Part 3: Dairy

Part 3:  Dairy Based on the book “What to Eat” by Marion Nestle

The dairy section is almost always hard to get to and not accidentally. Stores normally put these foods in remote places against the back walls. This makes it easier for their employees to stock the refrigerated cases, but the more important reason is to force you to walk past shelves of other products on your way there and to pick up a few impulse buys along the way. Trying to study the effects of dairy foods on health is especially difficult for one reason: the dairy industry is large and united and is diligent in exerting influence over anything that might affect production, marketing, and sales. Most Americans eat dairy foods and the industry sells more than 20 billion worth of milk a year. Furthermore, dairy farms are located in all 50 states and every state has 2 senators who eagerly accept campaign contributions from dairy donors and can be expected to listen attentively when called upon for assistance. As a result, dairy producers are largely exempt from the usual free market rules of supply and demand. For decades dairy producers have been protected by a system of government price supports and marketing payments so entrenched and so incomprehensible to anyone other than a lobbyist that any attempt to get rid of the system is doomed from the start. The result is that as a consumer, you pay for dairy in at least 3 ways: directly at the supermarket, indirectly through taxes that support subsidies to farmers who raise dairy cows, and also indirectly through tax supported subsidies to the producers of commodities like corn and soybeans that are used for cattle feed. The dairy council works hard to encourage nutritionists and federal agencies to take actions favorable to the industry. It supports advice to increase calcium intake. It supports efforts to encourage lactose intolerant/sensitive people to consume as much dairy food as they can tolerate. It opposes advice to restrict dietary fat (from animals). It strongly opposes advice to substitute soy products for milk. And of course it promotes advice to eat more dairy foods. Such efforts are often successful, particularly when it comes to federal recommendations about diet and health. Dairy foods are complex fixtures; they have some components that promote calcium retention and others that promote its excretion. The amount of calcium needed to balance losses is hard to know. Bones are not just made of calcium they are built on a protein scaffold and need practically all of the other required nutrients. When studies examine the effects of one nutrient at a time they show that some nutrients, like  magnesium, potassium, vitamin d, and lactose, promote calcium retention. Others like protein, phosphorus, and sodium promote calcium excretion. So calcium retention and the strength of your bones may depend much more on everything else you are eating and how active you are than on how much calcium you take in. Lactose is the sugar in milk and an 8oz glass of milk contains about 1 tablespoon of lactose. Lactose is a double sugar made of glucose and galactose linked together. Double sugars are too big to be absorbed into your body from the intestinal tract. To use lactose, your body has to split the link between glucose and galactose and release the single sugars that are easily absorbed. The enzyme that does the splitting is called lactase. By age 5 most children stop making lactase since it is no longer needed to ingest and digest breastmilk. Evolutionally, there is no longer a need. This is why so many people become lactose intolerant as they age. Overall, the fact that so much milk is produced and by such a strong industry cannot help but raise suspicions that commerce rather than health gets the last word in the dairy debates. The author takes on the current state of science that if milk does increase health risks these have to be small. The science also suggests that if there are health benefits to milk those too are small. Milk is just food. There isn't anything special about it. Cow's milk is not necessary and it is not perfect (for humans) but it's also not a poison. Yes, it is high in fat and saturated fat but you can just choose non-fat. You can also take lactaid if you still want to have dairy without the consequences. Yes, milk is sometimes produced in ways that are hard on cows, using hormones and other substances that you would avoid, but the dairy industry has even found a way for you to deal with those unattractive production issues: buy organic. You do not have to drink milk to be healthy, but if you like drinking it you can do so and also stay healthy. Then we have another dairy product, yogurt. With yogurt, the predominant flavor is sweet. Sweet sells and nearly all yogurts are sweetened in the most artificially imaginative ways: anything you could dream up they have a flavor for it. Yogurts are sweetened with added sugar, but also with honey, molasses, lactose, fructose, fruit concentrate, corn syrup, corn syrup solids, fructose syrup, high fructose syrup, aspartame, and other artificial sweeteners. As part of the health theme, you can get yogurt sugared and flavored with every conceivable choice of fruit. Some fruit flavored yogurts actually have fruit in them, but most have more sugar than fruit and many have no fruit in them at all just fruit juice concentrates, added colors to make them look fruitier and thickeners like flour, cornstarch, pectin, and carrageenan to hold them together. Yogurt has performed a marketing miracle, a fast selling dairy dessert with the aura of a health food. Yogurt's healthful mystique depends on its bacteria. For most foods, ensuring safety and palatability means getting rid of bad bacteria, but each of those little yogurt containers is supposed to have hundreds of millions of good bacteria, all alive, active, and ready to multiply as soon as the temperature warms up. The mere thought makes you want to add sugar. The starting point for yogurt is milk that is first pasteurized to kill off unwanted bacteria. Into it go two or more kinds of friendly bacteria of the lacto and bifidus species. Yogurt makers refer to these bacteria as cultures because they are cultured–cultivated, fed, and grown–on nutrients in the milk. Whatever the type, all of these bacteria go to work fermenting the nutrients in milk while producing lactic acid and other substances that curdle and flavor it. Most of the lactose gets used up which is why yogurt is tolerable to many people who otherwise cannot eat dairy products.

