy. Here, we simplify the thermodynamic argument and review some of the relevant principles. We show, moreover, that well-established data in the traditional nutritional literature predict metabolic advantage and no one should be surprised. The ironic conclusion is that the principle that weight gain on isocaloric diets must always be independent of macronutrient composition would violate the second law of thermodynamics.

Because it is a colloquial phrase, it is important to understand exactly what it is meant by "a calorie is a calorie." The most common meaning is that is it impossible for two isocaloric diets to lead to different weight loss. Frequently, the concept is justified by reference to the "laws of thermodynamics", but an explicit connection has never been spelled out. More recently, Buchholz & Schoeller [] appear to identify "a calorie is a calorie" with the first law of thermodynamics. They also admit that high protein /low carbohydrate diets can lead to greater weight loss than isocaloric low fat diets in agreement with our assessment []. Nonetheless they maintain that "a calorie is a calorie," now justifying it by their connection of the phrase to the concept of energy conservation. It is important to point out that no study of isocaloric diets has ever claimed that the first law of thermodynamics is not true. Buchholz & Schoeller [] have limited themselves by only including the first law and, therefore, do not understand how the differential weight loss could occur and think it "deserves further study." Our major point here is that there is more than one law of thermodynamics and that a more accurate understanding of the role of the second law shows that differential weight loss is not inconsistent with any physical principle.

The idea that "a calorie is a calorie" comes from a misunderstanding of the laws of thermodynamics. There are two laws of thermodynamics. (The zeroth law that establishes the concept of temperature and the third law that describes absolute zero are not relevant here). When speaking of "the law s of thermodynamics" it is important to be sure that one is including the second law. The first law is very different in character from the second law [, , ]. The first law is a conservation law: it says that the form of energy may change, but the total is always conserved. The second law is a dissipation law: it defines a quantity, the entropy, S, which we traditionally identify with disorder or high probability. The second law says that in any (real) irreversible process, the entropy must increase (ΔS > 0); balance is not expected. Entropy is, in fact, identifiable with irreversibility.

It is important to understand that it is the second law that drives chemical reactions. The first law is a bookkeeping law and tells us that the total energy attributed to work, heat and changes in chemical composition will be constant. It does not tell us whether such a reaction will occur, or if it does, what the relative distributions of the forms of energy will be. To predict the tendency of the reaction to occur, we must employ the second law that says the entropy must increase. In a chemical reaction, at constant temperature and pressure, the entropic and energetic effects are combined into the change in the Gibbs free energy, ΔG, whose sign predicts the direction of reaction, and whose magnitude indicates the maximum amount of work realizable from the reaction.

To understand the implications of "a calorie is a calorie," that energy yield could be path-independent and the same for all diets consider that it implies that carbohydrate and protein are equivalent fuels as shown in Figure . The diagram indicates that, because it is a state variable, the free energy (ΔG') for Path 1 must be equal to that for path 2 + 3. If the ΔG' values for path 1 and path 2 are taken to be their calorimeter values, they will be approximately equal (~4 kcal/g, path 1 corrected for ureagenesis). This means that ΔG' for path 3, the conversion of protein to carbohydrate (also corrected) must be about zero. There exists at least one condition where this is not true, the standard state; it is generally considered that gluconeogenesis from one mole of alanine requires about 6 ATP [, ]. Of course free energies are concentration dependent, so in vivo values will differ from standard state values but they are continuous functions of the concentrations and there will be numerous conditions under which ΔG' is not zero. In other words, assuming that protein and carbohydrate are energetically equivalent leads to a contradiction.

The second law was developed in the context of the industrial revolution and the attempt to understand the efficiency of machines. The law describes the theoretical limits on the efficiency of engines and applies as well to living (irreversible) systems. The second law says that no machine is completely efficient. Some of the available energy is lost as heat and in the internal rearrangement of chemical compounds and other changes in entropy. In other words, although the first law holds even in irreversible processes - energy is still conserved - the second law says that something is lost, something is unrecoverable. The efficiency of a machine is dependent on how the machine works and, for a biochemical machine, the nature of the fuel and the processes enlisted by the organism. A simple example is the inefficiency of low-test gasoline in high compression gasoline engines. If a "calorie is a calorie" were true, nobody would pay extra for high test gasoline. (The calorimeter values of a gasoline will be the same whether or not it contains an antiknock compound). In weight loss diets, of course, inefficiency is desirable and is tied to hormonal levels and enzyme activities

In nutrition, one component of inefficiency is measured in thermogenesis (thermic effect of feeding), or the heat generated in processing food. There is a large literature on this subject and the general conclusion, as summarized in a recent review by Jéquier [], is that thermic effects of nutrients is approximately 2-3 % for lipids, 6-8 % for carbohydrates, and 25-30% for proteins. It is interesting that this data itself might be enough to explain metabolic advantage. Here we took the average of Jéquier's values (2.5, 7 and 27.5 % for fat, CHO and protein) and calculated the effective energy yield for a 2000 kcal diet. If we assume a diet composition of CHO:fat: protein of 55:30:15, within the range of commonly recommended diets, the calculated effective yield is 1848 kcal. We now consider the effect of reducing carbohydrate progressively and substituting the calories removed equally between fat and protein. Figure shows that the wasted calories due to thermogenesis increase as carbohydrate is reduced and reach 100 kcal at 21 % carbohydrate. This value of 100 kcal is recommended by several professionals as the goal for daily weight reduction (e.g. []). Notably, at 8 % CHO, the value for the early phase of the Atkins [], South Beach [] or Protein Power diets [], 140 kcalories are lost as heat. Now, there will be metabolic accommodations and one can't predict that the ratios will stay the same over a long term diet, but the calculations show that the possibility of metabolic advantage should not come as a surprise.

Recommendations for fighting obesity frequently call for small reductions in calories []. In fact, given the resistance of steady state systems to small perturbations it is doubtful that this is a promising strategy. Nonetheless, taking the goal at face value, if it could be achieved by a simple change in macronutrient composition, such a method would seem worthy of serious consideration. The arguments above show that such a phenomenon is possible. There are plausible arguments for how it could take place and substantial experimental evidence for its occurrence [].

A review of simple thermodynamic principles shows that weight change on isocaloric diets is not expected to be independent of path (metabolism of macronutrients) and indeed such a general principle would be a violation of the second law. Homeostatic mechanisms are able to insure that, a good deal of the time, weight does not fluctuate much with changes in diet - this might be said to be the true "miraculous metabolic effect" - but it is subject to many exceptions. The idea that this is theoretically required in all cases is mistakenly based on equilibrium, reversible conditions that do not hold for living organisms and an insufficient appreciation of the second law. The second law of thermodynamics says that variation of efficiency for different metabolic pathways is to be expected. Thus, ironically the dictum that a "calorie is a calorie" violates the second law of thermodynamics, as a matter of principle.

