Serving Sizes

An article written by Anahad O'Connor in the New York Times, The Problem With Serving Sizes, discusses the FDA and its efforts to get food manufacturers to change their serving sizes and nutritional content on their food labels to a more realistic serving that Americans typically eat.

Parts of this article, I agree with.  For example, have you ever read the food label on a can of soup? The majority of soup cans contain 2-2.5 servings, but typically, when someone has a can of soup for lunch, they eat the whole can.  The next culprit is cooking spray.  Technically, a serving size is a spray that lasts about 1/4 of a second, but I don't know anyone who uses that little amount, unless it's in a cupcake tin.  I think it would be reasonable for the serving size of soup to be changed to one serving per can, and for the serving size of cooking spray to be changed to a spray that lasts at least a few seconds, and adjust all nutritional content accordingly.

But here is where I have to disagree with O'Connor. O'Connor explains that "critics say these so-called reference amounts are often laughably small because they’re based in part on surveys of eating behavior that were carried out in the 1970s, when Americans ate less food and portions had not been supersized" (para. 3).  But when you think about it, isn't the fact that our portions are supersized the root of the problem?

O'Connor states that in a pint of Häagen-Dazs ice cream, there are four servings, and that when it comes to Oreos, "a serving is a paltry three cookies" (para. 2).  Is there really ANY reason why someone needs to eat an entire pint of ice cream or more than three Oreos in one sitting?  I understand that people do it, but if we increase the serving size to appease them, aren't we only condoning and even encouraging those bad eating habits?

New Research Against Multivitamins

Did you take your multivitamin today?  This is something that, at least in my house, has been drilled into my brain ever since I was taking Flintstones vitamins in elementary school.  At age 23, I just got into the groove of actually remembering to take it each day, and I've noticed that for the past year, I didn't get sick (other than a cold) and my hair and nails were growing faster and stronger.  However, new research suggests that women who take multivitamins won't live as long as those who don't.

The study was published in The Archives of Internal Medicine, and was covered by Nicholas Bakalar in the New York Times:

"Scientists followed 38,772 women, whose average age was 62 at the start of the study, over a period of 19 years, during which 15,594 of them died. Those using multivitamins or supplements of folic acid, iron, magnesium or zinc were more likely than women who did not to have died during that period, the researchers found.

Some supplements, like iron, were associated with a substantial increase in the risk of death, while others — vitamin A and vitamin D, for example — had no effect. Multivitamin use was linked to a 2.4 percent increase in the absolute risk of death, but calcium supplements appeared to decrease the risk."

The article also mentions that other studies have not produced such dramatic results, but it certainly makes you wonder if multivitamins are really necessary if you are eating a well-balanced diet.  After all, any claims made by vitamins or supplements are not approved by the FDA, so who should we believe?

Is Junk Food Really Cheaper?

"THE 'fact' that junk food is cheaper than real food has become a reflexive part of how we explain why so many Americans are overweight, particularly those with lower incomes. I frequently read confident statements like, 'when a bag of chips is cheaper than a head of broccoli ...' or 'it’s more affordable to feed a family of four at McDonald’s than to cook a healthy meal for them at home.'


This is just plain wrong. In fact it isn’t cheaper to eat highly processed food: a typical order for a family of four — for example, two Big Macs, a cheeseburger, six chicken McNuggets, two medium and two small fries, and two medium and two small sodas — costs, at the McDonald’s a hundred steps from where I write, about $28."

I LOVE every single word of this article written by Mark Bittman.  PLEASE read on for his full argument: Is Junk Food Really Cheaper?

nytimes.com

In addition, to support my argument I made about healthier happy meals a couple of weeks ago:

"Real cultural changes are needed to turn this around. Somehow, no-nonsense cooking and eating — roasting a chicken, making a grilled cheese sandwich, scrambling an egg, tossing a salad — must become popular again, and valued not just by hipsters in Brooklyn or locavores in Berkeley. The smart campaign is not to get McDonald’s to serve better food but to get people to see cooking as a joy rather than a burden, or at least as part of a normal life."

Another Benefit of IUDs

According to this article from USA Today, Study: IUDs may also prevent cervical cancer by Liz Szabo, women who use an IUD have about half the risk of developing cervical cancer as women who don't.  "The international analysis, published in The Lancet Oncology, combined data from 26 studies with a total of more than 20,000 women" (Szabo, 2011). 

