Happy Valentine’s Day! The big news this week was the Let’s Move campaign launched by the First Lady Mrs. Obama to fight the problem of childhood obesity in America. I think it is a worthwhile and timely initiative and I am glad that someone of her status is taking it on to give it the visibility it needs. While the cause is noble, the intentions are genuine and the star power is undeniable, I believe that the approach taken by her campaign is fundamentally flawed. I have serious doubts that it would create a change at the scale needed to make any real impact in the long term health of our nation.

I don’t normally consider myself a glass-half-empty-kinda guy. Yet, today I find myself compelled to give you 5 reasons why this initiative is destined to disappoint. I do sincerely hope I am wrong!

It will not change the demand for cheap fast food in any significant way

I admire Mrs. Obama’s candor in her acknowledgment that she found it hard to balance her family’s need for a healthful diet and demands of hers and Mr. Obama’s careers. Just too busy, not enough time…being unable to cook a good meal for my kids…going to fast food…ordering pizza. She certainly reflects the feelings of many Americans; however the ideas proposed under her first pillar, Healthy Choices, are simply too stale. Here is why:

• Empower customers by front-of-box labeling – interesting idea; already much talked about and being practiced, although not in a standardized way. I believe food marketers will eventually find a way around whatever regulations are introduced and customers will tune out the front-of-the-box information just the way they have tuned out the detailed and really informative nutrition facts label at the back.
• Prescription for healthier living – doctors and nurses will be encouraged to track body mass index and offer counseling for healthy eating early on. Nice thought – every time I go to the dentist, they tell me to floss daily. I don’t, even though I want to. I don’t even feel guilty about it anymore. I realize, they are just doing their job.
• Next generation food pyramid – Guess what, the USDA wants to revamp the food pyramid and online interactive tools! Great news for the academics. A busy parent is probably already overwhelmed; besides if they don’t find time to cook a good meal, do you really believe they will tinker around with online tools?
• Empowering change – very novel idea of a food atlas to show you food deserts around the country. If you live in one, watch out your property value may decline! Just kidding. Again, I think this is a gadget for the academic in us!
• Let’s move start up tools – so you need to stop watching TV and get out there and get some exercise! We all know that and no new tools are needed to convince us or help us out. There are plenty of them out there already.

The fundamentals remain unchanged – we live busy lives; we are always on-the-go; cheap fast food is readily available; it makes us feel good and solves a real problem. None of these ideas will change consumer habits in a fundamental way. At best, they will make people feel guilty, temporarily at least, but don’t expect them to change their habits.

It will not change how we farm and what we grow

What we grow is corn and beans – lots of them.  We practice industrial agriculture which is dependent on fertilizers, pesticides, genetic modifications and consumes an unbelievable amount of natural resources. If you have doubts, pick up a book by Michael Pollan. We process meat in feedlots virtually shut-off to the outside world and raise cattle on a diet of corn. Chickens are no better and quality of seafood is getting worse; what with mercury contamination and salmon being raised on corn! We are constantly battling risks with food safety because of loopholes in inspections.

The wheel of supply and demand turns day and night, getting faster with each turn as the population grows and our appetite explodes. If demand does not change in a fundamental way, how can we expect supply to change? The so called organic movement and sustainable farming are like toddlers in the face of industrial farming.

Granted that one should not expect the First Lady to address such political hot buttons. But one should also not get too enamored by the marketing of this campaign to forget that our problems really arise out of the farm driven by consumer demand.

It offers no incentives for the food industry to innovate

I was excited to read:

Let’s Move is building communities by bringing together families, schools, private industry and government to make healthy living easier

I kept looking for what is expected of the private industry and the only example I found was how the beverage industry is answering the FDA’s call to post calorie information on the bottle! This is no innovation, only a marketing gimmick to appear responsible. There are no real drivers for the industry to innovate to produce healthful products. And believe me, the so called soda tax or twinkie tax is unlikely to effect this desired behavior.

Now you could argue about the definition of a healthful product. Surely, reducing sodium, trans fat and sugar is a step in the right direction. But the fact remains that these products do nothing to reduce the share of processed food in a typical American diet. In fact, this notion is contrary to the business model – after all, the food industry stays in business by selling more of their products, not less. I would love to see food companies create products (and services) that actually increase the share of home-cooked food in an average family. That would be real innovation.