The analysis above might be said to be over-kill although it is important, intellectually, not to invoke the laws of thermodynamics inappropriately. There are also, however, practical consequences. The seriousness of the obesity epidemic suggests that we attack it with all the means at our disposal. Metabolic advantage with low carbohydrate diets is well established in the literature. It does not always occur but the important point is that it can occur. To ignore its possibilities and to not investigate the precise conditions under which it appears would be cutting ourselves off from potential benefit. The extent to which metabolic advantage will have significant impact in treating obesity is unknown and it is widely said in studies of low carbohydrate diets that "more work needs to be done." However, if the misconception is perpetuated that there is a violation of physical laws, that work will not be done, and if done, will go unpublished due to editorial resistance. Attacking the obesity epidemic will involve giving up many old ideas that have not been productive. "A calorie is a calorie" might be a good place to start.

Authors' original submitted files for images

Competing interests

None declared.

Below are the links to the authors' original submitted files for images.

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"A calorie is a calorie" violates the second law of thermodynamics

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The principle of "a calorie is a calorie," that weight change in hypocaloric diets is independent of macronutrient composition, is widely held in the popular and technical literature, and is frequently justified by appeal to the laws of thermodynamics. We review here some aspects of thermodynamics that bear on weight loss and the effect of macronutrient composition.

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The vast majority of conventional nutritionists and doctors have it mostly wrong when it comes to weight loss. Let's face it: If their advice were good and doable, we would all be thin and healthy by now. But as a general rule, it's not. And the mainstream media messages often confuse things even more. It is based on many "food lies".

And the biggest lie of them all is this: All calories are created equal.

Is this really true? Not really. Let us explore why.

Take a class of sixth graders. Show them a picture of 1,000 calories of broccoli and 1,000 calories of soda. Ask them if they have the same effect on our bodies. Their unanimous response will be "NO!" We all intuitively know that equal caloric amounts of soda and broccoli can't be the same nutritionally. But as Mark Twain said, "The problem with common sense is that it is not too common."

I guess that is why the medical profession, nutritionists, our government, the food industry, and the media are all still actively promoting the outdated, scientifically disproven idea that all calories are created equal. Yes, that well-worn notion-that as long as you burn more calories than you consume, you will lose weight-is simply dead wrong.

The first law of thermodynamics states that the energy of an isolated system is constant. In other words, in a laboratory, or "isolated system," 1,000 calories of broccoli and 1,000 calories of soda are, in fact, the same. I'm not saying the law was wrong about that. It's true that when burned in a laboratory setting, 1,000 calories of broccoli and 1,000 calories of soda would indeed release the same amount of energy.

But sorry, your law of thermodynamics doesn't apply in living, breathing, digesting systems. When you eat food, the "isolated system" part of the equation goes out the window. The food interacts with your biology, a complex adaptive system that instantly transforms every bite.

To illustrate how this works, let's follow 750 calories of soda and 750 calories of broccoli once they enter your body. First, soda: 750 calories is the amount in a Double Gulp from 7-Eleven, which is 100 percent sugar and contains 186 grams, or 46 teaspoons, of sugar. Many people actually do consume this amount of soda. They are considered the "heavy users."

Your gut quickly absorbs the fiber-free sugars in the soda, fructose, and glucose. The glucose spikes your blood sugar, starting a domino effect of high insulin and a cascade of hormonal responses that kicks bad biochemistry into gear. The high insulin increases storage of belly fat, increases inflammation, raises triglycerides and lowers HDL, raises blood pressure, lowers testosterone in men, and contributes to infertility in women.

Your appetite is increased because of insulin's effect on your brain chemistry. The insulin blocks your appetite-control hormone leptin. You become more leptin resistant, so the brain never gets the "I'm full" signal. Instead, it thinks you are starving. Your pleasure-based reward center is triggered, driving you to consume more sugar and fueling your addiction.

The fructose makes things worse. It goes right to your liver, where it starts manufacturing fat, which triggers more insulin resistance and causes chronically elevated blood insulin levels, driving your body to store everything you eat as dangerous belly fat. You also get a fatty liver, which generates more inflammation. Chronic inflammation causes more weight gain and diabesity. Anything that causes inflammation will worsen insulin resistance. Another problem with fructose is that it doesn't send informational feedback to the brain, signaling that a load of calories just hit the body. Nor does it reduce ghrelin, the appetite hormone that is usually reduced when you eat real food.

Now you can see just how easily 750 calories of soda can create biochemical chaos. In addition, the soda contains no fiber, vitamins, minerals, or phytonutrients to help you process the calories you are consuming. These are "empty" calories devoid of any nutritional value. But they are "full" of trouble. Your body doesn't register soda as food, so you eat more all day long. Plus, your taste buds get hijacked, so anything that is not super-sweet doesn't taste very good to you.

Think I'm exaggerating? Cut out all sugar for a week, then have a cup of blueberries. Super-sweet. But eat those same blueberries after bingeing on soda and they will taste like bland and boring.

Now let's look at the 750 calories of broccoli. As with the soda, these calories are made up primarily (although not entirely) of carbohydrates-but let's clarify just what that means, because the varying characteristics of carbs will factor significantly into the contrast I'm about to illustrate.

Carbohydrates are plant-based compounds comprised of carbon, hydrogen, and oxygen. They come in many varieties, but they are all technically sugars or starches, which convert to sugar in the body. The important difference is in how they affect your blood sugar. High-fiber, low-sugar carbohydrates such as broccoli are slowly digested and don't lead to blood sugar and insulin spikes, while table sugar and bread are quickly digested carbs that spike your blood sugar. Therein lies the difference. Slow carbs like broccoli heal rather than harm.

Those 750 calories of broccoli make up 21 cups and contain 67 grams of fiber (the average American consumes 10 to 15 grams of fiber a day). Broccoli is 23 percent protein, 9 percent fat, and 68 percent carbohydrate, or 510 calories from carbs. The "sugar" in 21 cups of broccoli is the equivalent of only 1.5 teaspoons; the rest of the carbohydrates are the low-glycemic type found in all nonstarchy vegetables, which are very slowly absorbed.

Still, are the 750 calories in broccoli really the same as the 750 calories in soda? Kindergarten class response: "No way!" So why do we all think that's true, and why has every major governmental and independent organization bought into this nonsense?

Let's take a closer look at just how different these two sets of calories really are.

