Speaking With...: Ian Smith

Most of you know him simply as "Doctor Ian," nutrition expert on Vh1's Celebrity Fit Club, creator of the 50 Million Pound Challenge, host of the nationally syndicated radio show HealthWatch on American Urban Radio Networks, and author of #1 New York Times Bestsellers like The Fat Smash Diet.

Yesterday, Dr. Smith -- a graduate of the University of Chicago Pritzker School of Medicine -- launched his latest work, The 4 Day Diet, which is composed of a variety of 4-day modules.

My e-mail interview with him, transcribed below, covers the new book (I received an advance copy last month in preparation for our correspondence) as well as other current issues of interest in the fields of nutrition and public health.

The concept of motivation plays a significant role in this book. What motivated you to pen The 4 Day Diet?

So many people who I've worked with over the years have always talked about a lack of motivation or the inability to stay motivated. They wanted to know how to figure out a solution to this deficit.

I looked at all of the best diet books and none of them really gave the topic of motivation any real coverage. I know as a fact that the mental part of dieting is the most critical, because if your mind isn't in the right place, then regardless of how good the plan might be, you're not going to succeed.

The 4 Day Diet is my rendition of a COMPLETE program. There's the mental plan, diet plan, and exercise plan. The people who I worked with while creating this program not only lost a lot of weight, they lost it consistently and they constantly told me how "doable" the program was compared to others they had followed.

I also wrote the 4 Day Diet so that if parents want to put the entire family on a program, this could be that program. Most diet plans are not kid-friendly, but the 4 Day Diet is one that everyone can enjoy and see results.

The psychological and emotional factors behind weight loss are thoroughly explored in The 4 Day Diet. Do you recommend that, if financially possible, people simultaneously seek psychological counseling before/while trying to achieve significant weight loss?

In the best of worlds, people who need to lose a serious amount of weight or who have some psychological component to their cause(s) for being overweight would seek some type of psychological consultation. It's not because they're crazy or not smart. It's because sometimes we have anxiety or stress-related problems and don't even know it, and a professional might help tease these problems out.

I know that everyone can't afford to go to a psychiatrist/psychologist or doesn't want to go, so that's why I've included this material in the 4 Day Diet.

A lot of people will learn more about the cause of their problems and the strategies they can employ to solve them as they go on and lose the weight while regaining their health.

On a similar note, do you think periods of high stress are not a good time to begin implementing dietary changes?

One of the worst times to start a diet program is during a period of high stress. I tell people all the time, if you have some type of major life disruption such as relationship problems, job problems, financial crisis, loss of a loved one, medical crisis--these are not the times to undertake a diet program.

Unfortunately, too many people start a program simply because they believe it's the right time on the calendar to do so and they don't make sure it's the right time in their life. Success is more attainable if one begins this journey at the most appropriate time.

That being said, one must also guard against coming up with every excuse in the book as to why they shouldn't lose weight. Major stress-inducing situations are the only things that should stand in the way, not the small stuff.

Are you at all concerned the "Be Thinner by Friday!" label on the cover of the book can set up unrealistic expectations in readers or make this look like a gimmick?

There is that risk and to be honest I wrestled with the idea of putting it on the cover. I had those exact concerns, but the publishing team felt as though given my history of creating medically sound programs and being honest with people, that they would not interpret it as a gimmick.

The truth of the matter is that with the 4 day detox that's at the beginning of the program, people will lose weight right away. Will they lose all of their weight? NO WAY! That's not what I'm saying. They will lose weight and they will think differently.

One of the chapters talks about "thinking thin." That is as important as the physical part of looking thin. So, people will be thinner by Friday not just physically but mentally, and they will be on the road to significant changes if they stick to the plan.

Is there a particular reason why the modules [in the diet plan] only allow one teaspoon of milk (even skim or low fat) in coffee?

Great question. The honest answer is that people tend to go overboard. If the limit is 1 teaspoon, then most people are going to have 2. If I said 2 teaspoons were allowed, then they would rationalize having 3. Sometimes you can't win.

The major point with this is that you must try to cut calories wherever possible, even a small amount. If you get into the behavior of cutting calories with drinking coffee, then you're also likely to do the same when there are bigger calories at stake such as eating an entree or dessert.

It's all about learning how to make lifestyle changes that will lead to permanent good health.

What is your approach to people who "excuse themselves" from ever attempting to lose weight by saying "it's just how they are built" because they come from "large families"?

This is one of the most frustrating excuses I hear when people talk about reasons they don't try or can't lose weight. The truth of the matter is that unless one has a genetic medical condition that has been inherited from their family, there really is no such thing as "coming from a large family, therefore it's inevitable that they are large."

Can you come from a tall family? Yes. But that's genetic. Weight is rarely genetic. Families tend to be large because the choices they make from a dietary and exercise perspective make them large. There are no genetic plans that say everyone in a family is going to be 50 pounds overweight.

But if there's a medical condition that's inherited, then that's a different story. The truth is that you have a better chance of winning the lottery than truly being large "because your family is large."

Only 40 percent of medical schools in the United States offer a nutrition course. Of that 40 percent, very few actually require it as part of their curriculum. What are your thoughts on the apparent dismissal of nutrition that appears to be prevalent in the medical field (i.e.: "to lower blood pressure, take this pill, rather than be mindful of sodium and potassium intake.")

I think the lack of nutritional education is medical schools is a tremendous oversight and we are now seeing the manifestation of it with the obesity crisis we're now facing. More doctors and nurses need to know a lot more about nutrition and supplements and non-medicinal ways to control weight.

Obesity is a medical epidemic just like the plague was an epidemic. The front line fighters against this epidemic should be the doctors and nurses and other healthcare professionals. But there's not enough nutritional and related training, thus they are not effective at fighting on the front lines.

Are doctors entirely to blame for the obesity crisis? Absolutely not. Do doctors share some of the blame? Absolutely. I hope in the coming years that medical schools will see the need to take nutrition as serious as they take pharmacology and physiology and help train a new generation of obesity fighters.

Mandatory calorie labeling has proven to be a successful policy in New York City. What are some other public health nutrition policies you would like to see implemented in the coming years to help people achieve their health goals?