Part 2: Produce

Part 2: Produce Based on the book “What to Eat” by Marion Nestle

What is fresh? Fresh is relative. The FDA says “fresh” foods have to be raw, never frozen, or heated, and with no added preservatives. But even “fresh” fruits and veggies are often subjected to processing before they reach the grocery store shelf. In grocery store  terms “fresh” refers to food that spoils faster than others. It does not mean foods were picked earlier that day or even that week. You will want to know where your produce comes from. Knowing this lets you make some guesses about freshness, taste, and nutritional value. The flavor of fruits and veggies certainly depends on freshness, but it also depends on the variety and the production methods. Grocery store raspberries are a case in point. At a pick your own, varieties burst with flavor but also burst when picked. Driscoll raspberries are bred for perfect berry architecture and the ability to withstand thousands of food miles and are picked before they are fully ripe. They look and taste like raspberries but the flavor lacks the intensity and complexity of eating them freshly picked (or a few days prior). Commercial growers consider taste as only one desirable characteristic among others such as shape, size, firmness, color, and resistance to pests. Shelf labels for packaged foods tells you the price and cost per weight or volume. When it comes to produce, however, you practically have to do a cost-benefit analysis before you can buy something as simple as a head of lettuce. On a per pound basis, the precut salad cost 4x as much as the intact heads. Is the convenience of not having to clean and chop lettuce worth that much? Maybe, but it would be nice to know the actual cost before you buy. What about organic produce? The most attractive feature of organics to the food industry is this: customers are willing to pay more for organic foods. It is easy to understand why any big food company would want to get into this business, but it doesn’t always mean better. Then we have that suspicious wax on fruits and veggies, it's normally coated in food safe wax to maintain freshness and is common in citrus fruits, apples, peppers, cucumbers and the like to replace the natural waxes that get washed off in processing. One type used is carnauba wax from palm trees better known as the wax used on your car and for polishing furniture. Wax retains the water in fruits and veggies and protects it against bruising, prevents mold growth, and extends the time that fruits and veggies last on the shelf without spoiling. From the point of view of the grocery store, the high shine gloss makes produce look fresh and attractive. Here is the deal: if you eat any fruits and veggies at all you get nutrients you cannot get easily from other foods. These foods are loaded with substances that do good things for health. Fruits and veggies are the main sources of Vitamin C, folate, and beta carotene, and they provide half the fiber in American diets (the other half come from grains). They also contain varying phytonutrients, the chemicals in plants that singly and together protect against disease. The author concludes that all fruits and veggies have something good about them, even though some have more of one good thing and others have more of another. That is why we nutritionists are always telling you to eat a variety of foods. It's the mix that is most beneficial and most protective. But produce is so expensive! Well, it is not the absolute cost of produce that seems so high but its cost per calorie. You get a lot more calories for the price of hamburgers and french fries than you do for carrots, not least because the government subsidizes the production of corn and soybeans, the basis of cheap corn sweeteners and vegetable oil. Marketing is an important barrier. American food and beverage producers spend 36 billion annually to advertise and market their products but practically none of this goes to promote fruits and veggies, a few million a year compared to the tens of hundreds of millions used to promote any soft drink, candy bar, or cereal. The companies that grow fruits and veggies get about 18 cents of every food dollar you spend on them. The other 82 cents goes to everyone else in the game: the companies that store, truck, package, display, promote, and sell produce. What's more there is no easy way for the companies to add value to fruits and veggies and so increase their profit margin. Tomatoes are tomatoes no matter their brand. From a health perspective fruits and veggies are good to eat whether they are organic or not. If the price of organics is a barrier go ahead and keep buying conventional produce instead. Conventionally grown produce offers plenty of health benefits to people. Does price matter? Of course it does! The price of organics is more of a political choice. When you choose organics you are voting with your fork for a planet with fewer pesticides, richer soil, and cleaner water supplies—all better in the long run. When you choose locally grown produce you are voting for conservation of fuel resources and economic viability of local communities along with freshness and better taste. Once you consider such things the choices in the produce section are much easier to make. The priorities are: 1. Organic and locally grown, 2. Organic, 3. Conventional and locally grown, 4. Conventional.