First, you wouldn't be able to eat twenty-one cups of broccoli, because it wouldn't fit in your stomach. But assuming you could, what would happen? They contain so much fiber that very few of the calories would actually get absorbed. Those that did would get absorbed very slowly. There'd be no blood sugar or insulin spike, no fatty liver, no hormonal chaos. Your stomach would distend (which it doesn't with soda; bloat from carbonation doesn't count!), sending signals to your brain that you were full. There would be no triggering of the addiction reward center in the brain. You'd also get many extra benefits that optimize metabolism, lower cholesterol, reduce inflammation, and boost detoxification. The phytonutrients in broccoli (glucosinolates) boost your liver's ability to detoxify environmental chemicals, and the flavonoid kaempferol is a powerful anti-inflammatory. Broccoli also contains high levels of vitamin C and folate, which protect against cancer and heart disease. The glucosinolates and sulphorophanes in broccoli change the expression of your genes to help balance your sex hormones, reducing breast and other cancers.

What I'm trying to illustrate here (and this is probably the single most important idea in this book) is that all calories are NOT created equal. The same number of calories from different types of food can have very different biological effects.

If you still think a calorie is just a calorie, maybe this study will convince you otherwise. In a study of 154 countries that looked at the correlation of calories, sugar, and diabetes, scientists found that adding 150 calories a day to the diet barely raised the risk of diabetes in the population, but if those 150 calories came from soda, the risk of diabetes went up by 700 percent.

Some calories are addictive, others healing, some fattening, some metabolism-boosting. That's because food doesn't just contain calories, it contains information. Every bite of food you eat broadcasts a set of coded instructions to your body-instructions that can create either health or disease.

So what will it be, a Double Gulp or a big bunch of broccoli?

If you're inspired to detox, to end your food addiction and your sugar and carb cravings and renew and reboot your health, check out my #1 best-selling book The Blood Sugar Solution 10-Day Detox Diet! Plus, get these great bonus gifts right away to jump-start your program:

In the Kitchen with Dr. Mark Hyman - In this three-part online video series, I teach you how to cook amazingly delicious healing foods quickly.

The Missing Ingredient Report - Why we get stuck and how we can sustain our weight loss goals.

Dieting 101 Guide - My review of the top 10 weight loss programs, in which I share what works and what doesn't and WHY?

Wishing you health and happiness,
Mark Hyman, MD

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Why Calories Don't Matter - Dr. Mark Hyman

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The vast majority of conventional nutritionists and doctors have it mostly wrong when it comes to weight loss. Let's face it: If their advice were good and doable, we would all be thin and healthy by now. But as a general rule, it's not. And the mainstream media messages often confuse things even more.

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To Snack or Not to Snack, That is the Question

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To Snack or Not to Snack, That is the Question

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Confronting The Confusing World Of Nutrition

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If you are over the age of 40, then you likely have a clear memory of hearing this advice growing up: "Cut down on in between meals snacks"

Well, somehow, over the past few decades that advice has changed to: "You should eat every couple hours, to keep your body working, it speeds up your metabolism."

It doesn't take a genius to figure out that those two pieces of advice are polar opposites. This is a perfect example of what is known as "bro-science." You know, the kind of advise you might overhear from some random dude at the gym, or from one of your boss's friends at a dinner party. Unfortunately, in our country, this advise has made its way into the mainstream and is actually doled out by doctors and health professionals for the purpose of "speeding up your metabolism." They have even gone as far as to advise eating 6 meals per day, spreading them out to about every 2 hours.

The food industry has had no problem helping you to comply with this misguided mantra, as they have created an entire new genre of highly processed food items that are "snack sized" and ready, waiting for you as an impulse buy at every checkout counter in every grocery/convenient store in the free world.

Over the past few decades the influx of snack sized products have been positively dizzying. So called low-fat "protein bars"(which inevitably are loaded with sugar), nuts processed in partially hydrogenated oils, 100 calorie chips, cookies, candy bars, diet sodas and energy drinks have completely infiltrated our society. And we've been convinced that we are somehow doing our metabolisms a favor by supplementing our daily eating schedules with these high glycemic foods. How many of these convenient snack items in this picture are actually healthy choices? Well, with exception to water, the answer would be none. Though it is true that whenever we eat, our metabolisms do accelerate slightly, it's not to any significant degree, not any more so than one would achieve by eating the standard "3 squares"over the course of a day, on average. Certainly not significantly enough to justify constantly being in feeding-mode.

So, at this point, you might be thinking to yourself, "So what?! If it makes no difference, then, no harm, no foul, right?" Well, unfortunately, as it is with most things having to do with our bodies, it's not that simple. Our bodies are complex hormonal mechanisms that are constantly reacting to what we eat. And even more importantly, NOT reacting when we don't eat! Understand that eating heightens the glucose level in your blood, triggering the release of insulin. Insulin is the main trigger for fat storage. The insulin does its job and returns to a basal level after some time has passed. If you are constantly eating, and thus constantly spiking your glycogen levels, your body never gets a chance to return your insulin to its basal level. Over time, this constant daily influx of insulin can cause insulin resistance. Insulin resistance over time can lead to obesity and type 2 diabetes. You need to allow for some insulin downtime! Also, the quality of your diet tends to suffer substantially when you supplement your meals with snacks. Foods designed for a long shelf life are highly processed and tend to be very high in refined carbohydrates. You need to give your body a chance to get its energy from your fat. Don't worry, you're not going to starve, I'll assure you. Did you know that a man once survived a 385 day fast? I'm sure you can make it till dinner time.
There is some good news:
If you find that you are always hungry inbetween meals, perhaps you should examine what you're eating for meals. Did you know that eating meals that are high in healthy fats will satiate your appetite and thus satisfy you for far longer than that of a meal filled with carbohydrates? That sugar crash feeling that we've all experienced is a very real thing. Both proteins and fat initiate the release of natural satiety hormones (peptide YY, Cholecystokinin), these are the hormones that tell your brain that you are full. The consumption of carbohydrates (sugars) do NOT activate this hormonal system and often leads to overeating. If you were to eat three meals a day that include a moderate amount of healthy fats and protein, you'll likely find that eating inbetween meal snacks will become unnecessary.

Here are some graphics that I borrowed from Dr. Jason Fung's book The Obesity Code, published just this year (2016). These graphs illustrate an example of insulin release over the course of an average day:

3 meals no snacks (adequate insulin downtime)

3 meals w/ snacks (minimal insulin downtime)

Insulin is, in fact, the main hormone that regulates fat storage. So, wouldn't you want to minimize its activity? It only makes sense that this first scenario would be more effective for weight loss.

Imagine if you were to only eat foods that were low on the glycemic scale and your insulin was rarely spiked to a significant degree, even during regular meals? Why that sounds a little bit like a recipe for healthy living! That would be a diet of healthy fats, proteins and only the carbohydrates that come from fiber rich vegetables and fruits. And guess what the side-effect would be? Yep, weight loss.

Perhaps we should collectively consider embracing some of the good ideas of our past, especially the ones that are based on truth and actually have a track-record of being effective. I mean, seriously, did we really think that eating more food, more often would be an effective strategy for weight-loss? It doesn't even make sense.

