Challenges to Good Nutrition 1: Fast Foods

This is the twentieth and final entry in a series of topics following the syllabus of my Human Nutrition & Obesity graduate summer course – each entry offers a snapshot or principal take home message from that lecture; the final lecture was entitled: Zen & the Informed Eater – and the first entry in a new series examining the personal challenges to good nutrition. @DrTomSherman or @GUFoodStudies

1 Zen & the Informed Eater

I began my summer nutrition course with, among many other points, a brief argument for mindfulness. If one is to engage in an activity several times per day, every day, and that activity is necessary for life, I argued it is in your best interests to engage in that activity while fully aware of why and how you are doing it, and to the extent possible, make it a positive, enjoyable experience. I wanted my students to become mindful eaters. People eat for many reasons, however, and only one of them is hunger: eating is a social activity, a coping strategy for stress, anxiety and depression, an activity bred from boredom, an accompaniment to studying or watching TV. And unfortunately, eating is an activity that makes many people feel guilty or ashamed because they are knowingly eating foods, or amounts of food, or for reasons that they feel are contributing to their own poor health. Thus, on the final day of class, I made the case that mindfulness was not enough – we also needed to be informed eaters.

Some people are fortunate enough to be in complete control of their diet, but many are not. Socio-economics, education, age, health, race, geography and other factors influence individual challenges to eating well. Beginning with personal factors and broadening to more social and public health factors, I offer my list of challenges that must be overcome by many in order to find, prepare and eat foods that optimally sustain good health. Let us begin with …

1.  Processed/Prepared/Fast/Restaurant Foods

Placed Insights 03-13Placed, Inc. is a company that utilizes the emerging field of location analytics to study, among other things, where people go – or more specifically – what businesses people visit. In March of 2013, for example, using location data from more than 70,000 volunteers registered with Placed, Inc., astonishingly, “nearly half (49%) of Americans over the age of 14 visited a McDonald’s.” Of the top 20 businesses visited, 10 are fast food restaurants (including Applebee’s; is Applebee’s a fast food restaurant?). Perhaps these 70,000+ volunteers represent a skewed demographic, but more likely, these data represent the modus operandi for food acquisition by many people today.

I have written extensively in this blog about glycemic index, sweetened beverages, the Mediterranean and DASH diets, and the benefits of home cooking, and all of these elements factor in our national habit of eating prepared, processed, fast and restaurant foods. In exchange for the convenience and low prices offered by the food-service chains appearing in the most-visited list is any semblance of control over what we are eating. Appearances are always deceiving, but never more so than in a fast food restaurant. What appears to be a simple hamburger on a bun with pickle and sauce, or what appears to be a simple milkshake or chicken nugget, is a complicated concoction of highly processed foods with a precisely calculated taste and mouth feel. More importantly, it has a very high glycemic index, a shockingly high amount of sugar (and yet does not taste sweet), and a tremendous amount of salt (and yet does not taste salty). As Michael Moss describes so terrifyingly in his new book, Salt Sugar Fat: How the Food Giants Hooked Us, food companies have identified the bliss-point for a wide range of prepared and fast foods, successfully creating a population dependent upon their products. Fast food restaurants are the opium dens of the 21st century.

The National Center for Health Statistics (NCHS) of the CDC presents the data somewhat differently than Placed, Inc. Figure 4 below, for example, from NCHS Data Brief No. 114 (Feb 2013) illustrates the percentage of calories obtained from fast food among adults aged 20 and over, by age and weight status: United States, 2007–2010:

2 Figure 4 NCHS Data

3 Eating away-from-homeEven with the important demographic of 14–20 year olds missing from these data, it is clear that fast food represents a significant fraction of calories consumed for many people, and that this behavior contributes to excessive weight gain. Factoring in prepared and processed foods would increase this trend, and undoubtedly, factoring in restaurant visits in general would increase it further still. Eating outside the home is a trend that has been steadily increasing since the turn of the 20th century, as shown in the figure at left by Derek Thompson in The Atlantic detailing money spent on food at and away from home; this figure was inspired by a graphic originally published in Bloomberg BusinessWeek:

According to a USDA report entitled Nutritional Quality of Food Prepared at Home and Away From Home, 1977–2008, we may spend half of our food dollars away from home, but we still consume the majority of our daily calories at home (~68%):

4 Fig 1 USDA at Home

5 SaltThe trend is clear, however: we are increasingly abdicating control of food preparation to third parties. In the process, we are losing control of both quality and quantity. The seemingly quaint practice of picking through foods at the market to select the perfect fruits and vegetables for our family, or the exaggerated arguments over the counter with the butcher on the choicest cuts of meat are no more. All quality assurances are in the anonymous hands of food service chefs and workers. Our loss of control of food quantity is best exemplified with salt content and portion sizes. On average, 77% of salt intake comes from processed, prepared and restaurant foods. In part, this reflects the ability of salt to improve the flavor of foods, especially under-ripe and poor quality foods. Food scientists and chefs both defend their heavy reliance upon salt, arguing they are simply responding to consumer demand, and their sales will suffer if they lower salt use. This is undoubtedly true, but it has also been demonstrated that consumers adapt, and as trans fats have been eliminated, etc, people grow accustomed to revised flavors and soon forget previous tastes and practices.

As food prices continue to fall, and the percentage of our incomes spent on food continues to fall (currently at an astounding ~13%, compared to 42% in 1900 and 30% in 1950; see story), portion sizes at fast food and other restaurants have grown and grown. The average consumer has seemingly lost all sense of what is a reasonable portion size, and would, I am sure, howl in protest if served a properly sized portion in a restaurant or fast food establishment:

myplate_green-(1)The ChooseMyPlate.gov initiative is only the most recent attempt to encourage people to gain a sense of perspective, but it is fighting a well-established history of generous portions and consumer expectations.

Responding to the Challenge:

I have several recommendations on how best to address the concerns raised above, but Michael Pollan says it clearly when he writes “the best way to recover the reality of food” is to cook at home, and he discusses this at length in his latest book: Cooked – A Nature History of Transformation. I also addressed this topic in an earlier post: A Perfect Antidote: Home Cooking. Nothing better serves the goal of regaining control of your food than home cooking. Not only do you regain quality and quantity issues, but choices such as organic, GMO-free, local, etc, are now yours to make, and perhaps more important, yours to know.

Most everyone loves to eat out. I will argue, however, that decreasing the frequency in which it is experienced only enhances the joy of a good restaurant meal. The money saved can go both to buying better, higher-quality ingredients for home cooking, and meals at better restaurants.

Future Topics in the Series:

  1. Cultivating a taste for sustainable foods: ecology of a foodie
  2. Informed Eating: Product Labeling
  3. Nutrition Advice: Research Literature, Media Reports & the Internet
  4. Food Marketing
  5. Food Deserts
  6. Farm Subsidies & Food Policy
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5 Responses to Challenges to Good Nutrition 1: Fast Foods

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