Carding Kids for a Can of Coke? Crazy! (or, is it??)

There are many good things about living in San Francisco. The weather is pretty decent 9 months out of the year, fresh, inexpensive produce abounds, the people are friendly, and the city is small enough that I can get across town in 30 minutes but big enough that I'm always discovering a new little hole-in-the-wall place to go to or a neighborhood to explore.

One of my newest discoveries of why I love SF has little to do with these previous attributes, except for the one about the people. Not only are the people here nice, they're SMART. Like REALLY, REALLY, SMART. Not surprising, since arguably three of the state's best colleges are located in the area. Between UCSF, UC Berkeley, and Stanford, we have a great concentration of brilliance per square mile. Throw in the students and faculty at UC Davis a mere 75 miles away and you have a force of intelligence to be reckoned with.

I recently took advantage of this when I attended two nutrition conferences in the past two weeks, one called the "Sugar Symposium" the other "The Sun Food Agenda" (the latter I will discuss in a separate post). The Sugar Symposium was the brain child of UCSF COAST (Center for Obesity Assessment, Study, and Treatment), UC Berkeley, and UC Davis. Among other things, what amazed me the most was the fact that I sat through 6 hours of lecturing about sugar biochemistry, brain chemistry, and the application of the mounting evidence of the realities of sugar addiction... without losing attention! The conference was absolutely fascinating, and by far the best part was Dr. Robert Lustig's diatribe against sugar at the end.

Dr. Lustig is traditionally known as the Chief of Pediatrics at the UCSF Medical Center, but I lovingly refer to him as the Chief of Nutrition Badassess. To summarize his schpeel is to not pay proper homage, but alas I don't have enough time to divulge all the details!

Note that when I refer to sugar in this post, I'm referring to a certain kind of sugar called fructose. Yes, you may recognize fructose as a carbohydrate that is found in fruits, but I'm not talking about that kind of fructose. I'm referring to the highly processed corn by-product called HFCS (high fructose corn syrup) which is a fairly recent invention that is manufactured in a laboratory, not something found in nature. You may have heard about or seen commercials from the Corn Refiners Association touting HFCS as "healthy in moderation," and "natural" like table sugar (sucrose) but after you read what I learned at the symposium, you might start to think differently.

Basically, this is what he said:

1) Sugar (specifically fructose, like that found in highly processed foods including soda) is just as bad for you as alcohol when consumed in excess. Fructose is metabolized in the liver at an unregulated rate (all of the fructose you eat gets absorbed, which is not the case for other sugars) and turns into little droplets of fat, as does alcohol. When people consume excess alcohol for long periods of time, they often develop a condition called hepatic steatosis, or alcohol-induced fatty liver disease. Not surprisingly because of the way fructose is metabolized, we're now seeing fatty liver disease in people (typically obese) who consume a large amount of fructose.

Fructose is damaging to the liver just like alcohol.

2) Because of government subsidies encouraging farmers to grow excessive amounts of corn and soybeans (what we like to call commodity crops), fructose (most commonly found in the form of high fructose corn syrup) is very inexpensive, readily available, and highly preferred as a sweetener over cane sugar since it is very sweet and very cheap. As such, it is found in many products, even ones that you wouldn't think would have sugar in them. It appears that sugar is seemingly added to food products just for the heck of it! (A conspiracy theorist could say it's just an attempt for food manufacturers to capitalize on the addictive nature of fructose) As compared to alcohol, you can often buy a 6 pack of beer or bottle of wine for less than a bottle of water. We all know how much cheaper a 2 liter bottle of soda is than the equivalent amount of water. Interesting...

Fructose is very cheap (soda is less expensive than bottled water) and readily available, just like alcohol. It is found in every corner store, just like alcohol.

3) Sugar consumption triggers pleasure centers in the brain that, when consumed in excess for many years, can simulate an addictive quality, just like alcohol. There is evidence that when people "come off" of sugar, their bodies rebel, just as an alcoholic would experience when starting rehab.

Fructose is physiologically addictive like alcohol.