If you're an older person, as I am, you may be able to remember back to the day, prior to the late 1970s, before our country was amidst this current obesity epidemic, when families ate 3 square meals a day as a general rule. You were constantly being hounded to finish all your vegetables. And God forbid, if you were caught eating before meal time, your grandmother would say: "Quit snacking, you'll ruin your supper!" Well, she may not have been an expert at "kick the can" or dodge ball like you were, but in this particular instance, you're grandmother was right.

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To Snack or Not to Snack, That is the Question

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If you are over the age of 40, then you likely have a clear memory of hearing this advice growing up: "Cut down on in between meals snacks" Well, somehow, over the past few decades that advice has changed to: "You should eat every couple hours, to keep your body working, it speeds up your metabolism."

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The Full-Fat Paradox: Dairy Fat Linked To Lower Diabetes Risk

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The Full-Fat Paradox: Dairy Fat Linked To Lower Diabetes Risk

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If you melt at the creaminess of full-fat yogurt, read on.

A new study finds the dairy fats found in milk, yogurt and cheese may help protect against Type 2 diabetes.

The research, published in the journal Circulation, included 3,333 adults. Beginning in the late 1980s, researchers took blood samples from the participants and measured circulating levels of biomarkers of dairy fat in their blood. Then, over the next two decades, the researchers tracked who among the participants developed diabetes.

"People who had the most dairy fat in their diet had about a 50 percent lower risk of diabetes" compared with people who consumed the least dairy fat, says Dariush Mozaffarian, dean of the Friedman School of Nutrition Science and Policy at Tufts University, who is also an author of the study.

The study does not prove a cause and effect, but it builds on a body of evidence suggesting that dairy fat may have protective effects, both in cutting the risk of diabetes and in helping people control body weight.

"For a long time we've had this notion that saturated fat [the kind found in dairy products] is always bad for you," says Mark DeBoer, a pediatrician at the University of Virginia.

But this assumption is being questioned. As we've previously reported, DeBoer has studied the connection between dairy fat and children's body weight. And he published a surprising finding.

"It appears that children who have a higher intake of whole milk or 2 percent milk gain less weight over time" compared with kids who consume skim or nonfat dairy products, explains DeBoer.

And there's some evidence that dairy fat may help adults manage weight as well. As we've reported, researchers in Sweden found that middle-aged men who consumed high-fat milk, butter and cream were significantly less likely to become obese over a period of 12 years compared with men who never or rarely ate high-fat dairy.

So, in other words, the butter and whole-milk eaters did better at keeping the pounds off. In addition, a meta-analysis -- which included data from 16 observational studies - also found evidence that high-fat dairy was associated with a lower risk of obesity.

Researchers can't fully explain these counterintuitive findings.

It's possible that "the fat in dairy makes you less hungry to eat some other foods," says DeBoer.

And there's evidence that "when people consume more low-fat dairy, they eat more carbohydrates" as a way of compensating, says Mozaffarian.

Many high-carb foods such as cereals, breads and snacks that contain highly refined grains are less satiating and can prompt people to eat more calories.

With all the new evidence that challenges the low-fat-is-best orthodoxy, Mozaffarian says it may be time to reconsider the National School Lunch Program rules, which allow only skim and low-fat milk.

"Our research indicates that the national policy should be neutral about dairy fat, until we learn more," says Mozaffarian.

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The Full-Fat Paradox: Dairy Fat Linked To Lower Diabetes Risk

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If you melt at the creaminess of full-fat yogurt, read on. A new study finds the dairy fats found in milk, yogurt and cheese may help protect against Type 2 diabetes. The research, published in the journal Circulation, included 3,333 adults.

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Confronting The Confusing World Of Nutrition

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The FDA recommends that Americans consume less than 12.5 teaspoons of added sugars per day. The average American consumes 60% more sugar than that allowance. Many health organizations believe that the daily limit of added sugar intake should be as little as 6 teaspoons per day. Though these new regulations are still based on a macro-nutrient ratio that is completely out of whack, they are at the very least, a step in the right direction. I would imagine it's difficult to squabble over the US daily allowance for added sugars with a government organization that still thinks Kellogg's frosted flakes are healthier than an avocado.

There are many reasons that processed food companies started utilizing "added sugars" in the production of their products. Due to an alarming rise in incidents of fatal heart attacks and heart disease in the late 70s, the US government implemented the dietary guidelines for America that mandated a reduction in dietary fats. This change was based on research that had not been proven, and was concocted by unqualified legislators instead of Nutritional Scientists. The food companies then had to reformulate their recipes to accommodate these new guidelines. The reduction and/or removal of dietary fat required that they be replaced by one of, or a combination of the two remaining macronutrients. Since many sources of fat were also rich with protein, the addition of carbohydrates was the only logical choice to fill that void. Sugar, being the Queen Mother of all carbohydrates, also happened to be delicious. The food companies discovered that the addition of sugars would not only improve taste, texture and palatability, but also improve shelf life. Scientific studies have indicated that "added sugars" also enhances addict-ability, which would obviously improve profitability. All of this to the unfortunate detriment of the public health. Sugars are undisputedly the main contributor to the obesity/diabetes epidemic that has plagued our country for the last three decades. This video illustrates the situation in a brief, yet entertaining way:

Processed food companies have become notorious for taking liberties with the truth in an effort to hide the existence of these added sugars from the consumer. Some of the language used on food labels would be more appropriate in the urban dictionary than on a list of ingredients. Their attempts at hiding "added sugars" on food labels have been nothing short of comical. As far as I can tell, there are nearly 300 different words being used to describe sugar on food labels in the US (a liberal estimation). Listed below are some of the most common:
Will the FDA's new Nutrition label lead to a whole new wave of trickery by the food companies? ...oh, you betcha!
Now that the FDA has issued a moratorium on "added sugars" with their required inclusion on product labels, the food companies are going to have to get even more clever when attempting to hide their existence from the general public. Since the FDA's announcement in 2014, many (most) food companies have been lobbying feverishly to squash these new regulations, but to no avail. Now they have no other recourse than to squabble over the minutia. One sugar lobby has already confronted the FDA with the claim that the teaspoon is a misleading unit of measurement. While another claims that grams are confusing. Let there be no doubt, the food companies will be doing everything within their power to blur the lines as to what "added sugars" actually are.
What's next?
Sugar accounts for a small fraction of U.S. farm output, but the industry contributes more to congressional campaign coffers than any other commodity producer. According to the Center for Responsive Politics, between 2007 and 2015 growers donated more than $22 million. They have money, and they are not afraid to spend it. The sugar lobby's power and influence should not be underestimated. They will most certainly be wielding cash to discover/create loopholes that we haven't even thought of yet. "There is likely to be litigation over what is and isn't added sugar," said Stephen Gardner, an attorney at the Dallas-based Stanley Law Group and former director of litigation at CSPI. A case will likely be made that sugar additives that are naturally occurring in nature, or that contain a slight modicum of minerals should not be counted amongst added sugars. Professor Jeremy Kees, a nutrition label expert from Villanova University School of Business, who has consulted for both the FDA and the food industry, said that he believes that the label change will have a relatively small impact on consumers, "I think front of pack labeling has more potential to have a bigger impact on consumers."

