Menu nutritional info: does it help you make healthy choices?

November 8, 2010 by  

How often do you read the nutritional info on a food package? Does the info influence your decision to buy? It does for me.

But what about food in restaurants? Would info on fat, cholesterol, sugar and salt content help customers make the right healthy choices?

As part of the US health reform bill, fast food chains may be required to provide nutritional info on their menu boards. This measure is just one of the many strategies aimed to fight the increasing prevalence of obesity and cardiovascular disease in the US.

When it comes to health strategies, New York City is at the forefront, from transfat elimination to salt reduction in restaurant food. It is also one of the first cities to require menu-label regulation.

But many are skeptical whether nutritional info labeling really helps people make wise choices. Researchers at Seattle Children’s Hospital conducted a study to gauge the effect of this strategy. They looked at consumer choices in King County, WA, a city requiring menu labeling. A survey was conducted before and after the regulation. San Diego, CA, where menu labeling is not required, served as comparator city.

Families in both cities were given $10 gift card to be used in a restaurant of their choice. They are asked to keep the food receipt and answer a questionnaire.

The results showed the following subtle but still discernible trends:

  • More parents noticed nutrition labels in King Country
  • Those who noticed the labels tended to act accordingly and purchased lower-calorie meals for their children.
  • Shared parent-child decision increased after labeling regulation was in place; preregulation survey indicated choices were frequently made by children only.

According to lead author Dr Pooja Tandon:

“Parental awareness of nutrition did seem to have an impact on what parents bought for their children, especially if their children were overweight. And in parents who reported seeing nutrition information [for the first time], the number of children’s calories went down.”

Other striking information that came out from the findings is:

A fourth of the children in the study were overweight and so were two-thirds of the parents. Based on body mass index (BMI), children and parents who had BMIs over 25 (indicating overweight) were ”more likely to select lower-calorie menu items after the menu-labeling regulation went into place, particularly those who said they noticed the nutritional information for the first time in the postregulation period—a finding not seen among normal-weight parents and children.”

The study results are giving health experts lots to think about. It indicates that food labeling regulation does work but whether this is enough to stop increasing obesity rates is not clear.

Statins to go with your Big Mac and soda?

August 17, 2010 by  

“A double cheeseburger with an extra portion of statins as topping, please.”  No, this is not a joke. A group of British cardiologist think it should be work.

Perhaps based on the principle “if you can’t beat them, join them”, these group of scientists suggest that if customers refuse to give up on the likes of McDonald’s and Burger King, the statins should be taken to the burger chains where they could be “…found alongside the salt, sugar, ketchup, and mayonnaise… sprinkled atop customers’ Quarter Pounders, into their milkshakes, or onto their supersized French fries to offset the mounds of fat found in these unhealthy meals.”

Dubbed the McStatin strategy, some experts call it “radical”, others “mischievous”. Others were just plain shocked.

However, these cardiologists defend their rather unconventional strategy with logic: If you consumers can have as much unhealthy add-ons to their meals as they want – mayonnaise, ketchup, sugar, etc – free of charge – why can’t a “potentially protective” additive such as statins be offered? In other words, offer the good stuff together with the bad stuff to neutralize the latter.

Can statins, delivered via the fast food way, really work in cardiovascular disease prevention?

The cardiologists conducted a study to prove their point. They investigated whether eating an unhealthy fast food meal can be “neutralized” by taking a statin by comparing “the increase in the relative risk of cardiovascular disease associated with the meal’s total- and trans-fat content with the reduction in relative risk observed from a recent meta-analysis of seven primary-prevention statin trials.”

The results showed that most of the recommended primary prevention regimens using statins do work in offsetting “the increased risk caused by eating a Quarter Pounder, which contains 19 g of total fat and 1 g of trans fat, or by eating a Quarter Pounder with cheese and drinking a small milkshake, an unhealthy combination that contains 36 g of total fat and 2.5 g of trans fat.”