I think NYC has gotten off to a good start and I hope it proves successful and others will follow this lead. There are lots of health nutrition policies that should be implemented over the coming years to help cut into our obesity problem.

I think that schools across the country are getting an F grade when it comes to providing healthy food for our children. This is an embarrassment for the US, a country so rich and so full of resources and intellectual capital. Our children need to be served healthier food and mandated to participate in regular physical activity. At a time when we need children to be more active, we're dramatically cutting funding to programs and classes that would help our children get moving and lose some of this weight that will only harm them in their adult years.

I also believe that the government needs to be more instrumental in helping lower-income areas attract healthier grocery stores. Too many neighborhoods have nowhere to shop but stores that sell unhealthy, calorie-rich, sweet, processed foods and not enough natural, fresh food.

Yes, the communities must first want and then work to get these stores in their communities, but the government at some level should step in and play some role in incentivizing businesses to set up shop in these very needy communities. Remember, the healthier our fellow citizens, the healthier we all are!

Many thanks to Dr. Smith for taking time to participate in Small Bites' "Speaking With" section!

In The News: Just Say No

Today's Chicago Tribune business section features a simple and to-the-point article on the -- pardon the pun -- massive weight loss aid industry.

While it does not break new ground, it effectively communicates a message that, in my opinion, should be displayed on huge billboards in every city: DIET PILLS ARE A WASTE OF MONEY.

Numbers Game: Answer

According to figures from the National Health and Nutrition Examination Survey (NHANES), per capita sodium intake in the United States increased 56 percent between 1970 and 2000.

Not at all surprising, considering the rampant increase in meals eaten at restaurants and consumption of frozen foods.

Dietary guidelines recommend no more than 2,400 milligrams of sodium a day, but the average adult in the United States consumes, on average, anywhere from 3,300 to 3,800 milligrams.

Remember -- the more processed a food item, the higher its sodium levels (i.e.: three ounces of grilled chicken contain approximately 10 times less sodium than three ounces of chicken nuggets.)

Ugh

The title of this post says it all.

Dr. Maximo Ravenna, who I blogged about earlier this year, continues his brainwashing of the Argentine population in regards to nutrition.

I have encountered a fairly high number of otherwise intelligent people who have bought into this man's claims that flour is addictive (this includes whole grain flours) and that the only guaranteed way to lose weight-- and keep it off -- is by going on a 600 calorie a day diet... for the rest of your life.

Suffice to say that someone I know down here who has been on this diet since 2004 eats three slices of cheddar cheese and one hard boiled egg for lunch most days.

Whereas most Registered Dietitians are weary of VLCD's (very low calorie diets), Dr. Ravenna condones them.

In a recent article for Argentina's Gente magazine, he writes, "Very low calorie diets have been used in clinical medicine for forty years, proving their efficacy and safety."

What he fails to mention is that VLCD's are used in very limiting situations and under strict medical supervision in hospital settings -- NOT by any Tom, Dick, or Jane in their day to day life.

Many people who start with Dr. Ravenna are recommended to go as low as 400 calories a day for as long as 16 weeks!

His quick detox plan, advertised as a "healthy way to lose up to 5 pounds in one week," suggests the following meals:

* A breakfast consisting of a cup of black coffee accompanied by one grapefruit

* A lunch made up of a one-egg omelette and mixed green salad

* A lunch consisting of 1 cup of roasted vegetables

* A snack consisting of whipped egg whites with Splenda and a quarter cup of strawberries

Since many of his patients lose quite a bit of weight (who WOULDN'T on a 400 calorie a day diet?) his popularity continues to soar and thousands of Argentine men and women consider him a bastion of hope.

I, of course, beg to differ. All I see in his diet plan is medically-backed anorexia.

Numbers Game: Soaring Sodium

According to figures from the National Health and Nutrition Examination Survey (NHANES), per capita sodium intake in the United States increased ______ percent between 1970 and 2000.

a) 19

b) 31

c) 47

d) 56

Leave your guess in the "comments" section and come back on Monday for the answer!

You Ask, I Answer: Calcium & Weight Loss

What are your thoughts on the belief that high calcium intakes help with weight loss?

-- Flor (last name withheld)
Buenos Aires, Argentina

Since the public loves the idea of magic bullets and fat-burning foods, the notion that a little extra calcium in the diet results in more effective weight loss really struck a nerve.

A few years ago, the dairy industry began advertising the claim that three glasses of skim or low-fat milk a day were more than just a good source of calcium -- they also helped with weight management.

Truth is -- there is no concrete science to support those statements.

The vast majority of clinical trials looking at calcium and weight loss fail to demonstrate a link between high intakes of the mineral and higher rates of weight loss.

Notice that even the "calcium helps you lose weight" campaign ultimately came down to calories. After all, consumers were encouraged to drink low-fat or skim milk, not whole.

If calcium in and of itself were a miraculous fat burner, it technically wouldn't matter if the product containing it were fat-free or not.

I encourage everyone to always be suspicious of specific foods or nutrients marketed as "fat burning," and instead keep in mind that weight management is more about general dietary patterns.

Drinking six cups of green tea a day isn't going to do much in terms of weight loss if your total caloric intake is 1,000 calories higher than it should be.

Similarly, chugging down a glass of skim milk along with a 450 calorie muffin isn't going to produce any amazing results.

You Ask, I Answer: Lectins

I was wondering if you had any views on the health impact of lectins in food, assuming the food has been properly prepared.

I've had difficulty finding anything reliable or well referenced.

-- Anonymous

Jersey, Channel Islands

Lectins are certain proteins -- and natural insectides! -- found in a variety of foods, including legumes, grains, dairy products, and some vegetables.

When consumed in certain quantities, they can cause severe gastrointestinal distress. It is also theorized that long-term lectin consumption can raise the risk for certain types of cancers.

However, cooking renders lectins inactive, so you are only vulnerable if you tend to eat certain foods (such as legumes or rice) in raw or undercooked forms.

Peter D'Adamo, author of The Blood Type Diet, blames lectins for a myriad of health problems.