Blurring the lines with buzz words

All natural, All natural ingredients, Natural, Organic, Pure, Raw, Unrefined, Wholesome, DOES NOT mean " healthy". You're going to be seeing this terminology used at nauseum. These words will likely be used liberally on front label packaging containing "natural" sweeteners. The sugar lobby will argue that sweeteners that come from fruit and other natural sources should not be counted as added sugars. The problem is, the sugar that comes from fruit and most other natural sources is just NOT healthier, NOT different in any substantive way from the sugar that comes from sugarcane. This misunderstanding is exactly how food producers will exploit this rule. They will add apple juice or agave to everything that kids eat, and then their product will technically have no "added sugars," even when they actually have loads of added sugars. Food companies would like nothing more than to trick you into believing that their product is somehow wholesome, or "good for you" just because it's sweetened naturally.

The term organic is regulated currently by the USDA, for the production of meats, poultry and eggs only. The FDA has no regulation for the use of the term organic and neither organization has implemented hard fast rules for the use of the word natural.
" ... but it's all natural!" You say ...
Oh yeah, well so is cyanide.

" How bout a nice little poison ivy salad with some cow dung mushrooms, black mold croutons and a crude oil dressing? Perhaps you could wash it down with a lovely poison oak tea? ... "

...why not, it's natural?!! Did you know that 97% of the vegetation that grows on the planet is not fit for human consumption, and it's all natural. Here's a breakdown of some of the natural sweeteners that the health food community often claim are healthy:

Agave (nectar or syrup) - A very popular sweetener in the natural health community. This sweetener is often considered a healthy alternative to sugar because it's low on the glycemic index. The harmful effects of sugar have little to do with the glycemic scale, and everything to do with the fact that Agave is very high in fructose content. Repetitive fructose consumption can lead to insulin resistance which will chronically elevate blood sugar and insulin levels. Sugar is nearly 50% fructose, while Agave contains 70-90% fructose, far worse than sugar gram for gram.

Raw Organic Cane Sugar - Many so called "health products" are sweetened with raw, organic sugar. Organically grown sugar has the same chemical composition as "regular" sugar. The fact that it "raw" or how it's processed means nothing, our bodies metabolizes it in exactly the same way.

Evaporated Cane Juice - This one always makes me laugh. Do food companies really think that describing the way the Cane Sugar is processed is going to make it sound healthier? This one is just deception plain and simple. Evaporated cane juice IS sugar.

Brown Sugar - Molasses forms as a by-product of the sugar refining process and is often added back in small amounts giving the sugar a brown color. Molasses is about 50% sugar and contains a small amount of minerals. Brown sugar is regular sugar diluted with a slightly less unhealthy, less concentrated sugar. The tiny amount of minerals hardly make up for it's contribution towards insulin resistance.

Coconut Sugar - Derived from the circulating fluid of the coconut plant.The processing method is very natural... it simply involves extracting the fluid, then allowing the water to evaporate. Coconut sugar contains a small amount of fiber and a few nutrients, also has a lower glycemic index than regular sugar. However, the glycemic index is just shy of irrelevant when it comes to the harmful effects of sugar. What really matters is whether this product is high in fructose or not. Coconut sugar is actually very high in fructose. It contains a small amount of free fructose, but 75-80% of it is sucrose, which is half fructose. That's about 35-45% total fructose. Due to its slightly smaller amount of fructose than sugar, and the tiny amounts of fiber and nutrients, you could say that coconut sugar is less unhealthy than regular sugar, gram for gram. However... being "less unhealthy" than sugar does NOT make it healthy.

Honey - Contains some nutrients which includes antioxidants and trace amounts of vitamins and minerals. However, it is 80% sugar, by weight. Several studies have compared honey to plain sugar and noted that honey has slightly less harmful effects on metabolism. This is yet another example of a sweetener that is slightly "less unhealthy" than sugar. While a better choice than high fructose corn syrup, it is not recommended if your goal is weight loss.

The Bottom Line: Your body metabolizes the fructose in all of these natural sugars the SAME way as it does with regular sugar. Your liver doesn't know the difference!

I know what you might be thinking ...is this the part in the article where he reminds us that we can satisfy our sweet-tooth with fiber rich fruits and berries? Is this just a full on assault on all things sweet? Must we live our days tasting only saltiness, sourness and bitterness if we want to eat healthy? Have we been presented with a problem that has no solution? Does the food industry even have healthy options for added sugar? What's with all the questions?
THE FACT OF THE MATTER IS: The food companies DO have healthy (or at least "not unhealthy") options in regards to the added sugars they use in their products!

Here is a short list of some of the most common "not unhealthy" sweeteners:

Stevia - A very popular low-calorie sweetener that currently holds a 13% share of the artificial sweetener market in spite of the fact that it is not artificial. It is extracted from the leaves of a plant called Stevia rebaudiana. This plant has been grown for sweetness and medicinal purposes for centuries in South America. There are several sources of sweetness found in Stevia leaves, the main ones are Stevioside and Rebaudioside A. Both are many hundred times sweeter than sugar, gram for gram, with virtually no calories. There have been several studies conducted with humans revealing Stevia to have health benefits. When blood pressure is high, Stevia can lower it by 6-14%. However, it has no effect on blood pressure that is normal, or only mildly elevated. Stevia has also been shown to lower blood sugar levels in diabetics. There have also been studies in rats showing that Stevia can improve insulin sensitivity, reduce oxidized LDL cholesterol, and reduce plaque build up in the arteries. Stevia also has the greatest consumer availability than most of the other safe sugar replacements.

Erythritol - is low-calorie sweetener. It's a sugar alcohol that is found naturally in certain fruits It contains 0.24 calories per gram, that's about 6% of the calories that sugar has, with 70% of the sweetness. Erythritol doesn't spike blood sugar or insulin levels and has no effect on biomarkers like cholesterol or triglycerides. It is absorbed into the body from the intestine, but is excreted from the kidneys unchanged. Studies show that erythritol is very safe. However, same as with other sugar alcohols, it can cause digestive issues if you consume too much at a time. Erythritol tastes very much like sugar, although it can have a mild aftertaste.

Xylitol - is a sugar alcohol with a sweetness similar to sugar. It contains 2.4 calories per gram, or about 60% of the caloric value of sugar. Xylitol has some benefits for dental health, reducing the risk of cavities and dental decay. It has also been attributed to improved bone density, helping to prevent osteoporosis. Xylitol doesn't raise blood sugar or insulin levels. However, as with other sugar alcohols, it can cause digestive side effects if consumed in high doses. Xylitol is toxic to dogs, but completely safe for humans.