But hey, is it safe to take statins like we take ketchup, without doctor supervision?

Senior author Dr. Darrel Francis of the Imperial College London replied:

“…but if patients need to see a doctor before they take a statin, then how come they don’t need medical advice to eat a hamburger?”

At lower doses, some statins are available over the counter but prescription is necessary for higher doses prescribed to high-risk patients.

Some experts think the McStatin strategy is counterproductive. Opponents of the strategy believe that putting statins in fast food would actually encourage people to eat more fast food and bigger portions, thus undermining lifestyle intervention campaigns that include a healthy diet.

Besides, an unhealthy diet does not only affect cholesterol levels. Cholesterol problems maybe “neutralized” by statins what about the bad effects on blood pressure, weight, and heart rhythm? Would we soon be taking a cocktail of drugs with our burgers to neutralize all these too?

According to Dr Dariush Mozaffarian of Harvard School of Public Health:

“The last reason that the approach doesn’t make a lot of sense to me is that we wouldn’t want to do something good and then do something bad and get a neutral result,” he added “We want to maximize the good. If somebody needs to take a statin, and they benefit from a statin and are compliant with that statin, then they should take the drug and gain the benefit. They should also gain the benefit from a healthy diet. Why would you not want to do both?”

Fast food calories: look who’s counting for who

March 2, 2010 by  
Filed under OBESITY

Look who is counting calories…not for themselves but for others – parents for their children. But only if the calorie info is available. This ground-breaking study by researchers at Seattle Children’s Research Institute investigated how parents react to calorie information that, at least in this study, comes with the fast food menus.

The researchers surveyed parents of 3- 6-year olds who occasionally eat in fast food restaurants with their children. 99 parents had to choose from a typical McDonald’s menu which included burgers, fries, salads, and even happy meals. Half of the parents had the usual menu with the prices, pictures of the food from which they would select food for themselves and for children. The other half received a similar menu, but with the calorie content of each food item clearly indicated.

The results indicated that parents tended to choose food items with lower calories for their children. On average, a reduction of 102 calories was observed among those parents who had access to calorie info than those who did not.

“They chose about 100 calories less than parents who didn’t see that information. And 100 calories, added up over time, is actually a significant amount.”

Surprisingly though, the parents were not as particular about the calories they take in. Their choices were not affected by the availability of the calorie information.

The study results suggest that nutritional labelling of food, not only in the supermarket but also in restaurants can help parents make smarter and healthier choices for their children. The decrease of 100 calories is equivalent is about 20% of total calorie intake.

According to study leader Dr. Pooja Tandon, research fellow at Seattle Children’s Research Institute and the University of Washington School of Medicine:

“Even modest calorie adjustments on a regular basis can avert weight gain and lead to better health over time. Just an extra 100 calories per day may equate to about ten pounds of weight gain per year. Our national childhood obesity epidemic has grown right alongside our fast food consumption. Anything we can do to help families make more positive choices could make a difference. Interestingly, by simply providing parents the caloric information they chose lower calorie items. This is encouraging, and suggests that parents do want to make wise food decisions for their children, but they need help. Now that some areas are requiring nutritional information in chain restaurants, we have opportunities to further study what happens when we put this knowledge in the hands of parents.”

Several  groups and sectors are pushing for nutritional labelling especially in chain restaurants. In the US, there is a growing trend in some states and localities to require nutritional and calorie info to be clearly visible at point-of-order. The possibility of making such a policy mandatory at the federal  level is being considered in connection with the health care reform legislation.

Recession obesity: getting fat during lean times

June 10, 2009 by  
Filed under OBESITY

burger_mealEver heard of recession obesity? It is getting fat during lean times. This is mainly due to the fact that people tend to cut back on the essential and healthy things (see previous post) during economic downturns such as what we are experiencing now. However, it is only lately that health experts realized how really serious the problem really is – especially among children and adolescents.

