The Thinkglobal Photo: Obesity and Flying on Airlines

I first saw this photo on a Fox News morning show and was quickly turned off by the mostly judgmental responses from the show's viewers. The Thinkglobal blog originally published the  photo, allegedly taken by an American Airlines flight attendant, reigniting the debate over obese travelers on flights: should they have to pay for multiple seats? (I wrote a relevant post on my political blog back in early May.) Some people believe the photo is doctored; other posts claim to be from witnesses whom say that the middle-seat passenger was booked on a subsequent flight with additional compensation. Another alleged witness noted, in response to the comments of others saying the man should have paid for multiple seats, that the flight was full and that wasn't an option.

I don't want to come across as defensive here; I have never been as big as this passenger is, but I understand the discomfort that my neighboring passengers may feel. I usually try to book an aisle seat so I can lean into the aisle versus invade his or her personal space. I usually take care when I'm aware of cart service down the aisle (although I've been bumped a few times without warning by unapologetic flight attendants). I do understand flight attendants have safety responsibilities, and most of them have professional attitudes; others, including the attendant whom took this photo, clearly intended to embarrass the man in question,  rationalizing their negative agenda, disingenuously citing a regard for public safety and the rights of the other passengers.

Most of us obese passengers dread flying. One pet peeve in my case--getting  a seat belt extension (for some reason I found I needed them on some flights although not on others). If there was some magic solution to become normal-sized for the duration of a flight, we would do it; it reminds me of a story I once read of an extraordinarily tall female basketball player (6'9") on a flight. A flight attendant told the woman, in no uncertain terms, she just had to do something about her long legs spilling out into the aisle. The player looked at the flight attendant in disbelief, asking her "Do you think my legs detach so I can put them in the overhead bin?"

What is missing in this discussion is the question of civility; you would think that many of the judgmental people would have family members, relatives or friends whom are overweight and would be more sensitive. I found one particularly poignant post on the blog that I want to excerpt here:

I realized, with great pain, that this man so many people are making fun is someone I know well. His mother died suddenly of cancer less than a month ago. Yes, he is overweight--diabetes and obesity runs strong in his family. However, he almost always pays extra to fly first class. I don't know the details of this specific flight, but suspect that for some reason first class was full...This gentleman, I assure you, has had to pay for two seats many times...Obesity...depends on the person and the situation and their medical history and, yes, genetics... I do know that he has struggled with his weight for many, many years. I can also tell the folks... that this man has a young teenage daughter who will likely cry her eyes out over every cruel word you have said.

I don't want to repeat my other post here, but my key point was that airlines should accommodate their flights not to accommodate some ideally-sized passenger but for passengers as they are. Some passengers are very tall; others are very big. A significant portion of the American people are overweight. I'm not saying that's a great thing; the very purpose of this blog is taking responsibility for my own health. I'm sure most big or tall people would readily pay a modest premium to get wider seats or more leg room. If many department stores now carry extended-size sections, why can't airlines find a way to address the transportation needs of the bigger passenger with dignity and tact?

My Ongoing Experience with the Nutrisystem Diet

On Monday, I'll be completing my fourth month on the Nutrisystem diet. Although the target weight might shift by 2 or 3 pounds, it looks as though I'll have attained a cumulative loss in the range of the mid-40 pounds. That, in my view, is impressive (better than some celebrity endorsers), but I have a lot more to lose and anticipate being on the diet through most of next year.

This post should not be considered an endorsement of the company's products or services. I have no financial stake in the company. What I'm addressing here is my own honest assessment and reasons for trying the system.

In part, this post is in response to the opinions of others. One unnamed relative by marriage unsuccessfully tried the company's products in the past and has a negative opinion; she and her husband subsequently had bariatric surgery, and they have been pleased with the results. I will not recommend their approach, which I regard as risky and a surrender without addressing the unresolved fundamental issues of proper nutrition and exercise. Is it wrong? Or are we simply indifferent to whatever the weight loss method, so long as it is effective?

I don't believe that I'm judgmental regarding other obese people. For example, I have a sister and a nephew whom have gained weight principally as a consequence of medication they are taking for other health reasons. I similarly remember seeing comedian Jerry Lewis whom had appeared on one of his MS telethons with a bloated appearance. I also know it is very difficult for a number of people to lose weight. There are individual differences (e.g., in terms of metabolism) that go beyond diet and exercise. But it's very difficult to get away from the fact that being excessively overweight goes beyond the social stigma and the difficulty in buying clothes; the inability to control your diet can affect your longevity and the quality of the end years of one's life.

In the case of my relatives having the bariatric procedure done, the motive was primarily aimed at improving one's appearance and sexual attractiveness. There is nothing wrong with wanting others to find you physically attractive, but in my opinion, one's general attitude (a positive self-image, good sense of humor and confidence) is more critical. Things like cosmetic surgery only address one's surface appearance; it does not compensate for one's deficient self-image. Perfection is never attainable in real life. What if you achieve your goal and discover the reality doesn't meet your unrealistic expectations? Do you go back to comfort foods and regaining your lost weight, pound by pound?

I have gone up and down in weight my whole adult life. But I've rarely purchased sugary foods or packaged snacks, do not frequent all-you-care-to-eat buffets, and the like. How is it possible that I regained nearly 90 pounds I lost on a low-carb diet from 2003 to 2004? The simple answer is: one pound at a time; I think it's a matter of slowing metabolism, in part due to an undiagnosed thyroid deficiency but also part of the aging process, and lack of consistent exercise (which I blamed on long commute times, work schedules and business travel), and also a lack of portion control.

Nutrisystem has done a good job addressing the latter issue (portion control).  I'm on a plan which explicitly plans for three heavier traditional meals and three light snacks, roughly at 3 hour intervals. The basic idea is not to overload one's stomach at once but to more efficiently spread one's calories through the day. A typical Nutrisystem meal consists of one packaged item for each of three regular meals and one snack item or dessert (for one of the 3 light snack/meals). Breakfast items include things like cereals, nutrition bars, or pastry items; lunch items include some microwavable bowls (e.g., small pasta dishes or prepared soups), packaged dry soups and nutrition bars; dinner items include a variety of pasta, meat and/or vegetable entrees; snack items include modestly sized cookies, pastries, or bars or various flavored soy chips, pretzels, and related items.

I personally find that I like the taste of the Nutrisystem items, but I don't go into meals with unrealistic expectations. For example, if you bite into a Nutrisystem cookie with the expectation of a Mrs. Fields' experience or a lasagna expecting the Olive Garden's version, you will be disappointed. You are not going to find a lot of high-glycemic (sugary) or fatty ingredients. What you will find are precisely portioned items with impressive ingredient lists, often in very subtle ways, not unlike mothers finding stealth methods for getting their kids to eat their vegetables. For example, many of the pastry items have a significant number of protein and fiber grams (e.g., soy-based ingredients).

As Nutrisystem explicitly notes, you need to supplement your diet with fresh or frozen foods, i.e., fruits and vegetables, beverages and very limited portions of other foods (e.g., breads, nuts, etc.)

Going back to the question if it's worth roughly $300 a month (including delivery): I think it's a good value, especially when you take into account that the meals are precisely portioned and quickly and easily prepared (many lunch and dinner items are ready in less than 2 minutes in a microwave). As to my relative's adverse opinions regarding the taste of the food: probably the best response can be seen in the context of a Nutrisystem website feature called the Daily Dose, a daily post message of diet/motivational advice. There is an accompanying click rewards item which you can click once a day, earning a minor discount each time you complete a fifty-click cycle. One of things you'll see when you load the Daily Dose page is the most recent aggregate click totals for the last 10 customers. I often see click totals from between 500 to 1500 clicks--meaning there are customers whom have purchased Nutrisystem items for more than a year. You don't keep customers paying $300 or more a month for a year or longer if they don't like the company's products.

I can't speak for other people. It is possible to carefully shop and prepare your own nutritious meals without paying a company hundreds of dollars a month; I did it during my low-carb phase. For me, I think the major motivation was the sobering potential risk of developing type 2 diabetes if I didn't get my weight under control. What I had been doing on my own wasn't working. Under the Nutrisystem method, I rarely, if ever, binge, and I've managed to eat under 2000 calories a day. (I did manage to lose 15 pounds over the past year before Nutrisystem, but the fact is my weight loss has picked up under the discipline of the new system.) The results are beginning to show; for instance, several months ago I had a belt which I could barely fasten, and now I'm going to have to buy a new belt. If most people looked at me, they would see still a seriously overweight man--but a man whom has lost roughly 60 pounds over the past year, easier said than done.

Organ Meat: Part of a Nutritious Diet?