It creates another food bureaucracy

A new Healthy Food Financing Initiative through a partnership between the departments of Treasury, Agriculture and Health & Human Services will invest $400 million each year to provide innovative financing to bring grocery stores to underserved areas. The idea is to increase access to healthy food, fruits and vegetables and to get rid of food deserts across the country. To me it smells like a new bureaucracy, unsustainable in the long run and at the risk of another budget cut. It addresses the issue of supply assuming that the demand will naturally be there. Really? Why not utilize the network of food banks and offer incentives to buy healthful products on food stamps? Do we really need a new system?

It will encourage schools to game the system

School administrators now have a new goal to accomplish – try to fit the mold of a healthier school with the Healthier Schools Challenge. The scorecard is simple – reduce salt, fat and sugar and increase whole grains. This is nutritionism at its best. It is probably not difficult to meet the standards – whatever they might be – over the 5-10 year-long time frame of the program. Does it mean that kids will start eating healthy? Maybe, but not a guarantee. With no real carrots and no sticks, my guess is that schools will simply game the system to generate a hype of healthfulness. And maybe they will figure out a way to correlate small drops in average body mass index with their efforts in the cafeteria! That will make it look really convincing – yeah, right!

I know, you are probably thinking that it is easy to be critical without offering an alternative. I agree – that is why I plan to write about a few out-of-the box ideas in future and invite a discussion on them. Stay tuned!

Enjoy and let me know what is on your mind.

Photo Source: baronsquirrel via flickr
©2010 Littlestomaks.com

Greetings! Hope you all are enjoying the beautiful days of Fall. I simply love this time of the year. We are getting ready for Trick-or-treat and pumpkin painting, and the twins are excited! They are already dreaming of collecting candy – it is going to be an uphill battle trying to keep them from eating too much. I won’t spoil the fun by telling you their costumes this year yet, but will surely post a photo after Halloween.

Here are the 5 nutrition related news that caught my eye this week. Enjoy and drop me a comment to share your thoughts.

A new index to help you select affordable nutritious foods

A new food rating system called the Affordable Nutrition Index (ANI) was introduced this week at the American Dietetic Association’s Food and Nutrition Expo in Denver. The idea is to provide a score that takes into account the cost of a certain food item in addition to its nutrition value. A food item with a high score means that it is high in 9 nutrients (protein, fiber, vitamin A, C, E, calcium, iron, potassium and magnesium), low in 3 nutrients (saturated fat, added sugar and sodium) and costs less on a per serving basis. Sweet potato, broccoli, green pepper, orange and banana scored high on the index (over 100) while packaged convenience foods scored lower than 100.

This index has been developed by Dr Adam Drewnowski, Director of the Center for Public Health Nutrition at University of Washington in Seattle. He used the Nutrient Rich Food Index (NFR9.3) which he previously developed and a price per serving information from food prices database, Seattle area supermarkets and industry sources. This research was sponsored by the Campbell Soup Company. Not surprisingly perhaps, many of the condensed soups from Campbell ended up with a high score around 100 compared to many fresh or cooked vegetables and even fresh fruits.

I am intrigued by this idea since we all want to select foods that have high nutritional value at an affordable cost. However, I don’t think that this is the only way to make that choice. I was disappointed to see that vitamin D was not included in the 9 nutrients to promote in the NFR9.3. Plus cost per serving is probably not the right measure of what a customer pays when buying a product. Also, you can manage cost by buying seasonal fruits and vegetables from local sources. Still, I think it is a good idea and I plan to write more about it in future.

Coke’s response to the debate on obesity is lame

Coca-Cola, the icon of sugary drinks is under attack! CEO Muhtar Kent wrote an Op-Ed piece in the Wall Street Journal on October 7th defending his company against proposals of soda tax. Coke Didn’t Make America Fat is what he believes; and quite arrogantly he points the finger to his own customers saying they lead a sedentary lifestyle! Well, Coke did make America fat according to my blogger colleague Dr. Ayala who wrote an excellent piece this week in response to Mr. Kent’s lame arguments.

So far, Coke’s response to the current debate on the role of sugary drinks in our obesity problem is rather lame in my opinion. They have announced that they will add calorie information on the front of Coke cans. They have given a large amount of money to the American Academy of Family Physicians (AAFP) to develop consumer education content as part of their Consumer Alliance Program. They are also a part of the Healthy Weight Commitment Foundation (HWCF), a group of 40 organizations seemingly engaged in a collaborative effort to address obesity. And now in their latest move, Coke has announced that they will introduce a 90-calorie mini soda can so that people can limit their intake of sugary cola.