4) Drinking a lot of alcohol causes people to gain weight in their mid-sections, which we affectionately refer to as the "beer belly." Fructose does the same thing (because it turns into fat droplets in the liver), so now we're seeing people with "sugar bellies."

Fructose will give you a "sugar belly," just like alcohol causes "beer belly."

5) Alcoholism is more common in lower socioeconomic populations (ie the poor) presumably because it is so addictive, inexpensive, and readily available. Sugar addiction is also common in the same population, presumably for the same reasons.

Sugar addiction disproportionately affects the poor, who also suffer from higher rates of obesity and other chronic illnesses.

In summary, I was in awe at Dr. Lustig's presentation. After making those shocking comparisons between fructose and alcohol, he then made some suggestions for regulating fructose. Can you imagine carding a teenager when they go to buy a soda, or to have quotas on sweetened beverages/snacks? Lustig think that's the way to go. He also believes in taxation on sugary foods (similar to a "fat tax") in an attempt at making a bag of cookies more expensive than a bag of apples. Related to that, he would love for the government to discontinue the subsidies on corn and soybeans, and instead encourage farmers to grow more fresh fruits and vegetables, which would make them less expensive. Lustig doesn't believe that educational programs are effective, and that our only way at winning this "war on obesity" is to have government intervention which will strongly encourage people to not buy the sugary foods by means of heavy taxation and regulation. After all, this was coming from the man who was responsible for San Francisco banning toys from Happy Meals (which I happen to support).

Personally, I'm not a big fan of "big brother" or the "food police," but when you look at the similarities between fructose and alcohol, it's pretty scary! We'd all agree that alcoholism is a public health concern, but very few people would consider obesity in the same light...until now, perhaps. I had never thought of sugar as something as physiologically addictive and damaging as ethanol, and I, for one, will never look at a can of Coke the same way again.

PS: For a laugh, check out SNL's parody on HFCS :)

The Franco-American Paradox

Anyone who knows me knows that I'm a total 100% Francophile who is convinced she used to be a French princess in her past life.

I love everything French...the country, the culture, the music, the movies, the boys (ha!), but most importantly, the food! The classic French diet contains quantities of butter that would make Paula Deen swoon; baguette so chewy it makes your jaw hurt, meats that are slow-cooked and fork-tender (nothing Rachael Ray could simulate in 30 minutes), buttery tarts of fresh fruits, and the most satisfying salads of organic vegetables perfectly accentuated by homemade vinaigrette. But let's not forget the cheese--oh! the cheese!--full-fat raw milk magically transformed into enough creamy stinky goodness that you could eat a new cheese every day of the year. (IMAGINE!!)

And yet...I've never actually met a fat French person.

This brings to mind the classic French paradox: with a diet so rich in animal fats (and consequently saturated fat) and high in carbs, how DO they stay so thin? Author Mireille Guiliano attempts to answer that in her book "Why French Women Don't Get Fat." She cites the French "way of life" in where everything tastes, looks, smells, IS so good that overindulgence is literally a sin. A French woman, she says, has her Chanel bag in one hand and a bottle of water in the other. The French woman is refined, appreciates every bite of food she eats, and would never EVER "let herself go."

Having studied the language and culture for several years, and while spending my month-long "sabbatical from life" (or sabbatical living the life!) 5 years ago in Paris, I can personally attest to the fabulousness of how the French view life overall. For example, Americans, who are pretty accustomed to dressing casually, always are shocked at how well-dressed Parisians are. I noticed right away how the women AND men were perfectly dressed, complete with scarf and bag (or man bag/European carry-all for the boys). It seemed as though just an ordinary trip to the market required a full-on perfectly coordinated outfit. In the 32 days I spent wandering aimlessly around nearly every arrondissement in the city I never found a woman dressed in "frumpy" clothing, something I see nearly every day here in the States (especially in super-casual SF). Most people would consider that "showy" or "excessive" but I learned that that's merely a French person's way of appreciating beauty. In their minds, the world is beautiful, so if you are leaving your house and heading out, you should bring that beauty with you and share it with everyone you meet. A quick "Bonjour!" upon entering a shop is expected, and frankly it should be!