According to Dr. D'Adamo, lectins can cause red blood cells to stick together and form clots if they are eaten by someone with a certain blood type.

How he came to such a conclusion completely escapes me (and all other Registered Dietitians I have ever spoken to), since there is absolutely nothing in the scientific literature substantiating his theories.

I don't consider lectins to be a health hazard since properly cooked foods don't pose any health risks in that regard.

You Ask, I Answer: Fiber

I have a question I was hoping to get your take on.

Recent news advocate a higher consumption of fiber. In response, there seems to be an overwhelming array of new products supplemented with additional fiber.

I have noticed that 25 - 35 grams per day is deemed ideal, but with these new products, it is very easy to go over that figure.

I have estimated my total intake to be as high as 60 grams a day sometimes.

Is it dangerous to consume too much fiber? Should I be worried about vitamin absorption?

-- Susan (last name unknown)

Via the blog

Fiber recommendations have been around for decades. The 25 - 35 grams per day guideline is not as new as many people think.

What has emerged over the past few years are new studies highlighting the importance of fiber in the diet.

Some people erroneously believe that if "x" amount of fiber is beneficial to health, then twice or three times as much is even better!

Not quite.

Although 25 - 35 grams are the standard recommendation, the majority of adults can take in as many as 50 grams without any negative health consequences.

Your body is sure to let you know when you've had too much of a good thing.

In the case of excessive fiber intake, the symptoms to look for includes abdominal pain, very loose stools, bloating, and persistent gassiness.

Mind you, those symptoms can also show up if you are suddenly increasing your fiber intake (say, from 10 grams a day to 25 grams a day) or if your diet is high in fiber but very low in liquids.

I am not a big fan of extremely high fiber cereals like All Bran.

Although they can provide as much as 80% of daily fiber needs in one sitting, I would much rather people spread out their fiber throughout the day and get it from foods that naturally contain it (as opposed to added on in copious amount during processing.)

Excessive fiber intakes don't tend to inhibit vitamin absorption; iron and calcium absorption is most heavily impacted.

Numbers Game: Answer

A prospective study on holiday weight gain published in the New England Journal of Medicine in the year 2000 found that, on average, people gain 1 pound(s) during the holidays (from mid-November to early January).

I know, I know. Just one?

It may not sound like a lot, but consider that these holiday pounds are usually not lost once the New Year begins -- or ever, for that matter.

You can see, then, how someone can gain ten pounds in the course of a decade simply by being careless over a five-week period -- even if they are on top of their game the other 47 weeks!

Some studies have also found that people who are already overweight tend to put on an additional pound during the holidays.

I would be interested in seeing this same study done in countries where the holidays take place during the Summer months (i.e.: anywhere south of the Equator,) where rich, high-calorie foods aren't as weather appropriate.

Supersize Skies

I arrived to my home country of Argentina earlier today.

There are certain things I can always count on during my annual December trip: ninety degree weather, daylight past 9 PM, and looks of confusion when I mention things like "tofu," "seitan," "hummus," and "vegan desserts."

Prior to arriving to Buenos Aires, I flew from New York City to Miami.

I found the on-board snack choices quite interesting.

We coach-class passengers could purchase a jumbo 450-calorie cookie for $3, an entire container of Lay's Stax for that same amount, or a cheese/nut/raisin platter for $4.

The platter aside (which, nutritionally speaking, I was very satisfied with,) we are looking at jumbo portions being the ONLY options.

As Brian Wansink and others have found, when food is in front of us, we are highly susceptible to eating it in its entirety, regardless of our hunger level.

It boggles my mind that instead of offering, say, a 200 calorie bag of potato chips, the only option provided to passengers is a tube containining eight 150 calorie servings!

Since some of these flights last 3 or more hours, it is completely feasible that what starts out as a desire for a small nibble could easily turn into intermittent snacking on three or four servings of potato chips.

This is why I always recommending bringing your own healthy snacks on board. You'll save money -- and unnecessary calories!

Dear Governor...

Several readers have e-mailed me over the past week asking what they can do -- and who they should contact -- to get mandatory calorie labeling in their state's fast food chains.

The folks at the Center for Science in the Public Interest kindly provide a form letter you can submit electronically to your Governor.

If advocacy writing is your forte, you can always use that letter as inspiration for your own missive.

If You're Still Looking For That Perfect Gift...

... for a nutrition-phile, I highly recommend What The World Eats (which I was actually gifted yesterday!).

An adaptation of last September's Hungry Planet by award-winning photo journalist Peter Menzel and author Faith D'Aluisio, this made-to-be-displayed-on-the-coffeetable book captured what a week's worth of groceries looks like for 25 families in 21 countries.

Weekly food expenditures are broken down by category (i.e.: dairy, fruits/vegetables/nuts, snacks, etc.) and meticulously itemized.

The beautiful photographs are accompanied by illuminating narratives of each family's experience with food.

The Aboubakar family, for instance, is originally from Sudan, but resides in a refugee camp in neighboring Chad.

Their food is rationed and minimally diverse (their only two sources of grains consists of sourghum and a patented corn-soy blend).

The Dong family of Beijing, meanwhile, spends $155.06 US dollars on food each week; $27.95 are spent solely on beverages like Coca-Cola, instant coffee, grapefruit juice, and beer.

Peppered throughout the book are incredible statistics (annual consumption of soft drinks per person in France adds up to 23.8 quarts; in the United States, that figure clocks in at 54.8 GALLONS!) and a variety of informative charts and graphs.

This work of food for thought should satisfy many curious minds' hunger.

You Ask, I Answer: PolyCystic Ovary Syndrome, Milk

I have a condition known as PolyCystic Ovary Syndrome, which results in my hormones being all out of whack.

I'm befuddled as to which would further alter my hormone levels more (and which hormones that would be): cow's milk or soy milk?

I have read that bodybuilders [try to avoid] soy-based protein powders because they increase estrogen [levels], but I have also read reports that the hormones in cow's milk can cause girls to [begin] puberty at a younger age.

Would drinking organic milk be the solution?