While I am no fan of the twinkie tax, I do not believe that these actions by one of America’s top brands are of the high caliber needed to solve one of America’s most challenging health problems. Coke needs to do more than just pay lip service and make lame arguments defending their products in public. They need to take a more grass-roots approach – building playgrounds in schools, sponsoring healthy lifestyle events, developing after-school programs, integrating nutrition and physical education, sponsor healthy nutritious school lunches just to name a few examples. They need to measure the effectiveness of these programs in reducing obesity and make the data public.

Coke’ 3Q financial results show that they generated $6.3 billion in cash from operations year-to-date in 2009. They spent $241 million buying back their own shares. A little more of that cash spent on real programs to solve our obesity problem will not make a dent in their profits! What do you have to say about that Mr Kent?

FDA puts the hammer down on front-of-box labeling

The Smart Choice program it seems was the last straw according to Marion Nestle who writes a blog called Food Politics! In a letter to the food industry, the FDA is openly questioning the arbitrary nutrition standards used by companies to develop these labels which end up showing their own products as healthy. FDA wants to develop a set of independent criteria which these labels will need to meet before companies can use them on their products. FDA also wants to understand how these front of the box labels affect consumer choice.

I say, it’s about time. The Nutritional Facts panel, usually at the back or the side of the box, is too complicated for most consumers to read and understand. Consumers are looking for something simple that allows them to quickly make a decision.

We are lagging behind other countries in this area. A traffic light based food labeling system developed by the industry based on government guidelines in UK seems to be working very well. Why can’t we do the same here?

Here is a good background information on different types of front of box labeling systems. What is your opinion? Have you come across a labeling system you really like?

Toddler diets a cause for concern according to the 2008 FITS data

Latest data from the 2008 Nestle Feeding Infants and Toddlers Study (FITS) confirms the sorry state of a typical toddler diet in America. Most toddlers and preschoolers are not eating fruits and vegetables. They are consuming too much saturated fat and sodium. French fries are the most popular vegetable!

Good news is that the diets of infants and older babies are much better compared to the 2002 data. Mothers are breastfeeding their children longer and consumption of sugary drinks is decreasing. There is a risk of iron deficiency in some children.

Looks like parents and caregivers are following the feeding guidelines for infants. So why do things go south during the toddler years? Is it because of picky behavior? Or is it because toddlers eat what their parents eat? Or a combination of the two?

Not much progress has been made in the diet of toddlers since 2002. We need to make a deliberate effort to improve this situation.  Having dinner together, being a role model and encouraging fruits and vegetables is critical to solving the problem of childhood obesity. And in case you are struggling, here are some tips for picky eating.

Let us bring the school nutrition standards to the 21^st century

Can you believe that it was 1995 when the standards for the National School Lunch Program (NSLP) and School Breakfast Program (SBP) were last revised? Yet the NSLP served lunch to over 30 million children and SBP served breakfast to over 10 million children in 2008! If we are serious about fighting the battle of childhood obesity, we need to revise these standards and bring them to the 21st century!

Well, the good news is that the Institute of Medicine (IOM) has now issued its recommendations in a report titled School Meals: Building Blocks for Healthy Children, which the US Department is going to consider as they revise these standards. Recommended meal requirements encourage more fruits & vegetables, whole grains, min and max levels of calories and limit saturated fats  and sodium.

This is good news! I hope they will begin to implement these recommendations by the time our twins start going to school. I think progress may be slow due to cost and bureaucracy, but at least it’s a good start.

Enjoy and do let me know you think. I would love to have you share your best tips in comments below.

Photo source -cambodia4kidsorg on Flickr via everystockphoto

©2009 Littlestomaks.com

Greetings!This week is the World Breastfeeding Week. Organized by the World Alliance for Breastfeeding Action (WABA), the focus this year is In Emergencies, Breastfeeding is a Lifeline. I never thought about breastfeeding this way, but it makes sense. Children and infants are most vulnerable during a catastrophic emergency – whether natural or man-made. According to WABA estimates, child mortality can be 2 to 70 times higher than normal under these conditions due to diarrhea, malnutrition and respiratory illness. They believe that by supporting breastfeeding in non-emergency situations, we can be better prepared to save the lives of young children during emergencies. Here is a great post by my blogger friend Annie on this subject by Annie on PhdInParenting.

Here again are 5 interesting nutrition stories of the week that caught my eye. Enjoy and drop a comment to let me know what’s on your mind.

Millions of kids vitamin D deficient – here we go again!