One of the funniest scenes I've ever seen in a movie was in 1988's Funny Farm, starring Chevy Chase. He sets a new restaurant record (3 helpings) for eating euphemistically named "lamb fries", which, unknown to Chevy's character, are stir-fried sheep testicles. His reaction to the waitress' post-record explanation of the secret behind the making of a great lamb fry is hilarious...

Many people have a similar reaction to the consumption of organ meat in general (e.g., hearts, liver, tongue, kidneys, brain, feet, ears, stomach (tripe), intestines (chitterlings), etc.) Brian Wansink in Marketing Nutrition explains how the American government during World War II, sending typically preferred muscle meat overseas for the troops, were trying to coax a reluctant public to eat more nutritionally-dense organ meat.

Occasionally on my political blog, I will discuss feijoada, a Brazilian meal concept I experienced during my 1995 work trips to São Paulo. The Brazilian restaurants where I ate served feijoada on Wednesdays and Saturdays; it attracts a large crowd of yuppies. There were two adjacent buffet lines, emphasizing a variety of organ meats (including ears and tongue) and black beans. [I'm an adventuresome eater and tried a variety of dishes, including pig ears; I think it must be an acquired taste...] I was told that the traditional meal dated back to the days of Brazilian slavery when the slaveowners would harvest the choice cuts from a hog (e.g., ham, bacon, and other muscle meat), leaving the organs. I also noticed some churrascarias (Brazilian steakhouses) serve dozens of chicken hearts on skewers (thumbs up). [Waiters in churrrascarias circulate around tables bearing large chunks of various meats, from which they carve servings onto your dinner plate.]

I have observed when I roasted dozens of chickens and turkeys over the years, the first thing I generally look to eat is the giblets (or miscellaneous organ meats) for the poultry (often packaged separately from the bird). Eberling and Geary argue that organ meats are non-plant superfoods; they claim that in mankind's early dietary history and in many cultures, nutrient-dense organ meats were often preferred to muscle meat. In fact, native groups in the far north often eat organ meats in place of scarce plant-based food sources. There are a number of distinctive nutritional benefits depending on the type of meat, including iron (liver), B vitamins, vitamin D, CoQ10 (heart), Omega-3, CLA and various important minerals. For those not preferring the source meats, the authors suggest certain products containing a seasoned mixture of organ meats, such as Braunsweiger, liverwurst, and head cheese. They also point out that the amount of certain nutrients depends on the source animal's diet, e.g., pasture or flaxseed versus conventional grains.

An interesting related discussion is the anecdotal evidence that many wild animals, after killing their prey, will target the organ meat first. (One can argue that "the world is complex", because what an animal chooses to eat may depend on factors like when the animal last ate, the relative abundance of prey, complementary sources of nutrition, etc.)

I believe in the principle of nutritional diversity--having noted in past posts that cherrypicking of foods (e.g., filtering out egg yolks or refusing to eat fattier dark meat from poultry) arbitrarily excludes some excellent sources of nutrients for one's daily diet. Thus, I'm making an explicit attempt within my own diet to rotate in cold-water fish, beef and other red meat (buffalo and ostrich), poultry, pork and organ meats.

Nutrition Miscellany: 10/7/09

State Fairs and Making Use of Deep Fryers

Corn dogs. The All-American treat. Nearly 500 calories, 60 carbohydrate grams, and 40% of the suggested daily amount of sodium. Texan cooks sometimes add a block of cheddar cheese to the mix. What better for one's health than processed meat, refined cornmeal, and deep-fried in Omega-6 vegetable oil (with bonus trans fats)? Granted, an occasional indulgence isn't a major concern. But the obsession with deep frying goes beyond hot dogs; in Minnesota they have put other "nutritious" fare, such as cheese curds, pasta, and pizza, on a stick. Not to mention batter-coated Oreo cookies, candy bars, Twinkies, ice cream, and even watermelon, optionally served with French fries or ice cream.

Is it any wonder that McDonald's continues to innovate with products like the 400-plus calorie McGriddle sandwiches? According to Dietblog, "For starters - the word healthy is no longer used by McDonald's because "our consumer research shows people don’t understand it and it’s actually a turn off when it comes to food items.” (McDonald's)." This is, plain and simple, resistance to change and a state of denial. I mean, is it really necessary to candy walnuts for salads? When I cracked walnuts at home, I never even thought of asking my mom for some table sugar to mask the taste of shelled walnuts... There are a lot of ways for McDonald's to make things healthier without resorting to tofu burgers, e.g., options like baked or broiled fish or tuna fish (vs. fried breaded fish), low-fat cheese or mayonnaise, reduced sodium and more imaginative seasonings, improved, more generous vegetable fixings (or a condiment bar), ground turkey, whole-grain buns or flatbreads, and more flexible combos (allowing substitutions of yogurt, side salads, veggie cups (e.g., broccoli, celery, and carrots), or vegetable soups, bottled water, etc.)

In the meanwhile, if you want something on a stick, might I suggest bringing along a 1.5 oz stick of Ostrim jerky? 14 protein grams, a good source of potassium, low-fat and 80 calories.

Food Journals

Madeline Vann of Everydayhealth.com wrote a recent post entitled "Write Your Way to Weight Loss", pointing out a recent study where overweight dieters who kept a food journal or diary were found to have lost twice the weight of those whom didn't. There's certainly something to be said about creating goals and fleshing out more specific behavioral objectives.

Obviously writing things down isn't diet and exercise themselves. I see it as a means of self-discipline; many websites, including Nutrisystem, provide interactive tools to log diet and exercise, including a default menu boilerplate based on Nutrisystem and supplemental items. I have to define foods not in the Nutrisystem database, including unit measures and calorie counts. The daily process of recording my weight and my dietary choices in details keeps me honest and less likely to cheat or binge. Maintaining multiple observation points also allows me to plot meal/daily calories and weight trends over time.

I have not reviewed all the weight-loss software and websites, but one could easily conceive obvious feature improvements over the rudimentary tools I've primarily used to date. For example, one way would be improve integration of standard grocery and fast food items; one could also visualize utilities able to separate macronutrients (protein, carbs, fats), fiber, vitamin and mineral intakes and configure alerts to flag nutritional gaps or imbalances and/or to enforce certain dietary rules (e.g., eat cold water, oily fish twice a week) and to generate intelligent grocery shopping lists (identifying more nutritious food items/brands for target menus and suggested buys, e.g., sales on in-season fruits and vegetables, lower-calorie frozen meals, etc.)

Fast Food and Nutrition Disclosure

AP writer Megan Scott wrote a short article entitled "Calorie Counts on Menus Force Hard Choices", noting that consumers have been rethinking their food choices as local regulations force disclosure of nutrition facts. For example, the Chipolte wrap, by itself, is nearly 300 calories; the burrito fillings can add up to 700 (or more) calories. That Dunkin' Donuts low fat blueberry muffin is roughly 400 calories. NOTE: Many fast food chains (e.g., McDonald's) post nutritional information on the Internet. However, it is cumbersome to navigate several websites to do things like compare competitive products. Some websites, such as myfitnesspal.com, have food databases where you can search for items (and their relevant nutrition labels), e.g., "Kraft macaroni and cheese" or "Chipolte burrito".

Ms. Scott discusses a recent self-report study showing that providing additional nutritional information to New Yorkers influenced their decisions on where to eat half the time and what they ordered (up to 80%) of the time. [I am generally supportive of regulations providing basic information consumers need to know to make informed dietary choices.] These kinds of results challenge the orthodox opinions (cited above) that customers don't want healthier food choices. I've noticed this anecdotally on my trips to Sam's Club; I'll notice other overweight people with healthier items in their grocery carts, including vegetables, fruits, and heart-healthy wild salmon.

I do want to take issue with nutritionists cited in the article. One worries that people may make food purchases based on short-term nutritional considerations (like lower calories) and may binge later. (This is more likely if you eat a meal high in simple carbohydrates versus satiating protein/fats/complex carbs.) I am skeptical about these concerns; I think the New York consumers are more concerned about right-sizing their meals or improving their nutritional value.

Another dietitian argues that people are one of three types: one doesn't care about nutritional information; the other extreme makes too much of nutritional data and simplistic dietary principles like "low fat", "low calorie" or "low carb" versus general principles of nutritional diversity; and those in the middle (e.g., preferring a varied, balanced diet) don't really need it. The point is more that people may not realize that comfort foods they've been eating all their lives are often higher than they realized in calories, fat, and sodium; in addition, a lot of people don't realize that low fat foods don't necessarily mean low calorie--so, for example, a food company may substitute sugar calories in place of fat grams. It can also be difficult to realize portions are oversized without that information.