Researchers at Duke University looked at a variety of indicators that could assess how children are faring now compared how they fared in the past and how they would do so in the future. This compilation of indices resulted in the “2009 Child Well-Being Index”, which calculates the health and economic status of American children. The Index addresses questions which include:

A possible scenario that could lead to recession obesity:

Parents opt to feed their children cheap but filling fast food meals and cut down on the relative more expensive fresh fruit and vegetables.

According to Kenneth Land, project director of the Child Well-Being Index and sociology professor at Duke University:

“There is concern with ‘recession obesity’ apart from the general trend toward an increasing number of obese American children. There is a concern that parents will substitute fast food, high carbohydrate and high sugar-content food, for healthy food and that this will cause an uptick in the rate of overweight children and adolescents.”

A study published in the Journal of the American Medical Association last year reported that 32% of American children overweight, while 16% were obese.

Aside from the obesity problem, the researchers also observed the following:

  • Mortality rates for children aged 1 to 19 years old increased in previous recessions. This is expected to happen again.
  • The rate of violent crimes among teenagers also increased, and is anticipated to occur again.
  • The recession is resulting in a housing crisis, uprooting many adolescents.
  • A large number of 16 to 19-year olds are out of school but can’t find work, “leaving them particularly vulnerable to delinquency and crime.”

Photo credit: stock.xchng

What’s fast food got to do with your heart?

May 28, 2008 by  

“A double cheese burger, fries, and soda to go.” How many times do we repeat this phrase in a week? A month? A year?

But what has fast food got to do with Battling Heart and Stroke? A lot, actually. Because here we also tackle nutrition and diet and how they affect your heart and blood vessels.

We have heard it before. Fast food is not good for your health. But of course you would want proof! Specifics! What exactly happens when I gobble that burger and rinse it down with soda?

According to recent research article

“The highly processed, calorie-dense, nutrient-depleted diet favored in the current American culture frequently leads to exaggerated supraphysiological post-prandial spikes in blood glucose and lipids. This state, called post-prandial dysmetabolism, induces immediate oxidant stress, which increases in direct proportion to the increases in glucose and triglycerides after a meal”

In other words, Big Mac, Whopper or even pizza are high in calorie and low in nutrients. After eating these high popular meals, the sugar and fatty acid levels in our blood dramatically go up resulting in a state known as postprandial dysmetabolism. This state is characterized by our body`s inability to deal with the “sugar and fat rush”. The results are not-so-beneficial physiological changes that include oxidative stress, inflammation, and narrowing of the blood vessels. 


a diet high in minimally processed, high-fiber, plant-based foods …will markedly blunt the post-meal increase in glucose, triglycerides, and inflammation.”

Examples of such foodstuffs are vegetables and fruits, whole grains, legumes, and nuts. In addition,

lean protein, vinegar, fish oil, tea, cinnamon, calorie restriction, weight loss, exercise, and low-dose to moderate-dose alcohol each positively impact post-prandial dysmetabolism.” 

The normal fast food fare is definitely not good for our hearts. And if you think that diet soda minimizes the adverse effect of such a diet, think again.

In contrast, traditional Okinawan and Mediterranean diets are said to be heart-friendly and can prevent inflammation and lower cardiovascular risks. These so-called anti-inflammatory diets are highly recommended for the prevention of coronary artery disease and diabetes. I will go into more detail about heart-healthy diets in future posts. A couple of easy-to-follow healthy recipes are also coming.

But before you go out there today, think seriously about your body and what fast food can do to your and your heart.

Are you ready to order?


O’Keefe JH, Gheewala NM, O’Keefe JO, 2008. Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health. J Am Coll Cardiol, 2008; 51:249-255, doi:10.1016/j.jacc.2007.10.016

Photo credit

Fast Food Frenzy

July 11, 2007 by  
Filed under OBESITY

By Laurie Barenblat

Fast Food Frenzy

A dependence on fast food is not new. Thousands of years ago ancient Roman cities had bread and olive stands, and five hundred years ago, Spaniards encountered tacos in the marketplace of today’s Mexico. In this country, in the 1900s, train travelers ate quick meals from the dining car. Then, “drive-in” restaurants developed in the 1950s, which evolved into the “drive-through” window of today.