This intense appreciation for beauty very easily extends to the incredible cuisine offered in France. Anyone who is familiar with classic French cooking, or knows anything about Julia Child's Mastering the Art of French Cooking, understands that there is no such thing as quick French food--a basic stew takes hours to prepare, but the flavors that develop in that time are incomparable to what Rachael Ray tries to pass off as "slow-cooked flavor" in her 30-minute meals. The aesthetic beauty of a simple tarte aux pommes with the concentric rings of caramelized apples on top can be overwhelming--at least for me. One unspoken rule of French dining: it should take as long for you to eat the meal as it did to cook it. I LOVE THIS! From my last trip to France where I spent 1 week in the Alps and 1 week in Paris, I remember eating meals every day that were at least 4 courses long--sometimes 6. These meals were epic--lunch lasted at least 1-2 hours and was followed by a lovely restorative nap. Dinner usually involved 5 courses of food and 3 types of wine--I was in heaven! I was there during the Christmas season so the foods were definitely special aka super rich! I basically slept in every day, feasted on homemade foie gras, various terrines, omelette, bread, cheese, wine, chocolate, cheese, soup, and more cheese (but never was "full" mind you) and I managed to lose 2 lbs! Did I mention I love France!?

When I got back to the States I was reminded of the infamous "New Years Resolution" and was barraged by ads for reduced-price gym memberships. I always laugh and think, this is the country of $12 BILLION of wasted money on gym memberships--I'm not buying into your gimmicks! We Americans spend $61 BILLION on supplements--vitamins, minerals, protein shakes, most of which is not utilized by the body and ultimately ends up in the toilet. I like to call supplements "really expensive urine." Add to the supplement industry an additional $6 BILLION in "diet" foods--aka processed "food-like substances" that have no flavor and actually make you fatter. We are a nation of perpetual dieters, compulsive exercisers, consumers who buy into the latest "fad"--whether it be a home gym that will give you 8-pack abs in only 5 minutes a day, a Shake Weight contraption, Muscle Milk expensive urine, or P90X extreme body workout. But *SURPRISE* the obesity epidemic continues to worsen. This is the American paradox.

The only way I can explain the mechanisms of the French paradox is thus: through the intense appreciation of beauty in all its forms that is so paramount in French culture, specifically relating to food, the French eat so well but take time to enjoy their food which gives the body enough time to recognize satiety (it takes 20 minutes for the brain to know the stomach is full). I think this appreciation of every bite taken also leads people to not over-indulge. I have experienced this when I dine at fine restaurants in the US; the food is of such high quality and so exquisitely prepared that despite the miniscule portions, I'm always perfectly satisfied at the end of the meal. Surely the accompanying drawn-out conversation plays a big role as well!

The food culture in the United States is sorely lacking in appreciation of real cuisine, although I have seen that change a bit over the past few years. I do think that our viewpoint towards food is inextricably linked to our view on life and beauty in general, and the attitudinal adjustment necessary to improve our waist lines is going to take some time to achieve. As people learn to appreciate their bodies and the interaction with the world in which we live, we're going to see a shift in the way the society looks at food. I hope this happens sooner than later!

So this former French princess would like to conclude with a bit of wisdom that she shares with her clients: a quote from her idol, Julia Child: "The only time to eat diet food is while waiting for the steak to cook."

Bon appetit!

Cure your diabetes in 30 days!! Part Two

Ok, so to follow-up on Part One of this post, here is my interpretation of this "phenomenon." As a reminder, diabetes is conventionally thought of as a chronic illness--ie one that will never be "cured" but rather "managed" through proper diet, physical activity, and medication compliance. The belief (and what decades of sound medical research supports) is that people with good glycemic control can become resistent to a hormone called insulin that is produced by an organ in our body called the pancreas. When we eat, the carbohydrate in our food is converted to glucose, which is absorbed into our blood and supplies the necessary energy to our body. In order to bring the levels of glucose back down to normal, the pancreas produces insulin. Sometimes, as we get older and/or gain weight, our bodies don't use the insulin as efficiently--this condition is called insulin resistance or pre-diabetes. If this condition is addressed early on with diet and exercise (and sometimes medication), it can be reversed. BUT if it is not addressed, it can progress to full-blown diabetes. Once you become diabetic, your pancreas is so diseased that as far as we know it cannot suddenly heal and start working properly again. This is what makes diabetes incurable and a therefore qualify as a chronic illness.