Yacon Syrup - is harvested from the Yacon plant, which is native to the Andes in South America. This sweetener has recently become popular as a weight loss supplement because one study found that it caused significant weight loss in overweight women. It is high in fructooligosaccharides content, which functions as a soluble fiber that feeds the good bacteria in your intestines. Yacon syrup can help reverse constipation.

Monk fruit (luo han guo) - is a fruit native to China and northern Thailand. It's 300 times sweeter than sugar, and has been used in traditional Chinese medicine to treat obesity and diabetes. Luo han guo is a cousin of the cucumber, and contains mongrosides. Studies are underway to discover whether there is truth to the claim that these monogrosides inhibit tumor growth. Luo han quo has antioxidant properties, and may help manage diabetes. Because these antioxidants have inhibitory effects on blood sugar levels, they may also defend against heart disease. Teas made from luo han guo have been known to relieve throat inflammation or cough, cool heat stroke, help with elimination in the elderly, and aide in the relief of digestive distress.

The Bottom of the Bottom Line:

The Food Industry DOES in fact have healthy/not unhealthy options in regards to the use of added sweeteners to improve the palatability of their processed foods. The real question is - Will they utilize their considerable resources ($) to litigate in an effort to maintain the status quo? Will they direct their money towards developing and improving upon the use, production and implementation of healthier options? Though the most likely scenario is a combination of both (skewed heavily on the side of litigation) my hope is that the FDA will stand strong and not allow politics to influence the ingredients included in products targeting our country's children.

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The FDA recommends that Americans consume less than 12.5 teaspoons of added sugars per day. The average American consumes 60% more sugar than that allowance. Many health organizations believe that the daily limit of added sugar intake should be as little as 6 teaspoons per day.

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Sugar and Kids: It's Probably Worse than you Thought

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Sugar and Kids: It's Probably Worse than you Thought

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Your brain needs fructose and glucose. But your body can really do without the high fructose corn syrup or sucrose. And all those other added sugars hiding in processed foods and sweetened drinks.

That's why the American Heart Association has done a review of over 125 references to determine risks children ages 2 to 18 face from added sugar.

We hear from Dr. Rachel Johnson, professor of nutrition at UVM, about those risks and why it's important to keep added sugars away from your kids.

Also on the program, there's a group of weather watchers out there measuring precipitation on your behalf. Jay Shafer, professor of atmospheric sciences at Lyndon State College, explains about the Community Collaborative Rain, Hail & Snow Network (CoCoRaHS).
Broadcast on Monday, Aug. 29, 2016 at noon and 7 p.m.

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Sugar And Kids: It's Probably Worse Than You Thought

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Your brain needs fructose and glucose. But your body can really do without the high fructose corn syrup or sucrose. And all those other added sugars hiding in processed foods and sweetened drinks. That's why the American Heart Association has done a review of over 125 references to determine risks children ages 2 to 18 face from added sugar.

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centers for disease control and prevention

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We're consuming fewer calories, but not necessarily the right kinds of food.

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For years, the sugar industry has funded shaky science in an attempt to influence your diet.

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7 Common calorie myths we should all stop believing

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7 Common calorie myths we should all stop believing

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Americans eat far too much sugar because of ultra-processed foods

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Americans eat far too much sugar because of ultra-processed foods

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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Junk Food Ban In Canadian Schools Already Showing Results

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Junk Food Ban In Canadian Schools Already Showing Results

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HALIFAX - In Canada's ongoing battle against childhood obesity, one simple weapon appears to be working.

Over the past 12 years, six provinces have banned junk food from schools, and a new study says the measure is having a positive impact on student health.

"It's a small step in the right direction," said Philip Leonard, a health economist at the University of New Brunswick. "Combined with other policies of this type, you can hope to see real difference over time."

Leonard looked at the Body Mass Index (BMI) of 153,000 Canadians, aged 12 to 25, during an eight-year period. Within that sample, compiled from the annual Canadian Community Health Survey, more than 22,000 youths had been banned from buying junk food at school for at least one year.

His research revealed that for each year a student was exposed to a junk food ban, there was a corresponding 0.05 decline in their BMI, a value derived from height and weight.

As a result, the students banned from making junk food purchases at school for five or more years were, on average, about two pounds lighter than students who did not face a ban.

That may not sound like a big difference, but the findings send a strong message, said Leonard, a researcher with the New Brunswick Institute for Research, Data and Training.

"You wouldn't expect that a ban like this would suddenly change a whole bunch of overweight kids into dramatically healthy kids ... (But) the main message is that these types of policies are going down the right track."

The study also found there was a bigger impact on females, though Leonard said it's not clear what is behind that finding.

As well, younger students showed the most positive results. That probably stems from the fact that older students have more opportunities to leave their schools to forage for food.

"When you're in high school and you've got your driver's licence at 16, you can drive to McDonald's or just walk to the convenience store," Leonard said.

In October 2005, New Brunswick became the first province to impose a junk food ban inside its schools. Under its Policy 711, the Department of Education eliminated all foods from a so-called "minimum nutrition" list.

It's a huge problem. We're not going to solve it with one little policy change. But, this policy change did make a difference, so it makes sense to look at others.

Prince Edward Island followed suit later that year. Nova Scotia and Quebec did the same in 2007, followed by British Columbia in 2008 and Ontario in 2011.

Despite the positive results, Leonard said junk food bans, on their own, won't be enough to reverse the troubling trends associated with childhood obesity.

"It's a huge problem," he said. "We're not going to solve it with one little policy change. But, this policy change did make a difference, so it makes sense to look at others."

Using World Health Organization standards, Statistics Canada says close to one-third - 31.5 per cent - of Canadian children and youth were classified as overweight or obese between 2009 to 2011.

The federal Health Department has said it plans to update dietary guidelines by the end of 2018 that will reflect the most up-to-date scientific evidence on diet and health. Other initiatives include updated nutrition labels on pre-packaged foods and restricting marketing to children.

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Junk Food Ban In Canadian Schools Already Showing Positive Results

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HALIFAX - In Canada's ongoing battle against childhood obesity, one simple weapon appears to be working. Over the past 12 years, six provinces have banned junk food from schools, and a new study says the measure is having a positive impact on student health.

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Does Junk Food in Schools Really Matter?

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Does Junk Food in Schools Really Matter?

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Study: No Link Between School Junk Food Sales and Middle School Kids' Weight
Laura J. Martin, MD on January 18, 2012

Jan. 18, 2012 -- Junk food sales in schools, long blamed for contributing to childhood obesity, do not make a difference overall in the weight of middle school students, according to a new study.

The researchers followed more than 19,000 students from grades five through eight in 1,000 private and public schools.