-- Rachael (last name unknown)
(city unknown), NJ

Let's first begin by touching upon some nutrition-related specifics regarding PolyCystic Ovary Syndrome (POS).

The hormones found at high levels in affected individuals are a group of male hormones known as androgens.

One interesting theory that has emerged about risk factors for POS (other than being overweight or obese) surrounds the body's inability to use up insulin efficiently.

Since high levels of free-floating insulin building up in the blood can increase the amount of androgens produced, it is believed this could be a factor behind the development of this syndrome.

This is also why POS in itself is a risk factor for Type-2 diabetes.

From a nutritional standpoint, the best recommendation is to lose excess weight, as this often results in more efficient use of insulin by the body and, consequently, lower production of androgens.

The catch-22 is that, for many individuals, it is precisely this hormonal imbalance that can add a degree of difficulty to achieving weight loss.

Consequently, I highly recommend that you speak to a Registered Dietitian (as opposed to picking out a diet plan from a book or magazine, even if it is from a highly reputable source.)

With POS, you need a customized plan based on your individual situation.

It really doesn't make a difference to your condition whether you include dairy or soy milk in your diet, as neither of these have a particular effect on androgen levels.

As for the link between hormones in milk and early puberty -- I don't buy it.

After all, milk consumption has been on a steady decline over the past two decades. It's children's intake of soda -- not milk -- that has skyrocketed since the 1980s!

A much more realistic explanation for the recent trend of earlier puberty initiation? Increasing obesity rates among children.

Highly respected endocrinology journals have published a handful of studies over the past few years -- such as this one -- making interesting physiological connections between high BMI levels and earlier sexual maturation in girls.

You Ask, I Answer: "No Salt Added"

I bought some soup [labeled] "No Salt Added."

[The nutrition label on the back] says each serving (there are two in each can) has 25 milligrams of sodium.

Shouldn't it be zero milligrams since there's no salt added?

-- Rebecca Alpert
(city withheld), GA

Welcome to the confusing world of food labeling.

For starters, many people mistakenly interchange the terms "salt" and "sodium," even though they mean different things.

Sodium is a mineral. Salt is the combination of sodium and chloride (approximately 40% sodium and 60% chloride).

If you're talking numbers, this means that one gram (1,000 milligrams) of salt contains 400 milligrams of sodium and 600 milligrams of chloride.

A lot of people get confused when they read some literature calling for no more than 5 grams of salt a day, while other materials make reference to 2,400 milligrams of sodium.

Five grams of salt amount to roughly 2,000 milligrams of sodium (40 percent of 5,000), NOT 5,000 milligrams.

As for "no salt added" items containing sodium -- they are technically telling the truth.

"No salt added" simply means that sodium chloride is not tacked on. Ingredients naturally containing sodium can be included in these products.

Remember, many foods naturally contain tiny amounts of sodium. A cup of raw broccoli, for instance, provides 30 milligrams.

From a legal standpoint, products with a "no salt added" claim are required to also print "not a sodium-free food" in the front of their packaging (although this is usually done in tiny print.)

Considering that most soups pack in as much as 700 milligrams of sodium per serving, 25 milligrams is certainly very low!

In The News: The City of Brotherly Love Gets Tough

Add another city to the "calories on menu boards" list!

On Thursday afternoon, Philadelphia mayor Michael Nutter "signed a bill that orders chain restaurants [— including coffee shops, ice cream parlors and convenience stores — with a total of 15 or more stores, whether in the city or elsewhere,] to display calorie, saturated fat, trans fat, carbohydrate, and sodium information [for all menu items by January 1, 2010.]

The cherry on top? "Nutter signed the bill at the Center for Obesity Research Education at Temple University," the Associated Press reports.

I am personally looking forward to the day trans fat labeling becomes irrelevant following a national ban on restaurants' use of partially hydrogenated oils (that is no starry-eyed dream -- Denmark paved the way in 2003, and Switzerland followed suit in April of this year.)

Numbers Game: 'Tis That Time of Year...

A prospective study on holiday weight gain published in the New England Journal of Medicine in the year 2000 found that, on average, people gain ________ pound(s) during the holidays (from mid-November to early January).

a) 1

b) 2.5

c) 3

d) 5

Leave your guess in the "comments" section and come back on Tuesday for the answer!

In The News: Stevia Is A-Okay, Says the FDA

I have a feeling soft drink companies are toasting the latest news -- the Food & Drug Administration has given the green light to "a highly purified form of stevia known as rebaudioside A, supplied by other companies to Cargill and Merisant, which have further developed it for tabletop, food and beverage use," The Wall Street Journal reports.

Prepare for the onslaught of Stevia sweetened beverages in 2009, including Sprite Green, Stevia-sweetened Odwalla juices, and three flavors of SoBe Lifewater.

Do you predict these products will financially sizzle or fizzle?

You Ask, I Answer: Stoneground Wheat

I have seen a few breads labeled as "100% stoneground wheat."

Does that have any nutritional implications?

Is it similar to a whole wheat bread?

-- Mariana (last name withheld)
(city withheld), NJ

The literal way to produce stoneground flour is to grind it solely in stone mills (rather than conventional roller mills.)

Most conventional breads sold at supermarkets (which I assume are the ones you are asking about), however, use the term as a healthy-sounding catchphrase in an attempt to confuse consumers who are looking for healthier breads.

The main problem here is that the Food & Drug Administration has not drafted a legal definition of "stoneground." It can basically mean whatever food companies want it to mean!

This is very much akin to the lack of definition of the term “natural ingredients,” which permitted 7-Up to launch a “made with all natural ingredients” campaign a few years back.

Most major bread companies can get away with labeling their breads as “stone ground” if the flour has gone through a stone mill just one time.

This is all irelevant, though. White flour has the same nutritional profile regardless of the type of mill it is processed in.

The most important thing to look for when purchasing bread is that the first ingredient is a WHOLE flour.

Any word other than whole -- such as "stoneground", "unbleached", or "enriched" -- means the main ingredient is white flour with virtually no fiber.

Numbers Game: Answer

Taco Bell's new limited-offer Fully Loaded Nachos contain 17 grams of saturated fat, 4.5 grams of trans fat, and 2,190 milligrams of sodium.