Part 1: The Grocery Store

Part 1: The Grocery Store Based on the book “What to Eat” by Marion Nestle

The grocery store as we know it can be a very overwhelming place with an overabundance of products. This overabundance leaves food companies with three options: 1. They can make fewer products or smaller portions and raise prices, 2. They can entice you to buy their products instead of their competitors, or 3. They can get you to eat more of what they sell. Competition for your food dollars has led food companies to develop marketing strategies that help them to sell more food and encourage you to eat more, strategies that encourage you to eat more food whether or not you need it include: convenience: if a food is easier to take with you and eat, you will eat more, ubiquity: the more places food is available, the more food you will eat, proximity: if a food is close at hand, you will eat more of it than if it is harder to get, frequency: the more times a day you eat the more you will eat, variety: the more foods that are available, the more you will eat (buffet syndrome), larger portions: the more food in front of you the more you will eat, and low prices: the cheaper the food, the more you will eat. An astonishing 300,000 plus edible products are for sale in the US and any large grocery store might display as many as 40,000 of them. The big companies that own most grocery stores want you to do as much searching as you can tolerate which is why the aisles are long and everything you actually need seems to be at the other end of the store. You are forced to go past thousands of other products on your way to get what you need. Grocery stores say they are in the business of offering choice. Perhaps but they do everything possible to make the choice theirs not yours. If you belong to a grocery store's discount shoppers club the store gains your loyalty, but gets to track your personal buying habits in exchange. This research tells food retailers how to lay out the stores, where to put specific products, how to position products on shelves, and how to set prices and advertise products. Grocery stores want to expose you to the largest possible number of items you can stand to see without annoying you so much that you run screaming from the store. Grocery store design follows fundamental rules, all of them based firmly on extensive research: place the highest selling food departments in the parts of the store that get the greatest flow of traffic—the perishables like meat, produce, dairy, and frozen foods generate the most sales so you put them against the back and side walls, use the aisle nearest the entrance for items that sell especially well on impulse or look or smell enticing–produce, flowers, or freshly baked bread–these must be the first things customers are to see in front or immediately to the left or right, use displays at the ends of aisles for high profit heavily advertised items likely to be bought on impulse, devote as much shelf space as possible to brands that generate frequent sales, the more shelf space they occupy the better they sell, place high profit center aisle food items sixty inches above the floor where they are seen easily by adults with or without eyeglasses, place store brands immediately to the right of those high traffic items so that the name brands attract more shoppers to the store brands too, avoid using islands–these make people bump into each other and want to move on–keep the traffic moving but slowly, do not create gaps in the aisles that allow customers to cross over to the next one unless aisles are so long that shoppers complain–if shoppers escape mid aisle they will miss seeing half the products along that route. The grocery store is an intense real estate market where every product competes fiercely against every other for precious space. You can see the products most easily at eye level, at the ends of aisles, and at the checkout counters, these areas are prime real estate. Which products get the prime space? The ones that are most profitable for the store. The stores create demand by putting some products where you cannot miss them. What about Walmart? If a food company wants its products to be in Walmart it has to offer rock bottom prices. Low prices sound good for people without much money, but nutritionally there's a catch. Low prices encourage everyone to buy more food in bigger packages. If you buy more you are likely to eat more. For example: a 2 liter container and the special for members 6 pack of 24 oz bottles were less than half the cost of the equivalent volume in 8 oz cans. Grocery store managers say this kind of pricing is not the store's problem. If you want smaller sizes you should be willing to pay more for them. But if you care about how much you get for a price you are likely to pick the larger sizes. And if you buy the larger sizes you are more likely to drink more of it. The choice is yours but anyone would have a hard time choosing a more expensive version of a product when a cheaper one is right there. You have to be strong and courageous to hold out for healthier choices in the grocery store system as it currently exists. Research says about 70% of shoppers bring lists into grocery stores but only 20% adhere to them. The additions are in store decisions or impulse buys. Grocery stores hope you will: listen to the background music–the slower the beat the longer you mosey, search for the “loss leaders” (items you always need but at a discount)--the longer you search the more products you see, go to the bakery, prepared foods, and deli sections–the sights and good smells will keep you lingering and encouraging sales, and taste samples because if you like what you taste you are likely to buy it.