I support this information at the place of purchase on the principles of consumer information usability. In my articles on computer documentation and usability, I mention work done in applied psychology, e.g., Patricia Wright; one relevant point is that readers do not perform well in dealing with fragmentary information, making interpolations, etc. Having salient information at the point of a task, in this case, a food purchase, is important. I would expect informed nutritionists to come into a food purchase decision highly motivated, with memorized facts and heuristics; this is not a realistic assumption for most consumers.

It is true that people may be aware of nutrition labels and not be motivated to read them. There are a variety of reasons that doesn't happen, including not knowing how to read and interpret a list of ingredients, but also coming to the purchase decision with invalid product assumptions. I mentioned in a recent post that I had been purchasing a popular brand guacamole dip. There were pictures of avocados on the container and I saw obvious bits and pieces of avocado in the dip. Then I discovered, through a Rodale website, that the leading ingredient of this product was soybean oil. So while I thought I was getting a large portion of heart-healthy monounsaturated fat in the dip, I was really getting a large portion of n-6 PUFA's, something we have far too much of in the typical American diet.

I think that forcing restaurants to come clean with nutritional information may result in a strategy similar to Denny's, as mentioned in a prior post: smaller portion desserts, healthier sides, lower-sodium preparation, etc. I think when restaurants see that their bigger-portion/higher-calorie/salt/fat foods are losing sales momentum, they may choose to right-size their menu options. To some extent, the chains are already recognizing that; for example, you can order a Subway salad or wrap equivalent of their popular sandwiches, and you can purchase a burrito bowl at Chipolte.

Nutrition Miscellany: 10/4/09

Beef: Consider the Source...

Men's Health has an interesting post over the "world's most powerful eating strategies". In an earlier post I argued that what animals eat makes a significant difference in the nutrition characteristics of their meat or products (e.g., eggs). Phillip Rhodes points out that Argentinians eat on average over 30 lbs. more a year in beef, a favorite whipping boy of establishment nutritionists, without any increased risk of heart disease. What accounts for the difference? A quarter-pound of conventionally finished American beef has over four times the saturated fat and twice the calories of a grass-fed Argentinian beef patty (140 calories, 2.5 grams of saturated fat). I mentioned in earlier posts that grass-fed beef also has a more balanced Omega-6 to Omega-3 PUFA ratio and higher amounts of CLA, a "good" type of natural trans fat. There are some online sources of American grass-fed beef (e.g., U.S. Wellness Meats). [NOTE: I have not ordered shipped items from relevant vendors.]

The China Study?

I have not personally read T. Colin Campbell's 2005 study, which purports to provide an empirical foundation for a preferred vegan diet based on extensive empirical data, based in China. I'm an omnivore and proud of it (some of my favorite foods are plant-based...) and will reserve substantive comments for my own review.

[I once was criticized by one of my mentor professors in undergraduate school for relying too much on secondary sources. I also discovered that in the process of developing a documentation measure that there were issues with a widely respected and used computer user satisfaction measure in my interdisciplinary academic field (management information systems). I decided to read the original dissertation, initially intending to look at its methodology as a potential model for my own approach; on closer investigation, I soon found myself with serious doubts about the reference measure (statistical tests, deviations from scale development in the applied psychology literature, etc.) and abandoned the author's approach. A few years later, I tried to publish my criticisms of this and other MIS measures and their utilization in the literature (in fact, I was unaware of any other academic raising these issues, and I simply wanted to open a serious debate before other researchers continued to crank out research using suspect measures). My article was rejected in personal terms with predictable criticisms, e.g., why didn't I submit my own user satisfaction measure? In hindsight, it was not surprising that the editor would farm out the article to reviewers with a vested interest in the criticized measures.]

You might think this would make me sympathetic to Professor Campbell; after all, the vegan lifestyle (no meat, fish or dairy) is not widely followed and challenges a more conventional American diet. And there are some noteworthy developments, like middle-class Asians eating a more Western diet and developing similar health issues. My intuition, though, tells me that blaming meat and dairy is a red herring, especially given the fact that recent domestic health trends have not been accompanied by commensurate increases in the consumption of meat and dairy; I would also like to see more evidence of a suspect, implied zero-sum relationship with the consumption of vegetables and fruits. I suspect that there are issues with the nature and extent of carbohydrate and fat intakes, in particular, an unbalanced amount of n-6 PUFA's and trans fats, the nature of animal feeds and more prevalence of fast foods, processed foods, and refined carbohydrates. I also wonder, in the process of presenting a case for a vegan lifestyle, whether Dr. Campbell sufficiently addressed known issues related with a vegetarian or vegan lifestyle. (In fact, one of my nieces adopted a more vegetarian lifestyle before abandoning it.) There are other anecdotal observations as well, for example, Asian-Americans (including females) towering over their parents (suggesting nutritional factors).

One of my favorite pastimes during my academic career was to go around the college bookstore, shelf-reading, particularly for research methodology texts being used in other disciplines. In an analogous way, one of the things I might do with a book like Colin Campbell's is to look at the reader reviews on Amazon.com's website. I wasn't so much interested in enthusiastic readers saying how reading the book changed their lives and their views on food, but in the readers whom DISAGREED with him--and not in personal terms, but for very specific reasons. For example, there's a criticism that Campbell makes a case against a specific milk protein (casein) but doesn't examine counterbalancing effects of other milk proteins. Another notes that Campbell is the co-author of a China-based article pointing out beneficial effects of fish/fish oil, but this (among other studies) doesn't fit in with his book's pro-vegan slant. A third criticism is Dr. Campbell's tendency to jump to other broad generalizations that simply aren't true, such as the assertion that folate is exclusively available from plant sources (versus, say, organ meat). Chris Masterjohn provides a good summary of criticisms against Campbell's book and replies to Campbell's response. [I was not favorably impressed with Campbell's use of ad hominem arguments. Furthermore, I am troubled by Campbell's relationship with certain special-interest groups; a scientist must be impartial in fact and appearance.]

Turkey Legs!

I LOVE turkey; it's more than just a holiday food to me. And in that recurring holiday debate: I prefer dark meat (the color is due to higher levels of myoglobin, which facilitates oxygen transport) to white meat; being the oldest of seven growing up, I usually lucked out in getting one of the drumsticks. Later, in fact, the mother-in-law to one of my sisters was going around a few years back with a camcorder, catching me right in the middle of chomping down on a turkey leg and asking how I liked it (now THAT'S a flattering picture I won't post in my blog anytime soon...)

Carolyn Kylstra, in Men's Health post entitled "6 Power Foods You Should Be Eating", points out poultry dark meat stimulates production of the hormone cholecystokinin (CCK), which promotes a feeling of satiety, has only modestly higher calories per ounce (approximately 8) over white meat, and only about 15% of the saturated fat, which accounts for a third of total fat, is the "bad" kind.

Dr. Fernstrom points out ostriches bear only relatively low-calorie dark meat. Not to mention: "compared with white meat, [dark meat] contains more iron, zinc, riboflavin, thiamine and vitamins B6 and B12."

These facts (including, as I mentioned in a past post, the fact that egg yolks contain a lion's share of nutrients) point out the danger in blindly following conventional nutritional heuristics (e.g., low-fat/low-cholesterol) white meat, nonfat milk products or egg whites: Consider more of a "whole foods" approach and limit your portions.

Remembering Why I Love Trader Joe's

I first came to experience Trader Joe's while serving as the Oracle Consulting tech lead on an Oracle ERP implementation project for the City of Oakland, CA back in 1998. Oracle had leased some corporate apartments in Emeryville; Oracle felt there was no need for us to rent cars, because there was a nearby BART station (to get to the client site in downtown Oakland) nearby and a shopping mall with a large food court across the street. Some of my colleagues didn't like to do fast food and had very specific dietary preferences; a couple of people on the project did have cars, and every once in a while, I got invited along for a ride to a grocery. There was this buzz in the car about Trader Joe's, so we went to a local store.

The first thing I noticed when I went into the store was the people, in particular a few silver-haired hippies and, of course, a number of yuppies (in most cases, the kind of people you might find at a Whole Foods). It doesn't quite fit the stereotype of a health food store; you won't find the bulk food canisters. What you will find is what I would consider a healthier version of a supermarket concept (e.g., no junk food but healthier version of snack foods) without the premium prices of a Whole Foods. It also differs by carrying mostly its own private brands (with a small number of competitively-priced healthier brand items, e.g., McCann's Oatmeal and Food for Life breads).

You will find a wider variety of healthier foods with a twist I would term as premium private-label foods. In most cases, we think of store or generic brands as less expensive, comparable quality variations of branded foods. Trader Joe's marries the concept of low prices with healthier, quality ingredient food variations, often with innovative twists. Let me discuss a couple of illustrative examples from the list below. You can purchase a 1 lb. jar of organic unsalted crunchy peanut butter made from Valencia peanuts for $2.99, and a dozen brown large cage-free (i.e., high Omega-3) eggs for $2.69. In contrast, my local supermarket starts Eggland's Best at over $3 a dozen--and organic and/or cage-free eggs are at a significant premium to that price.