(NOTE: Daily saturated fat intake should not surpass 20 grams; trans fat recommendations are set at 0 grams per day; daily sodium consumption should be below 2,300 milligrams )

Some more figures to make you go "yikes" -- this "dish" contains over one pound of food and clocks in at 1,390 calories.

Which means more calories, sodium, and saturated fat than a Big Mac with a side of large fries and a large soda.

Seems like thinking outside the bun isn't always such a good idea...

You Ask, I Answer: Cucumbers

The turkey myth posting had me thinking about people putting cucumbers on their eyes because they supposedly help get rid of bags.

Is that a myth or is there an antioxidant in them that helps reduce puffiness?

-- Rachel (last name withheld)
Morristown, NJ

There's no secret compound to speak of.

Cucumbers are great at reducing puffiness simply because they maintain their cool temperature and are largely made up of water.

The mechanism that creates bags under the eyes is the same one that promotes swelling after, say, a baseball strikes you in the face.

In both cases, the best course of action is to apply some sort of cold compress to the affected area.

It helps that cucumbers hold well and, since they can be sliced into the perfect shape and size to cover our eyes, provide an aesthetic touch.

It just wouldn't look or work the same if you placed celery stalks, apple slices, or something as acidic as lemons, limes, or oranges over your eyes at the spa!

You Ask, I Answer: Urinary Tract Infections & Cranberry Juice

I was just told to drink cranberry juice to help treat a UTI.

The nurse said the juice's acidity [would help].

This confused me because I thought that food from the stomach is neutralized by a base before getting digested in the small intestine, so it wouldn't matter how acidic foods are to begin with.

So, is there any reason to drink cranberry juice for a UTI?

I'm cautious because all of the juice brands I've seen at stores have a lot of sugar, and drinking cranberry juice needlessly seems like a way to ingest a lot of empty calories.

-- Christine (last name unknown)
Via the blog

Lots to cover here.

Does cranberry juice play a role in preventing and treating urinary tract infections? Yes, but it has nothing to do with the fruit's acidity.

Cranberries -- and blueberries, for that matter -- contain an antioxidant known as proanthocyanidin.

This just so happens to also be the flavonoid that gives these two berries their unique pigments.

Several studies (mostly conducted over the past five years) have concluded that this phytochemical inhibits certain bacteria from adhering to the cell membranes of the cells lining the walls of the bladder.

By not being able to stick to these cells, bacteria have no chance to claim land, play house, and set off an infection.

The majority of the research on these components in cranberries and their relationship to urinary tract infections has mainly focused on prevention.

This is not to say, however, you are wasting your time by using cranberry juice in your treatment.

In fact, cranberries' anti-adherent properties against pesky bacteria can be a great complement to the 8 to 10 eight-ounce glasses of water you should be drinking every day day to help flush out said organisms.

The key, though, is to drink PURE cranberry juice -- usually found at select health food stores.

This means cranberry "juice drinks," "cranberry-based fruit cocktails," "cranberry energy water" will not be of much help.

Since that can be quite bitter medicine to swallow (despite there being no official dosage, most recommendations call for anywhere from 8 to 16 ounces per day), you may opt for concentrated cranberry extract pills (which have been used in several clinical trials.)

Then again, since no government agency regulates supplements, you always run the risk of buying an extract pill that, for all you know, offers a tenth of the dosage it claims on its label.

In The News: Can Sodas Succeed with Stevia?

More Stevia controversy.

This time, it revolves around two soft drink giants -- Coca Cola Co. and PepsiCo Inc. -- desperate to gain back customers after experiencing tumbling sales this year.

"Coca-Cola Co. will begin selling products made with [the] new zero-calorie sweetener despite no official nod from [the Food & Drug Administration], but rival PepsiCo Inc. said Monday it won't follow suit," reports today's San Francisco Chronicle.

Pepsi actually has two Stevia-sweetened drinks on deck, but is waiting to launch them until the sweetener receives a "generally recognized as safe" moniker from the FDA.

"A no-calorie, all-natural sweetener is a huge opportunity for the beverage industry," Morgan Stanley spokesperson Bill Pecoriello said at today's Beverage Digest conference.

A huge opportunity to trick consumers into thinking these beverages are "healthy" and perhaps even a viable solution to the obesity problem?

My concern is that among all this Stevia joy, the main problem is being overlooked: soda -- diet or not -- is usually consumed with unhealthy foods.

Most people usually pair it up with chips, pizza, fries, hamburgers, hot dogs, and other high-calorie fare.

Complementing four slices of pepperoni pizza with a Stevia-based, rather than Splenda-based, soda isn't exactly that great of an improvement.

And although stevia is the least Frankenstein-ish of non-caloric sweeteners, all sodas contain phosphoric acid, which isn't something you want to consume on a daily basis.

You Ask, I Answer: Tortilla Chips & Salsa

I had lunch at a Mexican restaurant this weekend that labeled some [menu items] as low-fat and low-carb.

I was surprised that the chips and salsa appetizer wasn't [labeled] low-fat.

I know salsa is fat-free, so wouldn't [chips and salsa] be lower in calories than [an order of] chips and guacamole?

-- David (last name withheld)
Orlando, FL

Although a standard restaurant order of chips and salsa (approximately two ounces of tortilla chips and one cup of salsa) offers 330 fewer calories than that same amount of chips and guacamole, it is not a low-fat appetizer.

Sure, one serving (two tablespoons) of salsa contains a negligilble 0.1 grams of fat, but don't forget about the chips!

One serving of tortilla chips (one ounce in weight, or approximately 12 individual chips) contributes 140 calories and seven grams of fat. This is identical to the calorie and fat values of potato chips, by the way.

Assuming the restaurant is following FDA standards for low-fat labeling, they can only "award" that moniker to items contributing less than three grams of fat per serving.

Since one serving of tortilla chips alone offers more than twice that amount, you can understand why this particular appetizer didn't make the cut.

You Ask, I Answer: Tryptophan

I am writing to you so you can hopefully help me prove a point.