Mirena

Scientists aren't sure as to why the IUD could prevent cervical cancer, and I have a feeling it could be the result of an outside variable.  For example, as the article states, cervical cancer is caused by an HPV infection (humanpapilloma virus), which is a common STD.  However, since the IUD is only effective in preventing pregnancy and not STDs, and IUDs are generally marketed to women who are married or in committed relationships, it would be logical to assume that the majority of women who have the IUD do fall into that category and are not exposed to HPV or other STDs. Therefore, they are less likely to develop cervical cancer.


Just a thought! Read the article and see what you think!

Lucentis & Avastin, pt. 2

USA Today

In November, I published a post about the drugs created by Genentech, Lucentis and Avastin.  Lucentis is most commonly used to treat macular degeneration and costs about $2,000 an injection.  Avastin is only approved by the FDA to treat cancer, but studies have shown that it is as effective as Lucentis when used to treat macular degeneration, so it is commonly prescribed off-label because it only costs about $50 per injection.  This cost difference ended up saving the government and patients more than hundreds of millions of dollars each year.

My previous post discusses the ethics of using drugs off-label in return for kick backs from pharmaceutical companies, but the point of this post is to illustrate why I am always wary of the use of drugs off-label.  This story by Andrew Pollack in the New York Times reinforces my original thought.

According to Pollack, about 21 patients located in Miami, Nashville and Los Angeles that have been treated with Avastin for macular degeneration and other eye diseases have experienced serious side effects including: eye infections, loss of vision and brain damage.

The infections are thought to be caused by bacterial contamination of the drug, which can happen easily because "to use Avastin for eye disease, a vial meant for a cancer patient must be divided into numerous tiny doses and each dose placed in a syringe for injection into the eye. The extra handling increases the risk of bacterial contamination and other problems" (Pollack, 2011b).

Because these problems occurred when the drug was being used off-label, Genentech is not accepting responsibility for the infections:

"Genentech said it would not comment on the litigation, but said that it had always cautioned against use of Avastin in the eye.  'Avastin is not manufactured or approved and to date has not been proven safe for use in the eye,' a spokesman for the company said Tuesday" (Pollack, 2011a).

Even though drugs that are approved by the FDA are sometimes recalled or are found to cause harmful side effects after approval due to a longer "testing period" on actual consumers/patients, I think that this example proves that doctors and pharmaceutical companies need to be more careful when promoting the use of drugs off-label.  One thing important to point out, however, is that "the 12 cases of lost vision in Miami had been traced to a single compounding pharmacy" (Pollack, 2011b) and Avastin has been prescribed over the past 6 years with few problems.

Healthy Happy Meals

McDonald's Trims its Happy Meal

In response to complaints from parents, health groups, and legislation in San Francisco, McDonald's is trying to make its Happy Meals healthier.  San Francisco passed a law that banned restaurants from including toys in meals for children unless certain nutritional requirements are met, such as a serving of fruit and vegetables.  Similar legislation is being considered in New York City, so McDonald's is now reducing the amount of fries in Happy Meals and adding fruit.

"Parents will have the option of requesting more fruit or, possibly at a later date, vegetables instead of fries. McDonald’s will also offer a fat-free chocolate milk option, along with the option of low-fat milk or the traditional soda. The price is not expected to change.

Today’s Happy Meal with chicken nuggets has 520 calories and 26 grams of fat, and the reconstituted version, with 1 percent milk, will total 410 calories and 19 grams of fat, according to the company" (Strom)

McDonald's has had the option for parents to request apples in lieu of fries for awhile, but research conducted by Yale University showed that only 11% of parents took advantage of this option.  In addition, through research, McDonald's found that when they suggested eliminating fries all together or removing the option of soda for a drink, parents and consumers reacted negatively.

Blaming McDonald's for children's poor eating habits is a little ridiculous, in my opinion. I think that parents need to take more responsibility for what they are feeding their kids.  As McDonald's spokesperson, Dayna Proud, stated: “...ultimately, it’s a parent decision to make about their child’s well-being” (Strom).  

Updated Food Pyramid

Nutrition Plate Unveiled, Replacing Food Pyramid

I had high hopes for this new "Nutrition Plate," but honestly, it looks like a middle schooler created this in Microsoft paint. It conveys no helpful information, other than emphasizing an increased intake of fruits and vegetables.  I completely support Michelle Obama's campaign against obesity and the overall goal of improving the nutrition of Americans by redesigning the food pyramid, but I think they could have done a much better job. As Dr. Nestle pointed out, "labeling a large section of the plate 'protein' was confusing and unnecessary, because grains and dairy products also are important sources of protein and most Americans get far more protein than they need."
It's at least a step in the right direction.