It seems like our appetite for reporting vitamin D deficiency in kids is insatiable! In yet another study published recently in Pediatrics, researchers report an alarming prevalence of vitamin D deficiency in kids 1-21 years old. They find that 9% (about 7.6 million) children are deficient and 61% (about 50.8 million) have insufficient levels of 25-hydroxyvitamin D. This news got a lot of coverage this week, mainly because the numbers seem so high. Also, in the same article, these researchers highlight a link between low levels of vitamin D and increased risk of cardiovascular disease. This sounds really scary, and no doubt, makes a perfect headline for an attention-grabbing story.

I have a few problems with these types of studies. First, they rely mainly on the level of 25-hydroxyvitamin D in blood. There is no consensus among experts when it comes to estimating deficiency or insufficiency in children. Second, the biochemistry and processing of vitamin D is very complex, something I don’t claim to understand at all. But I am certain of this – it cannot be as simple as just the blood level of 25-hydroxyvitamin D which relates to cardiovascular health or bone density. But the real reason why I get frustrated is that these studies do not answer the “so what?” question a parent might be concerned about. Drink milk and vitamin D fortified OJ, let your kids out to play, not watch too much TV – well, that is old advice and should be followed with our without such sensational news.  Should you ask your pediatrician for a 25-hydroxyvitamin D test? Should you take supplements? There is no real, practical and actionable advice from these “experts”.

My 2 cents – when you hear this type of news, take a deep breath and don’t panic. Take a quick look at what your child is getting on average – milk, OJ, cereals, fish, eggs, cod liver oil etc. How much outdoor activity in the sun he gets on average. Take a long term view on this but continue to watch the diet and activity level regularly. If you still have doubts, ask your pediatrician if a supplement is needed.

No one wants to hang out with overweight kids

Why are overweight kids so picked on? A very interesting post from Dr Joanna Dolgoff – one of our Ask the Expert contributors – provides some insight. Appears that kids have more sympathy for children with handicaps, and would rather be friends with them, than hang out with overweight or aggressive kids. Deep down, overweight kids are blamed for their condition. They should be able to change it by losing weight is a common belief. I wrote about this in my post on childhood obesity because this kind of negativity leads to low self-esteem and a downward spiral of physical and emotional health problems among overweight and obese kids. Stereotypes about obesity form early in life it seems.

FDA and USDA get a budget of $125 billion

That is a giant number! Extra funding is supposed to go for improving food safety and farm subsidies. What surprised me though is the estimate that almost half of the budget for the two agencies is set aside for food stamps and Government nutrition programs. What kind of a return on investment can we expect from this level of spending? I find it ironical that on one hand we spend extra on healthcare in managing obesity-related diseases, while on the other, we have to also budget a huge amount fighting hunger and poverty. These two problems are two sides of the same coin in my opinion, but I do not yet see a comprehensive policy (and budget) to address them. We know that there is poor communication and cooperation between different Government agencies – the right hand does not know what the left is doing, but both want to get bigger and fatter and demand more funding! And as far as food safety is concerned, the approach is to focus on compliance rather than prevention. This smells of more bureaucracy to me!

So many cooking shows, so little cooking

Michale Pollan wrote a very good – although very long – article in the New York Times magazine this week. Out of the Kitchen, Onto the Couch takes us through the history of cooking shows starting with Julia Child to the likes of present day Iron Chef and Rachel Ray. We watch the Prime Time food network for entertainment value these days, not to learn anything about cooking the food ourselves! Pollan makes two great points – one, that the food industry along with the Television has been quite successful in taking over the “cooking” part from us by providing us with relatively cheap, readily available, packaged nutrition (poor nutrition I must admit). And second, that we are now quite comfortable ordering fancy items at restaurants and our appetite and desire for an ever increasing array of foods seem never ending. The less we cook, the more we eat and the more weight we put on. So how can we get back to cooking? We don’t have time for cooking, but we have time to watch a cooking show. Seems to me it is a matter of priority and attitude. I think we need to invoke Nike’s Just Do It! for preparing our own food. Not necessarily from scratch, as a lot of purists might want you to, but enough so that you can control what goes inside your body.

Check out this cookbook review and giveaway

Here is a shout out for my blogger friend Jenna of Kidappeal. She has done a great review of Vegetables Get the Royal Treatment by Jill Nussinow (aka The Veggie Queen!), and she is giving away a copy of this book to one lucky winner selected from the comments on the post. It is very simple to enter – all you need to do is to leave a comment about your favorite vegetable and your favorite ways to prepare and eat it. Check it out, the contest ends on August 16th.