My cousin claims the reason why people feel tired after Thanksgiving dinner is because of the tryptophan in turkey.

I say that's a myth.

She insists it has been "scientifically proven" that tryptophan makes you sleepy.

What do you have to say?

-- Lori Narth
(Location withheld)

Ah, yes, the "turkey makes you sleepy" myth. Let's break this one down.

Tryptophan is one of twenty amino acids (and one of nine essential amino acids which we must get from food.)

Tryptophan also happens to be a pre-cursor for serotonin (a neurotransmitter) and melatonin (a hormone), which play significant roles in the regulation of sleep.

That might make you think there is a direct link between the tryptophan in your turkey dinner and your desire to nap a short while later.

Not so much.

First of all, although tryptophan is one amino acid in turkey, it is also found in other foods.

In fact, chicken breast, tuna, soybeans, and beef contain more tryptophan than turkey! Snapper, black beans, and cod are also good sources of this amino acid.

More importantly, tryptophan is one of many amino acids contained in a Thanksgiving dinner.

This means tryptophan is competing with other similar compounds for absorption by the brain. Simply put, you aren't getting enough of it to make you sleepy.

Research has shown you would have to eat a significant amount of turkey -- almost the entire bird! -- on an empty stomach to feel any sleep-inducing effects.

A much more accurate theory for the sleepiness after Thanksgiving dinner has to do with the sheer amount of food eaten.

With that much food to digest, the body sends as much blood as it can to the intestinal tract, resulting in an energy zap.

This is the main reason behind the "small meals throughout the day" recommendation -- by not overworking your digestive system at any given time, your energy level is more likely to remain steady.

Remember, too, that most Thanksgiving meals consist of white bread, mashed potatoes, and cranberry sauce.

Those are precisely the kind of carbohydrates that make blood sugar levels rise and fall rather sharply, making for a more noticeable "energy crash."

It is also a known fact that meals high in carbohydrate increase insulin levels, consequently increasing the amount of serotonin produced by the body.

I also think people forget that the buildup to such events (traveling to someone's house, preparing the food, and being soecially "on") can be rather tiresome.

Numbers Game: Fully Loaded Arteries

Taco Bell's new limited-offer Fully Loaded Nachos contain _______ grams of saturated fat, _______ grams of trans fat, and _______ milligrams of sodium.

(NOTE: Daily saturated fat intake should not surpass 20 grams; trans fat recommendations are set at 0 grams per day; daily sodium consumption should be below 2,300 milligrams )

a) 15/2.5/2,560
b) 18/2/1,980
c) 14/3/2,340
d) 17/4.5/2,190

Leave your guess in the "comments" section and come back on Wednesday for the answer.

You Ask, I Answer: Methyl Bromide & Chocolate

I was going to buy a chocolate bar at a supermarket recently, and a fellow shopper informed me that the source chocolate that constitutes most chocolate bars (even the one I was buying, a 70% cacao Chocolate Santander bar) is treated with methyl bromide, a potentially harmful chemical, to inhibit the growth of fungus, etc. and exponentially lengthen shelf life of the finished product.

She said that one of the few chocolate bars available that doesn't undergo such treatment is Kallari.

You will note that the issue of methyl bromide treatment is addressed on the Kallari website.

Is there any truth to these claims? If so, what health risks does ingestion of chocolate that has been treated with methyl bromide entail?

Are there any other brands of chocolate in addition to Kallari that may be somewhat safer to consume than those treated with methyl bromide?

Finally, what is your informed opinion on chocolate consumption generally?

-- Tim Fisher
Boston, MA

Those claims are indeed true.

Remember, cocoa beans are a crop, just like fruits, vegetables, and legumes. This means you have conventional (grown with pesticides and chemicals) and organic (pesticide-free) varieties.

Methyl bromide is usually used to fumigate cacao beans when they depart from -- and arrive at -- ports.

Since it is not at all uncommon to have insect infestations on cocoa beans, methyl bromide is used as insurance. It also, as you state in your question, prevents the formation of fungus during the transportation process.

In fact, some countries -- particularly those that rely very heavily on cocoa beans for trade -- spray methyl bromide on the cocoa bean crops to ensure minimal losses.

Methyl bromide is so controversial -- it also happens to be a class 1 ozone-depleting substance -- that the Environmental Protection Agency only allows very specific uses (one of them being the fumigation of cocoa) in the United States.

The only way to ensure you are getting methyl bromide-free chocolate is by looking for a "certified organic" label, or going directly to the company's website.

I am sure that any company not using methyl bromide will be more than happy to let site visitors know!

I know, for instance, that Dagoba does not spray their cocoa beans with methyl bromide.

Although inhalation of the gas is known to have very serious effects on the lungs, kidney, and central nervous system, there isn't much information regarding health risks in the context of eating food that has been treated with methyl bromide.

Some in the industry believe that since this is a very quickly-dissipating gas, only minimal -- well below the permitted standard -- amounts make it to the actual food.

As for my informed opinion on chocolate, I think a high-quality product makes for a most excellent culinary treat.

Although higher cocoa contents offer more phytochemicals and antioxidants, it is always best to consider chocolate a sweet delicacy best enjoyed in small portions, rather than a "health food."

In The News: Holiday Eating

Last Friday I was interviewed for this Reuters piece on holiday eating.

I spoke with reporter Terri Coles about common traps people fall into during this high-caloric time where food is plentiful.

We also spoke about helpful behavioral modification tips readers can implement to enjoy holiday meals without morning-after regret.

Enjoy!

You Ask, I Answer: Gluten-Free Diets

I just learned I have celiac disease.

My doctor told me to avoid wheat [and wheat by-products.]

He mentioned to also steer clear of barley and rye.

A family member told me that's only the surface of things I should avoid, since things like soymilk and spelt should also not be eaten.

Can you give me some information?

-- Marie Brilmer
(Location withheld)

Although I am sure this new diagnosis seems initially overwhelming, I am glad you now have a way to explain a lot of the uncomfortable symptons I am sure you were experiencing.

It's a shame your doctor's advice was so vague. Your family member is right -- simply thinking of a gluten-free diet as "no wheat, barley, or rye" is only part of the puzzle.