Some drawbacks:

• Trader Joe's doesn't have locations in every state. I sometimes write about Trader Joe's to my mom in Texas, and she points out there aren't any local stores.
• Trader Joe's maintains a small number of stores in an area. [I used to have to drive to Bethesda until they opened up a location in Columbia (technically, Elkridge).]
• Whereas Trader Joe's is on the web, it doesn't have an Internet storefront (and it doesn't sound like they have any near-term plans to do so).

Sample Checkout Tape

McCann's Irish Oatmeal tin, $4.99

TJ Soy (Milk) Essential (unsweetened), 1 quart, $1.69 (2)

Butternut Squash Soup, 1 quart, $2.49

Unsalted Macadamia Nuts, 12 oz., $6.29

Brazil Nuts, 1 lb., $4.49

Raw Mixed Nuts, 1 lb., $4.99

Dark Chocolate Jet Black Cocoa Almonds, 1 lb., $4.99

Sunflower Seed Nut Butter, 1 lb., $3.99

Frozen Berry Medley (blackberry, raspberry, blueberry), 1 lb., 3.29

Buffalo Jerky, 3.5 oz., $4.99

Low Carb Whole Wheat Tortilla, 10 small, $2.69 (2)

TJ Oat Bran, 2 lbs., $2.69

Organic Extra Dark Chocolate Bar with Almonds, 3.5 oz., $1.99

Tetra Garden Patch Soup, 1 quart, $2.99

Swiss Dark Chocolate Bar with Hazelnuts, 7 oz., $3.99

Organic Crunchy Peanut Butter, 1 lb., $2.99

Ground Buffalo Patties, 20 oz., $5.69

Wild Alaska Sockeye Salmon Fillets, 7.99/lb, $8.47

Large Brown Cage Free Eggs, 1 dozen, $2.69

Lime Chile Mixed Nuts, 1 lb., $3.99

Canned Wild-Caught Pacific Red Salmon, 7.5 oz, $2.49 (2)

Crunchy Raw Almond Butter, 1 lb., $4.99

Whole-Wheat Pretzel Sticks, 12 oz., 1.99

Mini-Pearl Tomatoes, $2.49

Fresh Strawberries, 2 lbs., $4.99

5" Whole Wheat Pita, 8 pack, $1.49

Multi-Grain Wheat Sprouted Bread, 24 oz., $3.49

Whole Wheat English Muffins, half-dozen, $1.49

Just a few minor complaints: I would like my local store to carry frozen venison, grass-fed beef, and ostrich. (I have purchased venison at other locations in the past.) I'm not impressed with my store's current selection of tortillas/flat breads (I think they carry one lavash item in their fresh bread section. They do carry a few tortilla items in their refrigerated deli section. It would be nice if they carried Tumaro's, Flatout, or La Tortilla or offered a comparable private-label product).

An Abridged List of Free Recipe Links

Free Downloadable Recipe Books

Courtesy of Gizmo's Freeware, there is a webpage (click here) which maintains links for free downloadable cooking, food, and wine books in various e-book or audio formats. ["Free" does not include any related, applicable Internet service/download fee.]  NOTE: I have not personally pre-screened these recipes for nutritional value, and relevant e-book formats may require you to locate and install additional software on your PC. (Freeware viewers are available for most or all common e-book formats.)

Recipe Bookmarks


Here is an abridged list of recipe portal links from my personal bookmark collection. [Note: although I am not diabetic, there are relevant risk factors, and I believe in eating in a proactive, preventive manner, e.g., taking into account factors such as glycemic index/load.]:

123Drinks Free Mixed Drinks Recipe Website Cocktails Alcohol
All recipes – complete resource for recipes and cooking tips
American Recipes, on USA.gov
Arielle's Recipe Archives: Cajun
Bed & Breakfast Inns ONLINE - Cooking * Food * Dining
Beef Recipes
CDC Recipes
CookingCache.com
Cooks.com - Recipe Search and More
Cooks Recipes
Free Cooking Recipes
20 Quick Crock-Pot Recipes | Food | Disney Family.com
American Diabetes Association
Diabetic Recipes - Recipes by Category
Diabetic Recipes
Eating Well Recipe
efooddepot Recipe 
Epicurious.com: Recipes
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Low-Carbohydrate Recipe Links


Low-carbohydrate plans focus on limiting or eliminating the higher-glycemic (blood sugar-spiking) "white foods" (i.e., flour, potatoes, sugar, and refined rice) and related simple carbs (e.g., fruit juices and many fruits). I personally follow a less-restrictive lower-carb diet; for example, I don't think that emptying muscle glycogen stores is good for a healthy, active lifestyle. However, with breads, "less is more"; for example, if I was to eat pizza, the thinner the crust, the better (e.g., flatbread crust); if available, I would purchase whole-grain varieties. If I go to Subway, I'll order a wrap version of their sandwiches (available on request). [The low-carb purist will insist on making it a salad.]

NOTE: Many of the recipe portals listed above have low-carb recipes which you can access by doing a site search on low-carb. For example, RecipeZaar has a very low carb category with nearly 14,000 recipes and a reduced carbohydrate category with over 60,000 recipes.


Alt.support.diet.low-carb Recipes
Low Carb Cookbook
Low Carb Luxury Recipes
low-carb.com Low Carb Recipes
"My" Lowcarb Recipes

Nutrition Miscellany: 9/26/09

Sam's Club Update

--Salad Dressings. I noticed on my most recent trip that the club is now carrying twin pack bottles of Hidden Valley Light (40-50% lower fat and calories than the regular brand). Lately though, I've become much critical in reading salad dressing ingredient labels in general (beyond calories); in part, this was stimulated by the fact one of the Rodale websites pointed out a certain guacamole dip I was buying from a supermarket contained more vegetable oils than guacamole. Avocados are an amazingly nutritious fruit (eaten in moderation) and a superb source of monounsaturated fats. Things like soybean oil and high fructose corn syrup automatically set off yellow flags to me. Anyway, I took a pass, although I'm pleased to see lower-calorie versions available.

My personal preference is extra virgin olive oil for salads or cooking (olive oil is almost 75% monounsaturated). A second oil to consider (in a salad dressing, not for cooking) is flaxseed oil, which contains the highest percentage of an Omega-3 fatty acid, ALA. (ALA is a precursor to DHA/EPA, e.g., in fish oil, although we only able to convert a small percentage.) If I have to settle for another oil for salad dressings, the most reasonable alternative is canola oil, which is a runner-up in the monounsaturated and ALA categories. Litehouse (not carried by Sam's Club) has a jalapeño ranch (made with canola oil) that I like. [On a side note, beware of products which give you a multiple choice of vegetable oils like soybean or canola. I'm always going to assume the worst case scenario.]

The other thing I try to look for in salad dressings is how the product is sweetened. I mentioned in my Favorite Things post that I have purchased Walden Farms (which is sweetened with sucralose). Kraft used to offer "Carb Well" products and also used sucralose in its salad dressings (but they also used soybean oil, which is over 50% n-6 PUFA).

--Veggie Dips. I will often purchase the three-lb. bag of fresh broccoli florets; when I eat the broccoli raw and allow myself a dip, there are a couple of relevant items I have purchased from the deli/ prepared foods section of the store. First, my stores sell Yucatan guacamole (the vendor advertises its products as 95% avocado). Most lower-carbers like myself consider avocado as a preferred fruit, with low net carbohydrates and "good" fat (i.e., monounsaturated). Second, it also carries a ready-made branded spinach dip (at about 70 calories for 2 tablespoons).

--Jerky. I never cared much for the taste of jerky when I was a kid. There are a couple of things that made me reconsider: (1) it is portable and doesn't require refrigeration, and (2) you can get jerky for a number of meats or fish which can be hard to obtain in fresh or frozen form in many supermarkets, e.g., venison, ostrich, buffalo or salmon. Sam's Club offers some economical values on varieties of Jack Link's. (I have separately purchased Ostrim, a blend of ostrich and beef.) A 1-to-1.5 ounce high-protein, low-fat stick at under 100 calories is one way I cope with occasional between-meal dieter munchies.