First and foremost, the main problems I have with this film are with the claims these Raw Food people make of "reversing" and "curing" this disease--I believe them to be extremely misleading and potentially very dangerous. There is no evidence to my knowledge of the pancreas suddenly regenerating beta cells and producing more insulin--this is giving scared vulnerable people false hope. NOT GOOD.

Second, the people in the film were told to reduce their medications by half right off the start. As any physician/health care professional knows, it's generally not a good idea to drastically reduce a medication. Normally patients are weaned off their meds, as this provides the body more time to adjust and doesn't provide as much a shock as as drastic dose reduction would provide. So right there I became concerned.

Third, they were started on an vegan raw-food diet, which for all of them involved a complete swing of the dietary pendulum. I'm sorry, but anyone who goes from eating McD's twice a day to eating a diet of organic produce and sprouted grains is going to see a health benefit. But cure an illness in 30 days?! That seems a little far-fetched. As any nutrition professional knows, just getting people to follow any diet is nearly impossible long-term--imagine what it feels like to only be "allowed" to eat raw food! Talk about compliance issues, people. Tooooootally impracticle. On a side note, I went on a raw food diet for a week as a class assignment, and wrote about my experience. As you can imagine, I normally eat a healthy diet, so this wasn't such a huge switch for me, but let me just say I felt like CRAP and could barely stand it for 7 days. And I'm a nutritionist with fairly reasonable access to this food--how is the average person supposed to handle this?! Don't get me started...

Featured in the film were the numerous health benefits of this raw food diet that were aside from curing diabetes--blood lipids (think cholesterol) all decreased, blood pressure decreased, energy increased, and guess what--they people lots tons of weight! Something that averaged out to between 4-5 pounds/week. ASTONISHING! So many things wrong with this, where do I start!? First, if you want to be healthy and lose weight, losing 1-2 lbs/week MAX is what is recommended for sustained weight loss. Second, I recall some research done with obese diabetic patients who underwent bariatric surgery (think stomach-stapling). Miraculously after they lost 40, 50, 60 pounds within the first month or two post-surgery, their blood sugars were so improved that they seemed to have reversed their diabetes! So this would be my guess as to why the people in the film had improved glycemic control all of a sudden--it has nothing (or very little) to do with the raw food diet, but instead with the fact they lost so much weight in such a small amount of time. Something important to mention--the post-bariatric surgery patients' glycemic control returned to baseline (before the surgery) after a few months, so no cure for their diabetes. Interestingly enough, there was no follow-up with the patients in the film to see if they had still remained "cured."

Last but never least, the credentials of the people who spoke at this event in Oakland were wonky at best. The "doctor" was actually a "board-eligible chiropracter" who is "certified" in digestive disorders or something like that. "Board-eligible"...REALLY?! And this guy gets paid to counsel people!? Incredible. He flat-out told the audience that the pharmaceutical industry CAUSED their diabetes. CAUSED! He said the vaccines we received as kids CAUSE diabetes, and he quoted from this far-out British publication called What Doctors Don't Tell You. Fantastic stuff, and everyone paid $20 to attend. Plus $50 for the DVD of the film with its bonus footage, and $15 for some raw food to eat, plus $10 for the most wretched zero glycemic "chocolate" that was NO JOKE beign sold by a man in a head-to-toe pleather rainbow suit WITH matching top hat.

Need I say more?

A recipe for success

Pizza for breakfast. That's what America's children are eating at school, as witnessed by renowned (and super cute) British chef, Jaime Oliver. He has embarked on a mission in the States, one that he has spent the past 7 years conducting in England--improving school food. He says enough is enough--this is the first generation of children who are expected to have a shorter life-span than their parents because of their poor diet. Diabetes, heart disease, high blood pressure, high cholesterol--these are the things that are going to kill your kids 10, 15, 20 years early--and they are largely preventable through eating a good diet and exercising.