Part 6: Food Fraud

Part 6: Food Fraud: Based on the book “Metabolical”

There are six examples of food fraud that reached your restaurant’s or grocery store’s shelves without your knowledge: Dilution/adulteration. Something is added to the food to disguise or extend it. Milk is a common vehicle. In 2019 in India, milk was determined to have lower fat levels than advertised because the cows are inadequately fed. Another dilution is olive oil; it’s estimated that up to 80 percent of Italian virgin olive oil is neither Italian nor virgin. Substitution. It’s common for restaurants or food stands to substitute something of lesser value in an attempt to reap a higher profit. Vendors in New York City got caught selling beef gyros or goat gyros advertised as lamb; this occurs more frequently when the meat is shredded and mixed together. Another common substitution occurs in fish sales, where one study demonstrated that 21 percent of the fish underwent substitution, and that one out of every three establishments visited sold substituted seafood. Fish substitution is more likely to occur in restaurants (26 percent) than at grocery stores (12 percent). A common substitution occurs when tilapia (containing red dye), which costs $3.51 per pound, is swapped out for snapper, which costs about $15 per pound. Of the species tested, sea bass and snapper had the highest rates of mislabeling (55 percent and 42 percent, respectively). Much of the substituted seafood is labeled as a local favorite, while the truth is it may have been flown from halfway around the world. Intentional contamination/concealment. A famous international case occurred in 2008, where melamine was found in infant formula and other dairy products. In China, the milk was being diluted by dairy producers so more of it could be sold. The dilution decreased the amount of protein in milk, so the dairy producer replaced the natural milk protein with melamine, a nitrogen-rich compound used to make kitchen countertops. When ingested, melamine causes kidney stones and kidney failure. The melamine in milk killed six infants and sickened over 300,000 people in China, but dairy products laced with melamine were exported around the world and made it to our shores. Luckily no one in the US died. Another example is Parmesan cheese. In 2012, cellulose, a by-product of wood digestion, was added to several brands; in fact, one brand didn’t even have any cheese in the product at all. Country of origin. Many food items are prized because they come from unique places. But what if that place isn’t so unique? For instance, beer-battered pollock might come fresh from the waters of Alaska, or it might come frozen from a basin in China. More likely, the reason for this kind of fraud is to avoid paying duty on imported goods, such as alcohol. Organic. You might think that buying organic would save you from fraud. You would be wrong. The markup on organic is enormous, anywhere from 25 percent for avocados to 65 percent for milk. Furthermore, there’s a clear economic impetus to mark individual items as organic, as the only way to be caught is through laboratory analysis. One fraudster netted $142 million for faking organic on the label, and then spent his ill-gotten gains on Las Vegas casinos and sexual escapades. He eventually committed suicide rather than go to jail. Counterfeiting. Perhaps the most brazen of all food fraud occurs in the luxury space. Finding out that some high rollers were duped by the counterfeiting of rare wines and scotches may give you a moment of schadenfreude satisfaction, but this is a very alarming issue. If they can do that with something under that much scrutiny, imagine what they can do to you. In the meantime, what can you, the consumer, do to protect your health and your wallet from food fraud? It’s tough to say. But there are three precepts to remember: The more ingredients, the more risk (e.g., salted peanuts have three ingredients, Oreos have eleven ingredients). Avoid highly processed food. Buying organic may decrease your risk for cancer, but it increases the risk of fraud because fraudsters focus on organic due to the higher profit margin. Buy from the supplier directly (e.g., the farmer or the farmer’s market). Fewer middlemen mean fewer entities jacking up the price and people to hide behind, as well as more direct and face-to-face responsibility to the consumer. Distracting away from the real problem. We have the data to demonstrate that processed food is a primary causative factor for diabetes, fatty liver disease, heart disease, and tooth decay; correlative for cancer, dementia, hypertension, addiction to other substances, and depression; as well as plausible for autoimmune disease and anxiety. But when the food industry addresses these issues in public, they only refer to the “obesity epidemic.” Until about 2010, they ignored the problem entirely, deflecting the issue back to the consumer and using the tobacco industry meme of “personal responsibility.” When they couldn’t deny culpability any longer, they chose to divert the public health conversation specifically toward obesity, for two reasons: because for them and the dietitians, it’s still all about calories, and the public still believes it. Knowledge. Can you trust the food industry to tell you when something is healthy or not? People have no idea what they’re eating. The Nutrition Labeling and Education Act of 1990 gave us our current food label, which was supposed to provide information to the consumer of what’s in the food, but of course says nothing about what’s been done to render it poisonous. The food label is currently unintelligible in part because the industry skirts the rules. What the public needs to know (protect the liver, feed the gut) is what’s been done to the food—but that’s exactly the