--New Fad: Water Bottles. I recently purchased a reusable Clear2Go water bottle from Clear2O (not stocked by Sam's Club); this comes with a replaceable water filter attached to the lid. A principal concern is not having plastic that leaches into your drinking water and in particular is BPA-free (BPA is thought to be related to insulin resistance). The Clear2Go bottle is made of LDPE #4 (which is one of the non-leaching plastics). Of course, you can always fill a water bottle from a filtered water cooler or dispenser, but with this unit, you can refill your water bottle from any public source away from home. In any event, I was shopping for replacement filters for my Brita UltraMax and noticed most of the water filter container packages (e.g., Brita and Pur) seem to come bundled with free water bottles. Anything which that facilitates dieter exercise and good quality drinking water is a good thing.

The Angus Burger Wars

As a small investor, I have been interested in how McDonald's (and its competitors, such as Burger King) would finally address the premium burger segment, which is a mainstay in casual dining chains like Fuddruckers, Chili's, and others. Well, it seems as if they've decided on a particular cattle breed, a bigger burger (from a quarter to a third of a pound), more upscale fixings (e.g., types of cheese) and a bakery-style bun; it comes with a premium price tag and steep increases of calories (starting at over 640), fat, and sodium. [Heaven forbid instead of increasing portion size (I think a quarter-pound is enough), they should think of something like marinating burgers or seasonings beyond salt and pepper or offering customers a choice of  low-fat cheeses, condiments or a whole-grain bun!]

Hats off to Denny's for going beyond the typical fast food executive excuse ("our customers don't want to buy healthier food") for its innovative "Better for You" menu options, including things like smaller portions of calorie/fat-intensive foods (What a concept! Portion control! In a restaurant!), reduced-sodium food preparation, and vegetable sticks and fruit slices for kids.

The Thin Roll Wars

I've mentioned in past posts my fondness for Arnold's Multigrain Sandwich Thins (100 calories). (Speaking  of burgers, I like to get my George Foreman grill up and running, fry a low-fat burger and add a fat-free slice of cheese, a layer of baby spinach leaves, picante sauce, mustard, onions and some sliced jalapeño peppers. A quarter-pound burger fits the thin roll quite nicely.) Pepperidge Farm has come out with a competitive product, Deli Flats, which come in 3 flavors (100% whole wheat, 7-grain, and oatmeal). They also market a brand of very thin bread slices (about 45 calories) Let's hope the trend catches on (less is more). Of course, if you want to do away with bread altogether, you could try a trick every lower-carb dieter knows--substitute large lettuce leaves for bread...

Nutrition Action Looks at Nuts

If you read my last post, you know that I am a skeptic on the Lipid Hypothesis (the CSPI is in the tank for it). You would think the facts that some ethnic groups (e.g., Eskimos) have existed on diets high in saturated fats without significant coronary heart disease, that some studies show much of clogging arterial plaque consists of polyunsaturated fats, and that saturated fat is necessary for number of purposes (including calcium absorption, a preferred nutrient for vital organs, cell stability, and an improved immune system), and that mother's milk largely consists of fat, most of it saturated, would lead some people to pause before replacing saturated fat in one's diet with polyunsaturated Omega-6 fats (i.e., most vegetable oils and shortening, used in many packaged and deep fried foods), unbalanced without enough Omega-3 fats in one's body (particularly DHA/EPA, found in oily fish).

Generally, I frown with overly simplistic dietary heuristics and prefer nutritional diversity.  One of the differences I had with lower-carb contacts was their choice of vegetables based strictly on carbohydrate grams, even though vegetables vary in vitamins and minerals.

Nuts and seeds vary in vitamins, minerals, fats, etc. The October 2009 3-page feature article ("Going Nuts") gives short-shrift to the discussion of minerals (nothing beyond a gratuitous reference to magnesium and copper in the second paragraph) I don't have an issue with their criticisms of excessive salt, sugar, etc., and I don't mind their raising the issues of calories and saturated fats. The question, in my view, is more about limiting one's portions--NOT the number of saturated fat grams in a single serving.

CSPI systematically eliminates macadamia nuts (one of my favorites, a superb source of monounsaturated fat, highest in B vitamins), Brazil nuts (best source of selenium), and cashews  (highest in zinc) from "best bite" consideration, solely based on the ratio of polyunsaturated to saturated fat (re: Lipid Hypothesis).

A couple of other critical notes: David's Sunflower Seeds receive an honorable mention. I had stopped eating David's Sunflower Seeds a while back after I noticed, with considerable dismay, the third ingredient listed on the ingredient panel: partially hydrogenated soybean oil. Even most laymen know once you see "partially hydrogenated", you think "trans fat"; be aware of nutrition labels that read "0 grams of trans fat" because that's an artifact of label reporting requirements (e.g., less than half a gram of trans fats) and serving size. This article didn't say a single word about process-generated trans fats, even though they are worse than any other type of fat.

Finally, if I was going to pick a favorite nut, it's easy--almonds, hands down (best source of calcium and fiber, high in protein, vitamin E and monounsatured oil). CSPI got on my bad side by refusing to rate Emerald Almonds Cocoa Roast (there are additional health benefits for dark chocolate), a best buy or honorable mention, primarily because the producers use a small amount of acesulfame potassium (an FDA-approved artificial sweetener) in conjunction with sucralose. [This product is one of my favorite things.] CSPI has a known ax to grind against  this sweetener, based on cancer-related concerns, which the FDA and other organizations reject.

Coping With Conflicting Nutrition Guidelines and Evidence

Monica Reinagel of the Nutrition Data Blog recently posted an article entitled "More Evidence That Saturated Fat Has Been Falsely Accused?" The article begins by noting a commentary which summarizes a statistical relationship between obesity (particularly visceral or abdominal fat) interacting with insulin resistance and cancer. Thus, weight loss is seen as a key strategy in cancer prevention.

Nutrition and Obesity: Are Misguided Dietary Guidelines a Contributing Factor?

Diet and exercise. Ah, diet: that's the rub. We have a number of often contradicting guidelines; the orthodox diet point of view over the past 40 years has been the low-fat paradigm, but even with a supermarket flooded with low-fat products and slumping sales in higher-fat products like butter and cream, we see a growing prevalence of obesity, even young schoolchildren developing type-2 diabetes in unprecedented numbers. Could dietary changes, e.g., from away from dairy fats, eggs, whole grains, and minimally processed meats be part of the story?

Background: Why the Low-Fat Diet


We often discuss the macronutrients protein, fat, and carbohydrates; with protein and carbs at 4 calories per gram and fats at 9 calories per gram. If we look at restricting the diet based on food grams, limiting fat grams has been the classical low-fat diet to cutting calories and weight. [There are some important nuances; for instance, protein and medium-chain triglycerides (e.g., lauric acid, the saturated fat in coconut oil) have thermogenic effects. Proteins require more digestive processing, using about 10% of caloric intake, and MCT's are readily converted to energy for metabolism.]

Fats are primarily categorized as monounsaturated (MUFA), polyunsaturated (PUFA), and saturated fats. Monounsaturated fats (e.g., olive oil) tend to lower LDL (bad cholesterol), polyunsaturated fats tend to lower both LDL and HDL (good cholesterol). Saturated fats tend to raise both LDL and HDL. (The relationship between saturated fat and HDL is in dispute.) Polyunsaturated fats can further be subdivided into Omega-3 (n-3) and Omega-6 (n-6). These are considered essential fatty acids, i.e., our bodies do not manufacture them and hence depend on dietary sources. Omega-3 fatty acids, which tend to be understated in the American diet, are found in cold-water fish (DHA/EPA, e.g., in salmon and sardines), and certain plant forms (ALA, in flaxseed and walnuts); relevant benefits include better brain function, favorable cardiovascular characteristics (eg., anti-inflammatory and anti-coagulant), and some protection from certain cancers. Omega-6 fats include most vegetable oils and shortening, typically overstated in the American diet; they are generally considered inflammatory but promote healthy hair, skin, and nails and help regulate hormonal and emotional balance. Omega-3 and Omega-6 fatty acids interact with each other, so a proper balance is important.

Controversies Over Dietary Fats

In particular, saturated fat has been the focus of much debate; some studies show a significant relationship between a high saturated fat diet and coronary heart disease/stroke and atherosclerosis (hardening of the arteries) or between saturated fat and cholesterol (also considered linked to coronary heart disease). Enig and Fallon, however, note that the American diet at the turn of the twentieth century (when CHD was not a significant public health issue) was much higher in consumption in animal saturated fats (e.g., butter, tallow and lard); the primary American dietary shift in the early twentieth century, was from animal fats to vegetable oils, shortening and hard margarine. (Dr. Enig, I note with amusement, refers to her food industry and enabling government bureaucrats and establishment critics as "dictocrats". She makes a compelling case of academic politics and pervasive bureaucratic groupthink.)