"What we found basically is, there is no relationship between going to a middle school that sells junk food and gaining weight," says researcher Jennifer Van Hook, PhD, professor of sociology and demography at Penn State University.

The message, she stresses, is not that junk food is OK, but that schools are probably not the main source of kids' junk food intake. The study is published in the Sociology of Education.

However, obesity experts who reviewed the findings for WebMD say that kids need a consistent message about healthy eating.

Junk Food in Schools: A Short History

Public health experts have been concerned about junk food in schools for many years. Obesity now affects 17% of U.S. children and teens ages 2-19, according to the CDC. Advocacy groups have directed efforts at getting junk food out of schools. Some previous studies have found a link between junk food sales in schools and children's weight, although Van Hook says the studies were small and not conclusive.

One scientifically sound study, she says, did show a link between the availability of junk food in school and weight gain in high school students.

Van Hook's study was what's called an observational study, which means it cannot prove cause and effect, but only a link or association. Still, she expected to find a link, she says, but did not.

Junk Food in Schools: Focusing on Middle Schoolers

Van Hook and her colleagues looked at data on almost 20,000 children from the National Center for Education Statistics.

It was collected from the 1998-1999 school year, when the students were in kindergarten, until they were in eighth grade in 2006-2007.

The researchers looked at the children's body mass index, or BMI, at the beginning of the fifth grade and again in the eighth grade.

They considered whether the schools offered what Van Hook calls "competitive" food in addition to school-served food. These foods run the gamut from candy and ice cream to low-fat yogurt.

At the fifth-grade mark, 59% of the schools offered junk food. At theeighth-grade mark, 86% did.

The researchers considered race and ethnicity, socioeconomic status, and other factors that might affect unhealthy weight gain.

Children in schools with junk food sales did weigh a bit more by eighth grade than the kids in schools without. However, the difference was slight and not significant from a statistical point of view, Van Hook says.

In the eighth grade, 35.5% of kids in schools with junk food were overweight, while 34.8% of those in schools without it were.

In the report, the researchers write that their study provides "no support'' for the idea that the junk foods sold in school increase the risk of obesity in the age range studied.

"No matter how we looked at it," Van Hook tells WebMD, "we found absolutely no difference between the group of kids exposed and those who were not."

Van Hook says the story may change, however, by high school. She suspects the structure of middle school, which limits the chances a child has to buy junk food, may play a role explaining her finding. By high school, students have more unstructured time and more money.

Van Hook says she is not against efforts to rid schools of junk food. However, she says her study finding suggested that ''we can't count on schools to solve the problem of childhood obesity." The school setting and exposure to junk food, she says, may represent only a small part of the problem.

Efforts directed only at removing junk food from schools may be misdirected, Van Hook tells WebMD. Those efforts should be extended to the community and to the home.

Parents can educate children about healthy diets early, she says. Habits are formed early and may also affect a child's response to junk food later.

Junk Food in Schools: If It's Around, Will Kids Eat It?

The lack of information about each child's intake is a problem of the study, says obesity expert Marion Nestle, PhD, MPH, the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University. "I don't think this study can tell you much unless you look at actual food consumption, which this study was not designed to do," she says.

"It makes sense to think that if junk food is around, kids will eat it, and there is plenty of evidence to back that up," Nestle says.

"Junk food has no place in schools," she says. "Schools set an example for what kids should eat."

Kids need a consistent message about healthy eating, agrees Ginny Ehrlich, MPH, the CEO of Alliance for a Healthier Generation, which advocates for healthier food choices in schools. Kids are the first to point out the hypocrisy of learning about healthy foods in nutrition class and then being exposed to junk foods at school, she tells WebMD.

''In school environments, where kids spend probably the most time next to being at home, it's really important that those messages about healthy eating and physical activity are reinforced and promoted," she says.

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Study: No Link Between School Junk Food Sales and Middle School Kids' Weight Laura J. Martin, MD on January 18, 2012 Jan. 18, 2012 -- Junk food sales in schools, long blamed for contributing to childhood obesity, do not make a difference overall in the weight of middle school students, according to a new study.

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Defining Moderation

Since 1980, the US Government has published Dietary Guidelines for Americans, updating them every five years. In each version of the guidelines, there has been a general recommendation for Americans to moderate intake of sugars. The 2015-2020 Dietary Guidelines for Americans were the first guidelines to quantify moderation, recommending Americans limit added sugars to no more than 10% of calories per day. This recommendation is based on food pattern modeling (a tool used to figure out how you can meet all your food group recommendations within calorie needs), and the 10% target is an attempt to help individuals move toward healthy eating patterns within calorie limits. For more information about the dietary guidelines, visit dietaryguidelines.gov.

Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease...To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts.

Dietary Guidelines for Americans, 2015-20201

Overall, the public health recommendation about 'added sugars' must be balanced with the reality that sugar added to food is an important piece in the food science puzzle given its several functionalities in food. Not only can a spoonful of sugar help the medicine go down, but it can help fruit, vegetable and fiber go down as well.

Goldfien KR, Slavin JL. 20152

Added sugars provide sweetness that can help improve the palatability of foods, help with preservation, and/or contribute to functional attributes such as viscosity, texture, body, color, and browning capability.

Dietary Guidelines for Americans, 2015-20201

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Since 1980, the US Government has published Dietary Guidelines for Americans, updating them every five years. In each version of the guidelines, there has been a general recommendation for Americans to moderate intake of sugars. The 2015-2020 Dietary Guidelines for Americans were the first guidelines to quantify moderation, recommending Americans limit added sugars to no more than 10% of calories per day.

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Intakes of Added Sugars in the United States

For the past 20 years, added sugars consumption has been on a significant decline in the United States. ¹⁻⁴

Typically added sugars intake is presented in teaspoons (tsp), grams (g), calories (kcals) or % of total calories. The 2015 Dietary Guidelines for Americans recommends daily intake of added sugars make up no more than 10% of total calories. In a 2,000 calorie diet, this translates to: 12 tsp, 50 g, 200 kcals, 10% of total calories.

Percent of Calories from Added Sugars1, 7, 8

Added sugars consumption in 2015-2016 is reported to be about 13% of total calories, or around 270 calories per day. 7,8 This is still slightly above the Dietary Guidelines for Americans, as the 2015-2020 recommendations suggest no more than 10% of calories from added sugars per day. ⁶

What We Eat in America (WWEIA) captures U.S. dietary intakes as a part of National Health and Nutrition Examination Survey (NHANES). This survey is conducted every two years in partnership with the United States Department of Agriculture (USDA) and Health and Human Services (HHS) to assess the health and nutritional status of Americans. ⁹

Total added sugars intake is on the decline, but how much actual sugar (or sucrose) are we consuming?