information that’s withheld. Access. With 74 percent of foods in the supermarket containing added sugar, it has become almost unavoidable that you will, knowingly or unknowingly, consume contaminated food in your daily life. Processed foods are quick, easy, and have permeated workplaces, gyms, schools, and your refrigerator. People in poor neighborhoods live in “food deserts,” without access to Real Food because grocery stores are hard to come by. But the problem of food deserts becomes magnified when those same areas are rife with fast food outlets and convenience stores that provide only processed items (because of shelf life and depreciation). Sometimes these are called “food swamps,” the density of which predicts obesity and chronic disease in poor populations even better than food deserts. And why not? You can drown in a swamp faster than you can starve in a desert. Affordability. Assuming one wants to buy healthy food and has access to it, they have to be able to afford it. Analysis of the cost of food demonstrated that Real Food (fresh produce, eggs, and meat) was twice as expensive as processed food (Cheetos and Pop-Tarts) in 2002, and increased by 17 cents per pound of food per year over the next decade, as compared with processed food, which only increased 7 cents per pound per year. However, the cost of obesity to the individual ends up much higher. The amount of money that they pay directly for healthcare is double that of a person of normal weight. Furthermore, if you’re working three jobs and have kids, then you need something quick and easy. Affordability is coming from a place of privilege not just in cost of food, but in time for menu planning, etc. It’s one of many social justice issues—if you don’t have the time or the money to procure and prepare Real Food, what options do you have? And the processed food industry has positioned itself to perfectly fill the gap. Cheap food seems like a no-brainer—but not really. Externalities. The belief that your actions can’t harm anyone else needs reconsideration. For example, if you smoke, you not only hurt yourself, you hurt your employer, as the cost to that employer is $5,816 per year just to carry you. The cost to employers as a result of the obesity epidemic adds an extra $2,751 per employee. There are double the workers who are obese (45 percent) as there are smokers (23 percent)—never mind the costs of the diseases of metabolic syndrome. The medical costs of chronic metabolic disease due to processed food consumption will cause a doubling of social network costs in the next decade. In the US, Medicare will be bankrupt by 2029 and Social Security will be bankrupt by 2034, bankrupting healthcare systems around the world. There’s the additional burden of diet-related harm experienced by children who are especially vulnerable to poor diet at critical developmental stages. No label, packaging, or jingle can make an ultra-processed food healthy. Furthermore, you can’t make processed food healthy by adding supplements. Conversely, Real Food, which is universally healthy, doesn’t even have a label on which to make a structure-function or health claim. Most important  it’s not what’s in the food that matters; it’s what’s been done to the food that counts. None of that is on the Nutrition Facts label. Processed food kills people (eventually). Processed food kills pocketbooks (eventually). Processed food kills budgets (eventually). Processed food kills the planet (eventually). It’s a slow process, even glacial, but we know it’s happening—or at least some of us do. Others of us keep doing it anyway because it’s mindless, seemingly cheap, convenient, tasty, and most of all, addictive. It turns out, most people think that deciding what to make for dinner and then buying the ingredients is an enormous hassle. They want what is good for their household, but trying to pick out food based on health and ingredients is impossible, and the inadequacy of our current food label becomes overwhelming. They don’t know how to read packaging (wonder why—because there’s nothing on the label that’s worth reading?), and they certainly don’t know how to make food choices based on it. When they enter the supermarket, it’s like walking into the opium den with a cacophony of voices on the endcaps of the aisles, shrieking “buy me.” They fall prey to the siren songs of the tortilla chips, soft drinks, and cookies. Here are the seven shopping rules to abide by, even before you walk into the store (or order online), that will keep you from stepping on any of the landmines the store has placed in your way. Don’t go shopping hungry. Shop the edges of the supermarket. If you’ve gone into the aisles, you’ve gone off the rails. If a product is on the endcap of the aisle, the company paid to have it placed there. Don’t be a stooge. Any food that has a logo you’ve heard of or any food with a Nutrition Facts label has been processed. If a product lists a structure-function claim on the package, don’t buy it. Example: any food that says low-fat or no trans-fats is poison, because something else is in there instead. If it doesn’t say whole grain, it isn’t. And even if it does say whole grain, it probably isn’t. If the carbohydrate to fiber ratio is greater than 10 to 1, don’t buy it. If any form of sugar is one of the first three ingredients, it’s a dessert. Change your grocery buying habits. If you have a local butcher or produce store, shop there—your choices are limited to the healthy stuff. Unfortunately, so many convenience stores around the country don’t sell fresh produce, so go to the proprietor and tell them what you want. You’ll also have to change your mindset about food and money. One way or another, you’re going to pay. You can either pay the farmer or the doctor—which would you prefer? Make a conscious choice.