Among other things, Enig has focused on dangerous trans fats (which have a double whammy of raising bad cholesterol and lowering good cholesterol); her dissertation suggested that trans fats impede the effectiveness of enzymes in dealing with carcinogens. [Trans fats are generated in the process of hydrogenating heat-unstable (primarily Omega-6) vegetable oils, which enables baking and improves food product shelf life; deep-frying with partially hydrogenated vegetable shortening, a staple for many fast-food restaurants, is another important dietary source.] She also cites a long list of studies of adverse affects related to vegetable oil consumption (for example, one 1994 study reported about three-quarters of an artery clog was unsaturated fats, and other studies mention adverse affects on mineral or Omega-3 metabolism).

One of the relevant points of discussion is the ratio of Omega-6 to Omega-3 polyunsaturated fats in the diet. Iin a more natural food setting, this is roughly 2:1; in a more contemporary diet, this ratio can range from nearly 10-20:1.

What comes to mind is the old adage: "you are what you eat". We see this clearly from examples in egg and meat production. Many "free-range" hens or hens fed (high Omega-3) flaxseed meal produce eggs higher in vitamin E and lower in calories and fats. In finishing animals (fattening them up for butchery), cattle have often been fed Omega-6 feed (e.g., corn and soybeans, which have certain thyroid-suppressing effects) Farmers also discovered when they added coconut to pig's diets, pigs LOST weight. Ironically, in attempting to meet the current orthodox demand for leaner meats, pigs may be finished with saturated fats (like beef tallow or coconut) instead of soybean oil. A recent study in Pig Progress , with authors sympathetic to the orthodox benefits of polyunsaturated fats, comparing the effects of sunflower oil diet to a beef tallow diet, did not report any changes in meat quality, but discovered a significant difference in adipose tissues reflecting the nature of the diets (with the beef tallow-diet animals higher in saturated and monounsaturated fats and lower in polyunsaturated fat) and the sunflower oil-diet pig fat with an unsatisfactorily high n-6 to n-3 PUFA ratio.

Similar concepts occur in other dietary decisions. For instance, grass-fed cows produce milk with a higher concentration of CLA, a "good" natural trans fat believed to help enhance insulin sensitivity, resist increases in belly fat, and raise good (HDL) cholesterol. Grass-fed meat producers claim a more ideal, natural Omega-6 to Omega-3 ratio. We also see that age (and the accumulative effects of nutritional choices over a lifetime) may be a factor in phenomena like atherosclerosis; Enig cites a number of studies showing comparable results across cultures with different diets. One reason I will eat sardines and younger tuna (cf. Wild Planet brand) or wild seafood (e.g., versus farm-raised salmon) deals with minimizing the risk of metabolized contaminants.

The Anomalous Studies Cited By Ms. Reinagel

The Danish study reported on macronutrient intakes and waist circumference. Waist circumference (> 35" for women, > 40" for men) is considered to be a high risk indicator for several conditions (e.g., diabetes, heart disease, etc.) The typical orthodox advice is to limit sources of saturated fat (including beef, eggs, dairy and red meat), substitute leaner meats (e.g., chicken), and replace them with polyunsaturated fats and carbohydrates. The study looked at results by gender along 21 food and beverage categories for a 5-year period of men and women (analyzed separately) between the ages of 50 and 64. What's particularly interesting is that for both genders, the consumption of red meat was inversely related to waist size, and for women, the consumption of dairy fats (e.g., butter, cheese, and cream) was also inversely related (whereas processed meats, poultry, and potatoes were directly related). Reinagel mentions, "Some would argue that a diet higher in fat and protein may be lower in carbohydrates and that carbohydrates drive insulin resistance and obesity." In particular, I would suggest (and I believe Enig would agree) that higher amounts of "bad" (high-glycemic) carbohydrates, n-6 PUFA's and trans fats are problematic, and minimally-processed whole foods (e.g., whole grain vs. white flour and unprocessed meats) are underrepresented. I would also add that the thermogenic nature of metabolizing protein and the satiety resulting from fats (including saturated fats) might help dieters limit their aggregate consumption of calories.

The second international study showed no relationship between certain identified foods (with saturated fats) (i.e., meat, eggs, dairy fats) and breast cancer.

Concluding Thoughts

I have not done empirical research in the nutrition sciences, but a number of studies I have seen seem to have issues with things like the use of self-report questionnaires, the nature of sampling (e.g., gender, age groups, etc.), the lack of standard measures/units, statistical power (e.g., small sample sizes), and single vs. multiple observation points. I'm also concerned with the liberal use of guidelines based not on confirmed hypothetical causal links, but motivated by correlational data. These guidelines are not often empirically verified. One classic example is the 8-glasses-of-water rule of thumb. When I attempted to debunk this myth in a low-carb forum a few years back, citing a prominent review on the topic by Heinz Valtin, I ran into a lot of resistance. (Subsequent reviews have repeated the same, and even snopes.com has addressed the issue.)

I am concerned about the amount of groupthink that Dr. Enig has encountered; she has been poking at some of the sacred cows in current medical practice and nutrition, such as putting otherwise healthy people on statin drugs based on arbitrary cholesterol levels. Many cultures (e.g., French, Eskimo and Asian), not to mention our own past, have eaten diets far richer in "banned" saturated fats without comparable CHD statistics. Whereas a more sedentary lifestyle has an obvious effect on a population where a majority of Americans are overweight, we still need to come to terms that the typical American diet today has a disproportionate amount of Omega-6's and trans fats, which are not well-metabolized by our bodies, and underconsumption of Omega-3's, not to mention a surplus of blood sugar-spiking refined or simple carbohydrates (e.g., sugar, breads, potatoes, etc.). We need to ask--if, holding cattle activity constant, cattle gain a lot of weight eating corn or soybeans but get thinner if you add coconut to their diet, do we have reason to believe that these foods are metabolized differently in humans? And if pigs finished on vegetable feed store a disproportionate amount of n-6 PUFA in their adipose issues, what are the implications for losing weight on an n-3 PUFA deficient diet?

I'm not optimistic about the future of useful nutrition research given the predominant Lipid Hypothesis paradigm (not unlike how politically-correct "global warming" groupthink stifles alternative points of view in the scientific community): you won't win grants to sponsor your research, you won't get published in highly visible journals or be hired by quality colleges or food companies, and there is no authentic scientific debate.

What about laymen, such as myself, knowing the scientific community seems unlikely to provide reliable, useful, consistent results in the near future? I think one thing, from my own experience with the development and validation of measures, is that laymen need to express some skepticism about artificial dietary benchmarks--e.g., limit saturated fat to under 10%, limit carbohydrates to under 20 grams daily, etc. Second, consider a variety of foods in one's diet, because meats, vegetables, nuts, etc., can vary in nutrition (e.g., various vitamins and minerals).

Third, be wary of food processing or filtering. Take, for instance, the almost slavish preference for poultry white meat (mostly because of its low-fat nature); dark meat, on the other hand, has almost twice the amount of iron and zinc, key elements of a healthy diet. Another prominent example is vilification of egg yolks (at the expense of egg whites): one estimate is about 90% of the nutrients in an egg are in the yolk. So when people start filtering out nutritious animal parts, cream from milk or elements of an egg or grains (to make white flour) to be consistent with arbitrary dietary restrictions, I believe they need to stop and think: What is the function of these filtered elements? For example, does the yolk provide any useful purpose to a hatching chick? Does dairy cream provide any value for the weaning calf? And if it is nutritionally valuable to a young animal, why would it not be nutritionally valuable to us? The issue, in my view, is not removing these nutritional elements but in enjoying them in moderation.

Finally, keep your diet in aggregate nutritional balance. For instance, I think many (if not most) Americans do not get enough Omega-3's and soluble fiber in their diets. To bring one's n-6/n-3 PUFA ratio in balance, you should decrease the n-6 PUFA's and/or raise the n-3 PUFA's in your diet--and consider eating products where source feed reflects a better nutritional balance (e.g., grass-fed animals).

A Few of My Favorite Things

This post is devoted to products I am recommending based on past use or considering purchasing based on stated criteria. I do not have any financial interest with any specified vendor, and readers are invited to consider alternative products using relevant criteria or other sources. The Center for Science in the Public Interest publishes the Nutrition Action Health Letter, which often recommends or criticizes food products by name, and Men's Health (cited below) publishes an annual list of best grocery buys, not to mention Rodale's "Eat This, Not That" franchise. (I regularly review these and other sources.)


Diet Foods

As a dieter, I find that I'm turned off by gimmicky flavored nutrition bars (e.g.,apple cinnamon, s'mores, chocolate chip, cookie dough, rocky road, or caramel)  or shakes, especially as a meal substitute for breakfast, lunch, or dinner. Whereas I don't mind varying simple flavors to make a food more interesting, I don't like food manufacturers trying to pass off nutritious food as junk food or candy; it sends the wrong message. Under my current diet regimen of up to 6 small meals daily, I do consider them as a lighter meal.