Dietary data are frequently reported as total added sugars, a combination of the intakes of all caloric sweeteners: sugar, high-fructose corn syrup, honey, maple syrup, etc. If we look at just sugar intake, consumption of sugar (sucrose) from sugar beets and sugar cane, there has been a decrease of about 30% from 1970 to 2016, which is a drop from 283 calories (17.7 teaspoons) per day to 193.7 calories (12.1 teaspoons) per day. ⁵

While added sugars consumption increased sharply in the 90's, intakes today have come back down and are very close to what they were in 1970. Compared to 1970, daily added sugars consumption has increased by about 30 calories. ⁵

The USDA has been collecting food supply data for a long time! Looking back over 100 years, sugars and sweeteners made up 11.9% of all calories in the food supply in 1909. Over the past century there have been some ebbs and flows in this percentage, the highest being 18.2% in 1997-1999. However, since the turn of the century, the percentage of calories from sugars and sweeteners has dropped steadily. It is important to note that total calorie intake has come up since 1909, but as a percentage of total calories, total sugars and sweeteners consumption is on the decline. ¹⁰

National Data Sets

Did you know that the USDA has been monitoring food supply data since 1909? This extensive history shapes our insights on dietary trends and Americans' food intake.

References:

1. Welsh JA, Sharma AJ, Grellinger L, Vos MB. Consumption of added sugars is decreasing in the United States. Am J Clin Nutr. 2011; 94:726-34. [PubMed: 21753067]

2. Slining MM, Popkin BM. Trends in intakes and sources of solid fats and added sugars among US children and adolescents: 1994-2010. Pediatr Obes. 2013 August;8(4):307-324. doi:10.1111/j.2047-6310.2013.00156.x.

3. Bowman SA, Friday JE, Clemens JC, LaComb RP, Moshfegh AJ. A comparison of Food Patterns Equivalents Intakes by Americans: What We Eat in America, NHANES 2003-04 and 2011-12. USDA Food Surveys Research Group. Dietary Data Brief No. 16. September 2016.

4. Bowman SA, Clemens JC, Friday JE, Lynch KL, LaComb RP, Moshfegh AJ. Food Patterns Equivalents Intakes by Americans: What We Eat in America, NHANES 2003-2004 and 2013-2014. USDA Food Surveys Research Group. Dietary Data Brief No. 17. May 2017.

5. Food availability (per capita) data system: Loss-adjusted food availability documentation. USDA ERS. https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/. Updated Oct. 29, 2018.

6. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at: http://health.gov/dietaryguidelines/2015/guidelines/. Accessed April 10, 2018.

7. U.S. Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group, Beltsville, Maryland, Food Patterns Equivalents Databases and Datasets. Available at: http://www.ars.usda.gov/Services/docs.htm?docid=23869. Accessed January 31, 2018.

8. U.S. Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group, Beltsville, Maryland, WWEIA Data Tables. Available at: https://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/wweia-data-tables/. Accessed January 31, 2018.

9 . U.S. Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group, Beltsville, Maryland, WWEIA/NHANES Overview. Available at: https://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/wweianhanes-overview/. Accessed April 10, 2018.

10. U.S. Department of Agriculture, Center for Nutrition Policy and Promotion. Nutrient Content of the U.S. Food Supply, 1909-2010. Available at: https://www.cnpp.usda.gov/USFoodSupply-1909-2010. Accessed April 10, 2018.

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For the past 20 years, added sugars consumption has been on a significant decline in the United States. 1-4 Typically added sugars intake is presented in teaspoons (tsp), grams (g), calories (kcals) or % of total calories. The 2015 Dietary Guidelines for Americans recommends daily intake of added sugars make up no more than 10% of total calories.

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Are your children getting heavy metals in their fruit juice?

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Are your children getting heavy metals in their fruit juice?

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Mom Stephanie Trilling says she tries hard to keep her 4-year-old daughter away from juice, mostly because of its sugar content.

"It's not something I want to give to my kids but I also don't want to be that mom who is restricting everything," Trilling said.

But she may have another reason to restrict juice intake: a new analysis from Consumer Reports. James Dickerson is the chief scientific officer. His team tested 45 different juices for four heavy metal substances: inorganic arsenic, lead, cadmium and mercury.

They found that every single product contained a measurable amount of at least one heavy metal, except for mercury. Twenty-one of the samples contained one or a combination of heavy metals that reached a level Consumer Reports researchers deemed concerning for daily consumption.

The CDC says long-term exposure to heavy metals may put people at risk for kidney disease, diabetes, high blood pressure, damaged ability to learn and certain types of cancer.

Consumer Reports is recommending parents lower the amount of juice they give their kids.

"So they should be concerned but don't panic," Dickerson said. "Frequent exposure to these heavy metals through the juice is a concern."

The Juice Products Association, whose board of directors includes executives from PepsiCo, Welch's and other juice brands whose products were tested, said they haven't seen the full study but called the results "unfounded" and told us they are committed to providing "safe and nutritious" products that meet FDA standards.

They also said that there is "no scientific evidence" indicating that trace levels of heavy metals have caused any negative health outcomes.

But Dr. Leo Trasande, the director of environmental pediatrics at NYU School of Medicine, says, "The science is telling us increasingly that there are particular time points in life when even a small amount of exposure, for example, can disrupt hormones and thereby contribute to disease."

In 2013, the FDA proposed limiting inorganic arsenic in apple juice but no change was ever made. The FDA had no comment.

Consumer Reports says their findings are a "spot check" and "should not be used to draw definitive conclusions about specific brands."

CBS News reached out to all of the juice companies. Ten responded saying their products are safe and follow all food safety guidelines.

Consumer Reports says the metals found in seven of the 21 samples had the potential to harm children who drink only a half cup per day.

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are your children getting heavy metals in their fruit juice?

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Are your children getting heavy metals in their fruit juice?

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A new report says some popular fruit juices may contain heavy metals. The substances make their way into food because they occur naturally in the air, water and soil, but they can also wind up in food during manufacturing and packaging.

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Unblind My Mind: What are we eating?: Dr. Katherine Reid at TEDxYouth@GrassValley

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Eat This! book. Read 13 reviews from the world's largest community for readers. A follow--up to What's for Lunch?, Eat This! focuses on the impact on chi...

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(My reviews are intended for my own info as a language arts teacher: they serve as notes and reflections for teaching and recommending to students. Therefore, spoilers may be present but will be hidden.)

SUMMARY: I was surprised at what a quick read Chew On This ended up being for a nonfiction text aimed at young adult readers. Jam-packed full of interesting facts about fast food, authors Schlosser and Wilson have put together a book that is both appalling and eye-opening: either way, there's no...more

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(My reviews are intended for my own info as a language arts teacher: they serve as notes and reflections for teaching and recommending to students. Therefore, spoilers may be present but will be hidden.) SUMMARY: I was surprised at what a quick read Chew On This ended up being for a nonfiction text aimed at young adult readers.