Jaime Oliver's mission, chronicled on his show "Jaime Oliver's Food Revolution," is to completely re-vamp the way we think about school food. He's starting this food revolution in Huntington, West Virginia, the "unhealthiest town in America." He wants to throw out the processed life-shortening garbage we've been feeding our kids for so many years and give them wholesome, homemade food that sustains life! Seems like a simple task, right? Just stop buying the processed crap and bring in fresh ingredients into the school kitchens. But you have to stay on budget, meet the USDA's nutritional guidelines, make sure the kitchen staff are properly trained, that the kitchen has the right equipment, and oh yeah....that the kids will eat the food!

This last part proved much more difficult than Jaime had anticipated. When given the option between pizza and delicious homemade chicken, the pizza won. Fresh salad with homemade dressing wasn't a huge hit, either. And even after witnessing how that thing called mechanically separated chicken meat is made, and knowing how unhealthy it is for them, the kids still wanted to eat it once it was formed into the familiar chicken nugget shape, breaded, and fried. That little experiment had NEVER failed Jaime in all the times he had conducted it...except when it came to American kids.

There is certainly a mountain of challenges ahead, but nothing as disgusting as the mountain of fat consumed by the students in one school year Jaime showed to the parents--yeah, the parents weren't too excited about that! It'll be VERY interesting how this story unfolds. I see great things in Jaime's future, and so do the folks who awarded him with the TED prize. What's Jaime's wish? "My wish is for you to help a strong, sustainable movement, to educate every child about food. To inspire families to cook again, and to empower people everywhere to fight obesity."

We're all asked to donate whatever resources we have to make this dream a reality--I am planning to use my expertise in food and nutrition to give nutrition and cooking lessons, and I urge all of my fellow classmates and friends to do the same. Jaime's passion and dedication is so genuine, but there's only so much one person can do. It's up to us to join him in this revolution. Let's take this "yes, we can" attitude and put it to good use--improve the health of this nation, one school cafeteria and home kitchen at a time.

So here's what's cookin': Take one emboldened Brit on a mission, toss in a few million skilled Americans, and sprinkle in some blood, sweat, and tears. Turn up the passion to HIGH and that, my friends, is a recipe for success!

Cure your diabetes in 30 days!! Part One

A patient of mine emailed me about an ad she heard on the radio--a claim that you can reverse your diabetes in 30 days! A cure for diabetes!? How is that possible?! We've been told it's a chronic condition!! Well, she seemed so excited about it and was curious to know what I thought. The ad was for an event in Oakland that upcoming weekend that focused on the raw food diet and how it will cure illnesses like diabetes, high blood pressure, high cholesterol...pretty much anything you can think of! With this being the first I had heard of the movement, I was determined to go check it out. $20 later, I had my ticket!

The event took place at the East Bay Church of Religious Science on March 21st. It was centered around a documentary called "Simply Raw: Reverse Your Diabetes in 30 Days" which was co-produced by Supersize Me's Morgan Spurlock. The film chronicles 6 "average" diabetic Americans who were sent to the Tree of Life Rejuvenation Center in Arizona headed by Dr. Gabriel Cousens. While at the camp, the 6 were fed a very strict vegan raw-food diet for 30 days. Four of the six had type 2 diabetes, two had type 1, and all were on insulin therapy. The type 2 diabetics were also taking oral medications.

The first day at the camp, the 6 were instructed to cut their insulin shots by one-third, with the promise of being off all (or nearly all) medications by the end of the month. The camp's doctor was monitoring their progress as these 6 brave souls who had all been accustomed to the typical American diet of fast food embarked on their raw food journey. As one would guess, the food wasn't easy to tolerate for the first few days--keep in mind there was nothing cooked and no dairy was allowed (all vegan foods). Just A LOT of fresh fruits, vegetables, and sprouted grains...yummy!! The only saving grace was that the food was prepared by vegan raw food chefs.