There are a number of criteria I look for in consideration of these foods, including protein, fiber (especially soluble fiber), and vitamins and minerals, preferably lower in carbohydrates (particularly sugars) and calories. I also like to look for a blend of whole grains, seeds and proteins where applicable.

One of the nutrition shakes I have purchased is EAS Myoplex Lite powder mix. Under 200 calories (when mixed with water), these shakes provides a potent 25 grams of protein (whey and soy blend) and is fortified with 30% or more of the recommended daily requirements of a long list of vitamins and minerals. I'm also a big fan of Gnu Food bars, which pack 12 grams of blended fiber in up to 140-calorie bar.

Salad Dressing
This is one of those things which really irritates me about eating salads in restaurants (especially fast food). I have mixed preferences in this area: I prefer extra virgin olive oil if available, but otherwise I want a low-calorie substitute. [I have found at least one website which specializes in single-serve or travel-sized condiments (including salad dressings, olive oil and picante sauce) and other items: Minimus.] Walden Farms, which I discovered during my low-carb phase, sells a number of no-calorie flavored dressings, syrups, sauces and spreads--including single-serving packets (which are also carried by Minimus).

Breads, Tortillas,  Pasta/Noodles, Crackers

Food for Life is an interesting vendor with Biblical theme products; I originally found some of their organically grown sprouted grain breads (e.g., Ezekiel 4:9) in the frozen food section of my local Safeway. I have written of my fondness for Arnold's Select Multigrain Sandwich Thins, and as I write, my current loaf of bread is Arnold Natural Flax & Fiber; Arnold's products have no high fructose corn syrup. Healthy Life Breads is a vendor that I discovered during my low-carb period (whole wheat bread, about 35 calories a thin slice), but has often been hard to find and is a little pricey.   I have also purchased twin packs of Roman Meal Superseed when available at Sam's Club (watch the calories).

As a born Texan whom attended high school and college and Texas, I have eaten tortillas, tacos and burritos all my adult life. But I think my fondness to the concept of a wrap dates back to when I was a Coopers & Lybrand consultant based out of  the Chicago suburbs; I had an incredible tuna salad wrap at a ground-level small sandwich cafe. [I have pleaded with McDonald's for years to consider chicken salad or tuna salad wraps.and Subway, in my experience, allows one to substitute tortillas in place of their fresh-baked bread.] To this day, one of my favorite meals to make is to mix some water-packed tuna, no-sugar-added relish, low-fat mayonnaise or salad dressing, boiled egg, and a dollop of hot sauce to flavor, and wrap the mixture in a warmed low-carb tortilla. I have enjoyed a number of different lower-carb tortillas and lavash/flatbreads. In particular, three brands I like are: La Tortilla Factory, Tumaros, and Flatout Flatbreads.

One of the problems a lower-carb dieter faces is a suitable pasta; Dreamfields Pasta contains just 5 grams of digestible carbs per serving. (I'm particularly partial to the linguine product.) I have also tried Shirataki  konjac flour noodles, which are zero calorie and high in soluble fiber, e.g., Miracle Noodle or Konjac Foods. (One of my favorite light meals was to eat some Bela-Olhão sardines [see below] (hot sauce variety) with konjac noodles.)

I recently mentioned some whole-grain cracker products I've purchased at Sam's Club (i.e., Special K and Crunchmaster Multi-Grain crackers). One brand I became aware of due to a Men's Health 2009 nutrition award is Dr. Kracker. I'm intrigued by the Klassic 3-Seed, Pumpkin Seed, and Seeded Spelt varieties, with a blend of whole grains and seeds, yielding decent amounts of protein and fiber grams.

Meat/Fish


I love SmartChicken; I first tried the air-chilled, veg-fed whole chickens when my Columbia Safeway carried them. I haven't found them stocked lately, at least in more local supermarkets, but I have placed an occasional online order. A periodic item on my Sam's Club shopping list is a box of Morey's marinated, seasoned wild Alaskan salmon fillets. I have been a regular customer of Laura's Lean Beef. When I was a member of BJ's Wholesale Club, I was a regular purchaser of their ground buffalo 2-lb. packages; my local Safeway is now carrying buffalo (although at a stiff $7/lb). I've occasionally been able to find venison at Trader Joe's.

Eggs are a wonderful source of protein, and I eat at least one a day. I'm a frequent purchaser of Eggland's Best (which have more Omega 3's, fewer calories, less saturated fat and cholesterol, and more vitamin E than regular eggs.) I'll occasionally fry a couple of eggs in olive oil over easy, accompanied by a whole wheat bagel.

I'm also interested in grass-fed meats, which are a little pricey. I did have a positive transaction with a small business delivering locally to the Baltimore/DC suburbs. Tropical Traditions, an online vendor from which I've purchased virgin coconut oil during my low-carb days, has family-farm suppliers for grass-fed beef, bison, and lamb and pastured poultry, but I have not placed a transaction yet. The big issues with these often nutritionally-superior meats (e.g., more CLA and Omega 3's, lower saturated fat) are high prices reflecting limited production capacity and availability, not to mention shipping charges. When Safeway recently put 90% lean ground beef on sale for under $3/lb or regular whole fryers at just under 60 cents a pound, it's hard to justify justify the purchase of premium meats on an incremental nutrition/cost basis.


I'm a big believer in cold-water fish, so you'll find my pantry well-stocked with canned fish (tuna, sardines, salmon, and mackerel). There are a few things I particularly check for: the source/age of the fish, the nature of the packing (e.g., water or oil) and the sodium level. I generally prefer younger, smaller fish (less exposure to mercury contamination), wild-caught, water-packed cans (or anything other than polyunsaturated vegetable oils, e.g., olive oil, tomato/hot sauce, and mustard), and lower sodium.There are two brands I have purchased, prefer and highly recommend: Bela-Olhão sardines and Wild Planet tuna. [For some reason, the Bela products seem out of stock; Blue Galleon, the parent company, has not posted an explanation, and my own emails have gone unacknowledged. As I write, their Facebook page is still up (with a last posting in early mid-December 2008). I found a blog posting from a coop in late July saying the product was back in stock, noting unconfirmed rumors of insolvency and bankruptcy. However, I've only seen one vendor through Google Products claiming to take orders.]

Additives and Sweeteners

I've on a number of occasions purchased green foods like chlorella and spirulina, e.g., adding a serving  to V-8 juice. I like the idea of blended superfoods, and one such product I've recently purchased is Garden of Life Perfect Food, which include not only the above algae, but other source extracts, including grasses and veggie juices. Another Garden of Life product I'm using, e.g., to supplement my breakfast cereal,  is Super Seed, a high-fiber blend of chia and flaxseed and various sprouted grains, legumes, and other seeds.

I mentioned in a previous post that I'm a frequent purchaser of stevia extract powder, which I use primarily to sweeten my iced tea blend of black, green and decaffeinated teas. One of the interesting new trends I've seen recently is combining soluble fiber with a naturally low- or zero-calorie sweetener. One such product I recently purchased is Sweet Fiber, which combines the fiber of inulin (from chicory roots) and the no-calorie sweetner from monk fruit; the company claims that the soluble fiber in 3 servings of Sweet Fiber is equal to the amount of soluble fiber in a bowl of oatmeal. I've been sweetening every other cup of coffee with Sweet Fiber.

Miscellaneous Items

As an IT professional, I've had more pizza than I care to remember working evenings or weekends (although during my low-carb phase, I turned it down on a number of occasions). I'm intrigued by newer introductions like whole wheat or flatbread crusts (which cut down on an obscene number of carbs). South Beach brand individual pizzas have a whole wheat blended crust yielding about 25 net carb grams; my principal complaint is a limited variety. My favorite frozen pizza has to be the Lean Cuisine Margherita Pizza, with tomato bits and sauce, extra virgin olive oil, basil, and lower-fat cheese. (I would prefer a thinner, whole grain crust, especially with net carbs peaking 40, but the toppings make this pizza glorious.)

I have mentioned elsewhere that (like most lower-carb dieters) I really like Emerald Cocoa Roast Almonds. Almonds are an amazing food, packed with protein, vitamin E,  a variety of important minerals like calcium and potassium, and a good source of heart-healthy monounsaturated fat, i.e., lowers LDL cholesterol. Macadamia nuts are also a good source of monounsaturated fat, walnuts are known as a source of ALA (Omega-3), and Brazil nuts are re-nown as a source of selenium. So quite often I prefer to purchase or blend a variety of raw/unsalted nuts. However, one must carefully ration his or her portion of nuts because of the caloric density. I'm also a purchaser of a variety of nut butters, preferring more natural brands with a minimal number of additional ingredients.

