11/04/14 YES on E!

After careful consideration I have decided not only to vote yes on San Francisco's Prop E but also to urge others to do so. Politics are always muddy waters and I was not sure if I wanted to wade into them in a professional capacity. Upon further reflection I know that I would be falling short on my obligation as a Registered Dietitian if I did not share my views on this issue.

Prop E is a tax of 2 cents per ounce on the distribution of sugar-sweetened beverages. The tax will surely be passed onto the consumer at the point of sale; a twelve ounce Coke will cost an additional 24 cents. Revenues from this tax would fund health, nutrition, physical education, and active recreation programs in the city. My personal favorite planned use of funds is an allocation to the Public Utilities Commission for installation of water bottle filling stations.

Sugar-laden beverages are unique in their ability to contribute to overweight/obesity and the cascade of health consequences that follow (type 2 diabetes, obstructive sleep apnea, dyslipidemia, etc). Whether or not a price increase will lead to decreased consumption remains to be seen. My own review of the research on the effects of tobacco tax increases on usage indicates that increased tobacco prices do decrease smoking rates. Armed with this knowledge we owe it to the collective health of our city to give the "soda tax" a try. Reduction in sugary beverage consumption plus funds for nutrition and health promotion is a win-win in this nutrition professional's eyes. I urge you to review the proposition yourself and I hope you will join me on election day in the fight for a healthier San Francisco.

SF vote YES on E 11/04/14!

No one said it would be easy

"School lunch standards feed $10 billion controversy in D.C." Carolyn Lochhead, San Francisco Chronicle, June 2014

This article is one of my all time favorite pieces of nutrition journalism. The author shares insights from local school food service directors and chefs to prove that positive change is possible. And while the focus of the article is childhood nutrition, it's message holds true across the life cycle. Yes, you will have to put forth effort and spend a bit more to eat well. But Scott Soiseth, director of child nutrition for Turlock Unified School District says it best. "It has been a challenge. I don't want to downplay that. But I'd hate to go back."

Nutrition Facts label 3.0

"FDA proposes updates to Nutrition Facts label on food packages" fda.gov, February 2014

In news only a nutrition fanatic like myself may geek out over, the U.S. Food and Drug Administration proposed a set of changes to my favorite label recently. This would represent only the third major overhaul of the label in the 20 years it has existed. Some of the ideas presented stand to further empower consumers, while others may cause positive shifts in the food industry.

A healthier heart is the focus of two updates I believe consumers can use to make better choices. First is the removal of the phrase "Calories from Fat". It is old school, outdated logic that fat is "bad for you". Those of us who remember the 1990s and Snackwells cookies know that we are no slimmer or healthier for avoiding fat like the plague. "Total Fat", "Saturated Fat", and "Trans Fat" will remain on the label. By removing the dogmatic phrase "Calories from Fat" the focus will shift towards choosing heart healthy fats and avoiding damaging ones. The second proposed cardiovascular benefit is the inclusion of "Potassium" on the label. Much attention has been given to the role of Sodium in high blood pressure, and rightly so. But this is a two way street. As Sodium has the power to increase your BP, Potassium can conversely help keep it in a healthy range. Shooting for around a 2:1 Potassium:Sodium ratio can help keep your numbers in balance.

There can be no mistake that the Nutrition Facts label has the power to change the food industry. When version 2.0 mandated the inclusion of "Trans Fat" manufactures scurried to remove these man made solid fats from their products, much to the benefit of our collective health. By requiring "Added Sugars" on the new label, companies will hopefully begin to create palate friendly choices that are less sweet, or use whole fruits (with their beneficial fiber, vitamins, and minerals intact) to indulge our sweet tooth. "Vitamin D" is also slated for a spot on the new packaging. Vitamin D occurs naturally in few foods (sardines, egg yolks, and mushrooms exposed to UV light are the main sources) and has therefore been added to milk for years. Most American diets are low in this key fat-soluble vitamin. Therefore we test blood levels for most of our patients at the hospital where I work. Anecdotally I can say that the majority of levels I see are very low, indicating compromised bone health among many other maladies. In requiring it to be listed, I imagine food producers will begin to fortify more items with Vitamin D. While I advocate for a nutrients from food first approach, D is a rare case where supplementation is likely needed for the majority of the public.

Overall I applaud these proposed changes. Public comment will be accepted for the next 88 days, so feel to contact the FDA if you have a strong opinion or suggestions regarding the new direction of my favorite label.

Soda taxes your waistline.

"SF soda tax debate with Supervisor Scott Wiener" San Francisco Examiner, February 2014

In the city's latest effort to champion public health, San Francisco is going after a victory it's progressive peer to the east could not attain. New York City Mayor Bloomberg's effort to ban sugary drinks larger than 16 ounces fizzed out when a state Supreme Court Justice found it to be "arbitrary and capricious". Supervisor Wiener is seeking to reach similar ends via a different route. He is proposing a 2 cents per ounce tax on sugary drinks with the proceeds slated to fund nutrition and physical activity programs in schools and parks.

Only time will tell if the measure passes, and more importantly if it produces the desired result (less obesity and accompanying chronic disease). What we do know now is this; sugary beverages consumed in excess cause weight gain. What constitutes excess is difficult to quantify without considering the entire diet, so I will present an overly simplistic example. One pound equals 3,500 calories. At 140 calories per 12 ounces, 25 cans of cola equal 1 pound. That is an average of about 3 1/2 cans a day, 7 days a week. Drink 4 cans of soda daily and you can expect to pack on over 50 extra pounds this year.

Is a sugary drink tax good public policy? That can't be determined yet with available data. Is daily sugary beverage consumption good personal health policy? I believe that answer to be more clear than the ill-fated drink of my youth, Crystal Pepsi.

To choose organic or not?

"Organic Shmorganic" - Slate, January 2014 

Few topics evoke stronger opinions in food and nutrition circles than the virtues of choosing organics. The above article from Slate does a nice job sorting out some hefty data on pesticides concerning the organic versus conventional produce debate. The author concludes with a sentiment that I strongly endorse; the total quantity of whole fruits and vegetables in a child's diet is more important than what percentage of it is organic.

It has been a long held belief of mine that we are better off consuming five servings of conventional produce than two of organic. Organic agricultural practices are gentler on our environment, but they can be harsher on our wallets. I applaud consumers striving to choose organic produce, but I caution anyone from falling short of optimal intake due to higher prices.

The article is focused on children though the same applies to adults. We should each be aiming to fill at least half of our plates with fruits and vegetables. If you are able to do so, you are on the right track. If your resources allow you to do so organically, go for it. If not, you are still eating well.