Enjoy your weekend! And let me know what you think.

Photo source -Raphael Goetter on Flickr via everystockphoto
©2009 Littlestomaks.com

You probably already know about the Food Pyramid from the USDA. What you may not know is that now there is a new version just for pre-schoolers (2-5 years old) called MyPyramid for Preschoolers. On this website, you can get a lot of useful information, all in one place. Check it out.

• You can make a customized MyPyramid plan for your toddler based on age, sex and level of physical activity. One problem is that the age selection is only in whole years, so if your toddler is say 2 and a half years old (like ours), you probably want to pick 3 years. Here is how it looks for our boy (Armaan) and our girl (Asya). It gives you details of how many calories and how much from each food group you should be feeding each day. Click the thumbnail for full size image.

• In the Grow Up Healthy section, you can prepare a growth chart for your toddler based on height and weight. This is what you get when you visit your Pediatrician. Now, you don’t need to wait the whole year before the next physical check-up to get this information. A growth chart can help you monitor the growth of your toddler and compare it to other children of the same age and sex. One word of caution – don’t get carried away by what you see on the chart. In my opinion, you should pay more attention to the overall growth pattern over time rather than a single point on this chart. Check out the What Influences Growth section that describes the factors that affect the growth patterns of preschoolers. Notice the value of nutrition and sleep! I would also add physical activity level in this section if I had my way. But then there is a separate section on that (see below).
• Under Healthy Eating Habits and Picky Eaters sections, you would find useful tips for developing good feeding habits at an early age. I was familiar with most of their advice on this section; one thing that caught my eye was their advice on how to cope with marketing and advertising on TV. It is a good read and I recommend it.
• Under Physical Activity there is good information on how much (60 minutes per day, does not need to be all at once), outdoor and indoor activities, and safety. The most important thing to remember is that you are a role model for them; therefore if you maintain an active lifestyle, they will learn to do so too.
• Very good tips for Food Safety regarding general hygiene, snacking, choking hazards, food handling and food preparation.
• There are also ideas for Sample Meals and Snacks (based on the recommended calorie level – first make the customized MyPyramid Plan) and More Information on food groups with examples of different types of foods and the serving size in each group.

Check it out and let me know what you think. Did you find anything new that you did not know before? Would you recommend it to your friends?

You want to do the right thing for your toddler. You want to protect the environment. And you are willing to pay extra for it. Yet, when you pick that box of crackers with colorful graphics and catchy slogans, you are not sure if at $3.49 the crackers it contains are really organic.

You can take comfort in the fact that you are not the only one with this dilemma. And the good news is that the USDA’s National Organic Program (NOP) has now established labeling guidelines for organic food. Still, there can be a lot of confusion. The devil, as they say, is in the details; so you need to fully understand these guidelines before you can make an informed decision about your organic food purchase.

The USDA NOP has outlined three different types of labeling requirements based on the percentage of organic ingredients in a product:

1. Agricultural products labeled “100 percent organic” and “organic”
2. Processed products labeled “made with organic ingredients”
3. Processed products that contain less than 70 percent organic ingredients

Foods in the first category contain at least 95% organically produced ingredients(excluding water and salt). You can easily recognize them by this USDA organic certification seal on the package. Any remaining product ingredients must consist of nonagricultural substances approved on the National List including specific non-organically produced agricultural products that are not commercially available. Also, the side panel will explicitly show a list of organic ingredients and other non-agricultural substances.Here is an example from Earth’s Best (we obviously like their products!). Also notice that the name of the certifying agent must be shown on the side panel.

Foods in the second category must contain at least 70% organic ingredient. They do not show the USDA organic certification seal. However, they can claim that the food is “made with organic ingredients”. They can list upto three organic ingredients or food groups on the main panel. The side panel should show a list of organic and non-organic ingredients and the name of the certifying agent. Here is another example from Earth’s Best:

Foods in the third category cannot use the term “organic” anywhere on the main display panel. However, they may identify specific ingredients that are organically produced on the side information panel. They cannot show the USDA organic certification seal anywhere on the package.
Here are a few useful links for more information:

1. How to Choose Organic Baby Products: A Knol by Erica Jones
2. Certified organic label guide: an article on Organic.org
3. Natural and organic foods: a good article on USDA.gov

What kind of questions do you face when you go shopping for organic foods? What is your experience in the aisles when you browse the various products?