Her soymilk concern is somewhat on target.

Some soymilks use malt flavorings -- derived from barley -- as flavoring agents. As always, you must read the ingredient label to figure out which brands fit into your celiac-friendly eating plan.

Other things to look out for:

* Soy sauce, which can contain wheat

* Bulgur, which is a wheat product

* Durum flour, also a wheat product (this is what conventional pastas are made with)

* Triticale, a mixture of wheat and rye

* Products containing hydrolyzed vegetable OR hydrolyzed plant protein (this includes canned tuna) -- usually derived from wheat protein

* Items containing wheat starch (including, but not limited to, cake frosting, gravy, pre-sliced cheese, and over the counter drugs)

I should also inform you that many cosmetics companies add wheat starch to their lipsticks as filler.

Since even a tiny amount of wheat can set off all sorts of unpleasant reactions, be sure to research brands that offer celiac-friendly makeup!

Numbers Game: Answer

A single Brazil nut provides 97.5% of the daily selenium requirement.

Pretty nifty, huh?

This is a particularly valuable tidbit of information for vegans, since the vast majority of foods high in selenium are animal-derived.

That doesn't mean you can't get too much of a good thing.

Since the Upper Limit for selenium is set at 400 micrograms, snacking on a half dozen Brazil nuts every day could set the stage for a condition known as selenosis, which can result in in hair loss, fatigue, and intestinal discomfort.

This is literally a "one a day" recommendation.

You Ask, I Answer: Calories & Winter

I have heard mixed things about cold weather and its impact on calorie burning and was hoping you could clear up the matter.

Do you burn more calories in winter, or do you just feel like you do?

-- Luise (last name unknown)
Via the blog

It's funny, because some people ask me if it's true we burn more calories in the winter, and others want to know if it's true we burn LESS calories in the winter!

I chalk this all up to psychological impression.

Although it is true that an involuntary action like shivering -- our body's way of attempting to warm us up -- takes energy, it does not mean we automatically burn extra calories when temperatures plunge.

Besides, most people bundle up to prevent themselves from shivering.

Some research has shown that exercising outdoors in the Winter can slightly increase the amount of calories burned since the body has to work harder to keep us warm.

That said, it is important to not lose focus of the big issue here -- stay as active as you can, indoors or out.

It's not so much that temperature affects our caloric balance, but, rather, that our activities change as a result of the weather.

There is no simple answer to the seasonal calorie burning question because individual factors come into play.

Many people are more physically active in the Summer, and tend to turn to comfort foods when temperatures drop.

Then again, there are also those who become more active in the Winter (whether it be by skiing often or finding more time to work out at the gym since many Summer activities are no longer feasible.)

And then there are those whose weight does not fluctuate by season because their eating and exercise habits are fairly consistent.

Despite all this, it wouldn't surprise me if at some point down the road we see some scam artist hawking The Winter Diet -- Shiver Those Extra Pounds Away.... Until Spring!

Shame On You: The Results Are In

I am sure you have all been on pins and needles awaiting the results of Burger King's Whopper Virgins experiment. Or not.

Well, the wait is over!

And wouldn't you know it -- the majority of those "weird third world villagers who have never heard of a burger" prefer the Whopper to rival McDonald's Big Mac.

Wondering how the burgers stayed hot and palatable in desolate areas of the world, far from any Burger King?

Turns out the "expedition team" shuttled villagers to the closest city and had them bite into their first Whopper -- in front of a video camera no less -- in some sort of warehouse.

Supposedly, said warehouse had both a Burger King and McDonald's nearby, ensuring that both chains' offerings would be in a participant's mouth no more than 15 minutes after being purchased by the expedition team.

All this trouble to find out which corn-fed beef patty topped with high-fructose corn syrup ketchup and a single pathetic wilted leaf of lettuce is the more superior one? I don't get it.

Burger King chronicles their worldwide journey in this 7 minute, 8 second "cinematic piece".

Apart from seeing images of these "researchers" in remote third world areas (including scenes where they cook Burger King hamburgers for a small village in a portable broiler displaying the fast food chain's logo), we get to hear choice quotes like:

"[Some of these people] didn't even know how to pick [a hamburger] up."

Oh, wow! How backwards! And the majority of Americans don't know how to hold chopsticks properly. Your point?

The team is incredulous when a man practically missing all his teeth chooses to tear off a part of his burger rather than bite into it.

So incredulous, actually, that they instruct him to take a bite.

I cringed.

"You can not get an entirely pure taste from a group of Americans because they have been exposed to so much advertising."

Partially true, but this isn't only a problem in the United States. Fast food and soft drink advertising crosses borders and makes it to some very remote areas.

Have these people never heard of blind tastings? Simply blindfold your subjects (right here in the USA!), ask them to take a bite of Burger 1, a bite of Burger 2, and tell you which one tastes best to them.

And for all his "marketing virginity" talk, isn't "rewarding" those who selected the Whopper as their favorite of the two burgers with their very own Burger King cookout a form of advertising?

I am still waiting for the press release informing everyone this is a spoof along the lines of Waiting for Guffman or This Is Spinal Tap.

In The News: Santa Claus Is Coming To Town, and Evidently Going to the Gym!

Leave it to Tinseltown to have a fit Santa Claus.

Over in Los Angeles' Beverly Center mall, kids -- and adults! -- can see just how beefy Santa looks "when he's not eating milk and cookies."

Since 2002, "a young, muscled dude with bulging biceps and abs as flat as a gingerbread cookie" shows up at the upscale shopping center three nights a week in traditional Santa garb.

Well, make that semi-traditional garb -- his "fur-trimmed red velvet coat" is sleeveless.

This year's jolly hunk is 31 year old Eli Wilhide, who does more than just play the role of ocular sweetness .

Throughout his photo-taking sessions and hourly performances with the Candy Cane Dancers, Wilhide talks to children about the importance of nutrition and physical activity.

Although not a registered dietitian, he does hold a bachelor's degree in nutrition from The University of Maryland.