After one week on the diet, nearly everyone had reduced their medications by half and saw miraculous results with their fasting glucose levels! Even without meds, their fasting glucose had dropped several hundred points on average in only one week! Incredible! As the weeks progressed, the diet seemed to be tolerated much more easily and all of the people saw drastic reductions in their fasting glucose. Where their fasting glucose had been in the 400's or 500's, they now had levels less than 100, which is normal for someone without diabetes.

By the end of the month, all of the people who had been diagnosed with type 2 diabetes had discontinued all medications, and had consistently normal fasting glucose levels. One of the type 1 diabetics reduced his insulin from 70 units/day to just 5, and the other type 1 stopped using insulin altogether. According to his lab tests, his pancreas even started to produce its own insulin, something that we scientists didn't think was possible!

Pretty convincing evidence, right???

Corporate = Corpulent?

Why are we Americans so overweight?

That is a very simple question, with a very very complicated answer. While the purists out there maintain that obesity is simply the result of a mis-balanced energy equation (more calories consumed than burned will lead to weight gain), others believe that the answer is not so cut-and-dry. We happen to live in an environment of obesity, where fast food chain restuarants command the landscape. The accessibility of high-sugar, high-fat foods is astounding, as is the sheer number of junk food products in the grocery store. I'm a trained health professional where my job is to teach people how lead healthy lives, and even I struggle with making good choices, especially when eating out.

Why is that and what can we do about it?

Joel Salatin of Polyface Farms reviews the book, "Food, Inc.," explaining how corporate farming has influenced what ends up on our plate and ultilmately on our hips. As Salatin's article discribes, dismanteling the"corporate food system" may be a simple and plausible key to rectifying the obesity problem in the United States. But what do I mean by the "corporate food system"? I want you to imagine this scenario: think of a giant farm where thousands of chickens are caged together in small pens and fed a diet of corn and soybeans. OMG not corn!! OK OK OK not the worst thing, perhaps, but think of the few problems this presents: chickens aren't designed to be cage animals, they need space to roam and stratch the land for food. Additionally, their digestive tracts aren't designed to digest corn or soybeans, so the food they are fed inevitably makes them ill. Combined with the heat and unsanitary conditions of these foul confined to such a small space, disease quickly becomes rampant and farmers are forced to give their livestock large doses of antibiotics to stave off infection. These antibiotics end up in the muscle tissue of the animals (the meat) and are ultimately consumed by us humans. I don't know about you, but I'd rather not be receiving a dose of amoxicillin or growth hormone with my chicken nuggets.

Ultimately, the consequence of this type of farming has led to the demise of real food. REAL food. Like beef that tastes and looks like beef. Tomatoes that are red, have flavor, and go rotten after a few days (unlike the pink plastic ones that never seem to spoil). Fish that is not laced with fetal-defect-inducing levels of mercury. Real food.

As Salatin writes, this real food has "been replaced by an array of pseudo-foods that did not exist a mere century ago. The food additives, preservatives, colorings, emulsifiers, corn syrups and unpronounceable ingredients listed on the colorful packages bespeak a centralized control mind-set that actually reduces the options available to fill Americans' dinner plates." Pseudo-foods. Really?! Is that what you really want to eat? Faux food...mmm mmm good....right?? Wrong.

So how do we, as consumers and purveyors of justice, change this food environment? With the almighty dollar, my friend. Just don't buy it. Pass up the plastic produce at your supermarket and support your local farmer's market or CSA (community-supported agriculture). Insist on eating steaks that come from happy cows, chops from perky pigs, and cutlets from cheery chickens. All great revolutions start small...are you ready for the fight? I am :)

I would like a DD Iced coffee and a creme brulee on the side please

While stalking one of my friend's facebook pages, I came across this website called Fancy Fast Food whose tagline is "yeah, it's still bad for you--but see how good it can look!" Intrigued, I clicked on the link and was amazed by the creativity of what I was witnessing--ordinary fast food deconstructed and then reconstructed into "gourmet" food. My roommate and I have a favorite--the "Wendy's Napoleon". Surely between the two of us foodies we'll invent something amazing. Check it out!