Sometimes stopping at a “fast food” restaurant seems like the only option. Perhaps your whole group of friends is headed that way and you don’t want to miss out, the kids are begging mom and dad to make a stop, or you just feel there is no time for any other option. When these occasions arise, we must make the most of them.

Be Aware Of Portions

Deluxe, super, mega, and monster are all different sizes of “big.” Whether it is French fries, a burger, or a soda, bigger portions mean more calories, fat, cholesterol, and sodium. A super mega monster value meal can contain the amount of calories you need for an entire day, not just one meal. For most people, the small or regular size is enough. In fact, the kids’ meal can be a great option as well.

It Is Ok To Say “No”

Be prepared. You most likely will be asked if you would like to get the super or value size. But even if you will get more food for “less,” if it is more food than you need, be prepared, and ok with, saying “No, thank you.”

Split It

Halve the calories and double the pleasure by splitting a large meal with a friend.

Add A Side

French fries are not a vegetable! Add a side order of salad, raw vegetables, or fruit for added vitamins and fiber. Choose salads that have lots of greens. A Caesar salad is a good choice. (You don’t have to use the Caesar dressing that comes with it.) Also look for salads with vegetables such as broccoli or tomatoes.

Mix It Up

Try different types of fast food when you are on the go. Enjoy restaurants that serve fast ethnic foods, such as stir-fry dishes, tacos, burritos, sushi, falafel, and many other options.

Go Easy On The Extras

“Special sauces” and dressings can have a lot of extra fat and calories. Go for ketchup, mustard, and salsas, and ask for the others on the side so that you can add them yourself. Consider using only part of the dressing rather than the whole packet. Go for the veggies – ask for extra lettuce, tomato, and pickles to bulk up your sandwich.

Fried Sometimes

Choose fried foods “sometimes.” Try to eat grilled, broiled or steamed fast foods more often. Look for chicken tenders, which are real pieces of chicken, rather than reformed “nuggets.”

Even Better Pizza

If ordering pizza, opt for hand-tossed or thin-crust pizza, ask for extra vegetable toppings and forget the meats and extra cheese. You can request ½ of the cheese as well.

Don’t Drink It All

Calories add up quickly in drinks. A 32-ounce soda can contain 310 calories – the same as a small meal. Order a small soda, or better yet, drink low-fat milk or water instead. Refresh yourself by adding a lemon wedge to your water!

Look It Up

Consider looking up the nutrient information of the fast foods you most commonly eat. Most fast food restaurants have their nutrient information online now. If you decide what you can and should order before you arrive, it will make it easier to avoid the less nutritious, higher calorie options. Also, pay attention to changes in the menu and new offerings because many restaurants are finally starting to pay attention to the demand for healthy options. Many restaurants try new items out before they add them to the menu permanently.

Take Your Time

It takes 10 to 15 minutes for your brain to register that your body is full. Don’t feel compelled to eat everything.

And Enjoy!

All foods can fit into a well-balanced diet. Enjoy the foods that you love. Try to eat mindfully and be appreciative of the many food options we have at our fingertips – even when you do find yourself in a “fast food frenzy.”

Laurie Barenblat is a Nutrition Educator and Healthy Lifestyle Coach in Dallas, Texas. She offers creative, yet simple ways to help her clients create a healthier lifestyle with a focus on weight loss. She helps people change their habits so that today, tomorrow, and far into the future they will be looking and feeling their best. In addition to coaching individual clients, Laurie is a speaker, writer, and frequent contributor to the media. Visit her website and sign up for her free monthly newsletter.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.