Leaving Out Vital Information

Vending and food service company Next Generation has introduced Vitalities, a sticker-based initiative which "provides customers the ability to make selection based on healthy snack and beverage alternatives, while still having the flexibility to select name brand product options."

In essence, products that meet certain health criteria -- created with the help of a Registered Dietitian -- get a sticker next to their item code.

On the food side, the following categories are offered: lower in fat, lower in sugar, lower in carbs, and "higher energy."

Why are they leaving out the most important concept-- CALORIE information?

Consider the following. To qualify as "low in sugar", a product must meet one of the following criteria:

* Sugar Free
* No Sugar Added
* Contains less than 4 grams of sugar

These divisions are very helpful for snack companies because they don't evaluate their products from a whole nutrition profile.

Per the above mentioned standards, something like Sugar-Free Reese's Peanut Butter Cups would receive a "low in sugar" sticker (and therefore seem like a healthy choice) despite offering 6 grams of saturated fat (30% of a day's worth) in one 180-calorie serving.

Similarly, a bag of Skittles can receive a healthy-sounding "low-fat sticker", all while offering 250 calories and 12 teaspoons of sugar!

I am also perplexed by the "lower in carbs" sticker. Unless someone has diabetes, there is no reason to believe that low carb figures by default indicate a healthier choice.

The beverage stickers are slightly better, as they are divided into these four categories: lower in fat, lower in calories (yay!), lower in caffeine, and higher in nutrients.

My concern here is the "lower in fat" label, which makes no mention of calories in its criteria:

* Less than 2.5 grams of fat per 8 ounce portion
* Skim and 1% milk
* Flavored waters
* Juices
* Energy drinks

Notice that soda can not qualify for this sticker. Fine and dandy, but sweetened flavored waters (often containing just as much sugar and as many calories as soda) can.

This initiative is a start, but I would much prefer vending machines post calorie information on items.

After all, unless people have those figures memorized, they are unable to see them until they have already made their purchase.

You Ask, I Answer: Hydrogenated Starch

I recently saw an ingredient called "hydrogenated starch."

What is it?

Is avoidance prudent?

-- Corey Clark
(Location withheld)

Let me guess -- you saw hydrogenated starch as an ingredient in a sugar-free product?

Althrough hydrogenation always conjures up thoughts of unhealthy fats, that same process is rather harmless when applied to starch.

Hydrogenating starch is one way of producing a calorically low sweetener (approximately two to three calories per gram, compared to sugar's four.)

It's technically a type of sugar alcohol (just like sorbitol, maltitol, and other ingredients ending in 'ol' that you can spot on most low-carb candy bars.)

First, starch -- usually corn or wheat -- is partially hydrolyzed (meaning molecular bonds are broken by reacting them with water.)

The resulting molecules are then hydrogenated (saturated with hydrogen).

End result? Sweetness, bulk, long shelf life, and the ability to develop products labeled "diabetic friendly" or "low carb."

Hydrogenated starch in and of itself does not pose any health risks.

Looking To Have Your Intelligence Insulted?

Then please check out Burger King's latest shameful advertising attempt -- The Whopper Virgins.

Here is one of the television ads, too.

In an effort to find out whether the Whopper is superior to the Big Mac (does anyone seriously care?), the folks at Burger King have taken to remote villages in third world countries and videotaped people's first bites into 100% American fast food.

You know, because the "poor indigenous" people living in "those weird countries over there" don't know what they're missing!

I mean, come on, who wouldn't go nuts for a Whopper, right?

Okay, back to reality: this is one of the most pathetic food-related advertising campaigns I have seen in a VERY long time.

Burger King is actually proud of the fact that they are bringing Whoppers to parts of the world that don't have a word for "burger."

Hmmm... do they have a word for "trans fat"? I hope so, because the Whopper contains 1.5 grams (along with half of the daily maximum recommendations for sodium and saturated fat.)

I truly don't know what's worse -- the cultural arrogance, the complete disregard for local culture, or the idea that third world villagers are the equivalent of lab rats.

Besides, why not target their main demographic by simply asking random adolescent and twenty-something men in the United States to participate in a blind tasting?

Yum-mega Treat

As regular Small Bites readers know, I am a big fan of snack bars.

I can't tell you how many times they have saved me -- and my wallet -- from junk food hell (i.e.: Bronx Zoo, Six Flags, Broadway intermissions.)

I also like to name names, which is why I have given very high praise to Lara bars, Clif Nectar bars, Pure bars, GNU Flavor & Fiber bars, and Kashi's "Tasty Little Crunchies" granola bars.

Although each of those bars is uniquely different from the others, they all provide high-quality nutrition in a delicious way.

Today, my list expands to include Nana's Omega-Fiber Cookie Bars.

These bars are most reminiscent of Flavor & Fiber, and even have a similar ingredient list.

Each bar offers 130 calories, 1 gram of saturated fat, 40 milligrams of sodium, 8 grams of sugar, and 5 grams of fiber.

Certainly a great lunchbox treat -- and an even better snack to have handy at the office when thoughts of the King Size Crunch Bar in the nearby vending machine start to take over.

Here's the ingredient list for the double chocolate flavor (vanilla almond is my favorite, though!):

Fiber Mix (Whole Wheat Flour, Oats, Wheat Bran, Psyllium, Flax Seeds, Millet, Chicory Root), Fruit Juice (Apple, Pear, Grape), Rice Dextrins, Chocolate Chips (whole grain malted barley and corn, unsweetened chocolate, soy lecithin as an emulsifier, and pure vanilla), Dutched Cocoa, GMO-Free Expeller Pressed Canola Oil, Dried Apples, Raisins, Rice Crisp Cereal, Rice Syrup, Vegetable Glycerin, Baking Powder (non aluminum), Natural Flavors

I do have two suggestions for the Nana's team, though:

1) No need to advertise your bar's Omega-9 content. It is not an essential fatty acid, so we don't need to particularly seek it out in food.

2) The 250 milligrams of Omega-3 are great, but it would make them a lot more absorbable if you included ground -- rather than whole -- flax seeds in your fiber mix.

Still, these are certainly worth making room for in your pantry.