A key ingredient of the Emerald Cocoa Roast Almonds, of course, is dark chocolate, another health-healthy food. I have been a repeat purchaser of Lindt Excellence 85% Cocoa bars, although I restrict myself to 2 squares per serving.

Bodybuilders and Diets: Insights to Struggling Dieters

Some of us question the credibility of a number of different sources on our path to healthy weight loss: Do we believe health care professionals, even the new Surgeon General, many of whom are poor role models (i.e., overweight, smokers, etc.)? Do we believe weight-fluctuating TV talk show hosts, or nutritionists and trainers looking to hawk personal services, a book or a website? Do we follow the low-fat paradigm which has dominated the diet industry since the 70's, which has been accompanied by an increasing proportion of the US population being overweight, with a proliferation of low-fat products which may not, in fact, be low-calorie (e.g., a company could simply substitute carbohydrates, such as sugar, for fats)?

Before going further, let me note that I am speaking of diets in a general sense. Obviously people with specific dietary constraints for serious health conditions, e.g., organ disease, diabetes, lactose-intolerance, Celiac disease, various food allergies, etc., should eat in a manner consistent with medical advice.

One of the ways we learn is by emulating the example of someone whose performance we admire. For example, a young golfer may try to emulate Tiger Woods' swing, and a swimmer mimics Michael Phelps' strokes. In my case, I attempted to implement the swing and batting stance of my favorite baseball player, Hall of Fame home run slugger Harmon Killebrew.

So how do we apply this within the context of  weight loss? Well, of course formerly overweight celebrity athletes, entertainers and actresses promote prepared food programs by vendors like Jenny Craig and Nutrisystem; we do know that (whether or not it's fair), appearance is a factor in the entertainment field. What about nearly emaciated models? For me, they often look frail, not in robust health. Even some professional athletes have not been not in the best shape (e.g., baseball icon Babe Ruth, football player William "Refrigerator" Perry, and wrestler Dusty Rhodes). No, I would argue that the best role model would have a well-toned, fit body: in particular, competitive bodybuilders.

I have admired bodybuilders for their extraordinary discipline and detailed eating and training regimen leading to competition; they know exactly when, how frequently,  how much and what to eat; there is a purpose for everything that goes into their bodies.  They know how to tweak their diets to deal with plateaus and to lower their body fat for competition. I have learned a lot about nutrition simply by reading some bodybuilding forums (e.g., posted diets) and reviewing products sold by bodybuilding and health web superstores.

My interest in the bodybuilding regimen was not based on the example of Arnold Schwarzenegger or an interest in various competitions; rather, it stems from a project I was on in the Chicago area in the 1990's working with another Oracle DBA whom also was an amateur bodybuilder. This guy was so motivated to help me out with eating the right way he offered to give me $100 if I would go home and throw out everything in my refrigerator and freezer. (I turned down his offer but did listen to his advice.) I learned, for instance, that he had a small bowl of olive oil during his meals in which to dip his bread, thus impressing the fact that fat is not inherently bad but a necessary food; he also introduced me to products like EAS Myoplex (nutrition shake mix).

One of the best-written, most intrinsically interesting books I've come across and purchased on nutrition and weight loss is from a natural (non-steroid) bodybuilder named Tom Venudo; he sells an e-book called "Burn the Fat Feed the Muscle: Fat Burning Secrets of the World's Best Bodybuilders and Fitness Models".  I will not summarize what he writes here, but for example he discusses the bodybuilder strategy of carbohydrate cycling, caloric density, scanning ingredient labels of  foods, including nutrition bars (e.g., for sugar content), different types and dietary significance of carbohydrates (fibrous, starch, etc.), the relevance of the glycemic index to a specific diet [the glycemic index is a tool which attempts to measure the nature of individual foods to raise blood sugar], a daily strategy on the nature and timing of carbohydrate consumption, the thermogenic nature of protein consumption (versus carbohydrates and fats) and so-called negative-calorie foods,  tailoring carbohydrate consumption to body type, and the pros and cons of sustained low-carb dieting. I found affirmation for some of the same concerns I had with certain aspects of a strict low-carb regimen, including nutrition balance and the gimmicky nature of the induction period which promotes a motivating but artificial early weight loss by zapping water-dense glycogen (energy stores) in muscles and the liver.

Dieters often search for simple rules--low-fat or low-carbs. Certainly food product manufacturers understand that and market their products accordingly. But these rules must be interpreted in the context of overall dietary goals and objectives. For example, a certain amount of fat is necessary to facilitate the body's absorption of fat-soluble vitamins (A, D, E and K). Many Americans don't get enough brain-nourishing Omega-3 fats (e.g., cold-water fish) or heart-healthy monounsaturated fats (e.g., olive oil and nuts) in their diets. On the other hand, carbohydrates are a preferred energy source for brain functioning and movement and, in some foods, a key source of heart-healthy soluble fiber. Buying certain foods, e.g., nutritionally-vacuous pork rinds because they contain zero carbs, is a poor choice in calorie utilization, of maximizing basic nutritional coverage in one's daily diet.

One of the problems I've found as a dieter is that there is a lot of information in books and online to learn about diet and nutrition in a piecemeal fashion. You can find multiple websites, for instance, critiquing various diets, but quite often the criticisms are not independent. The nice thing about Venuto's book is that it provides both a conceptual model of how all of these items work together and a summary of practical advice distilled from his own search and trial-and-error experience of what works and doesn't work over his years in competition; instead of reinventing the wheel, we are able to leverage the knowledge of someone whom also started from ground zero. I would suggest, before my fellow dieters throw away good money after dietary supplements that don't work, the latest diet book which will be in the bargain bins a year from now, or gimmicky diet foods, they invest a little money in fundamentally understanding what goes on in one of the few things all people share in common--the need to eat.

Sam's Club: A Review of Product Buys

I went to Sam's Club last Thursday. Since I'm now in the second month of Nutrisystem, I'm mostly looking at supplementing the rest of my diet with items like fresh fruits and vegetables, skim milk and eggs. Produce items usually vary between visits; for instance, on this last visit, I couldn't find fresh cherries, blackberries or raspberries. On the other hand, they had a large carton of blueberries for $6.98, and I added typically in-stock bargains in economy packages of organic spinach, cherry tomatoes, mushrooms, and strawberries. [They also have a good price on kiwi fruit.] A gallon of skim milk costs $2.56, which is better price than I get at Safeway on sale. I  also saw a good price on 90% lean ground beef (under $3/lb), and a 64-oz  jar of jalapeno pepper slices sells for $3.28. My favorite bread item, hands-down, is an economy package of Arnold's Multi-Grain Sandwich thins: 100 calories per roll, 4 grams of protein, 5 grams of fiber (22-5=17 net carbs), no high fructose corn syrup.

Since my Nutrisystem plan calls for 6 small meals a day (and typically you have a Nutrisystem item for 4 of the 6 meals),  I often plan for the other two unbranded meals. A typical example I've done is to combine a couple of ounces of cold-water fish (salmon, tuna, sardines or mackerel) or a couple of tablespoons of natural crunchy peanut or almond butter with a half-serving of whole-grain crackers. Sam's Club has a couple of good bargains on relevant crackers:  Crunchmaster Multi-Grain Crackers sell for $7.16 for a 20-ounce package; this product is particularly notable for containing flaxseed and being gluten-free  and low sodium. For those customers whom are wheat-tolerant, Special K Multi-Grain Crackers sell for $5.87 a 24-ounce package.

Nutrisystem rations me to 6 almonds per serving daily; Sam's Club is carrying a 3-lb. jar of Sunkist Almonds, flavored with sea salt. Unfortunately, Sam's Club is currently not stocking two of my favorite past repeat purchases:  Emerald Cocoa Roast Almonds (38 oz.) and the 2-lb. package of Member's Mark raw/unsalted blended premium nut mix.

I usually drink coffee and iced tea (although I usually try to cut caffeine by mixing in decaffeinated items). One Sam's Club item which caught my eye was a selection of at least 3 different variety packs of flavored Bigelow teas (including regular tea, green tea, and decaffeinated varieties) for $7.86 per 4-box pack.

Other examples of items on my repeat purchase list include: economy packs of Sweet 'N Low packets, jugs of picante sauce/salsa, multi-packs of canned Alaskan pink salmon, sacks of boneless, skinless chicken breasts, 5-lb. sacks of flavored EAS whey protein, the 160-tea bag box of Bigelow Green Tea, a 101-oz container of extra virgin olive oil, multi-can packs of Progresso Light or Healthy Choice soups, twin packs of V-8 vegetable juice, 32-quart mix cartons of Crystal Light, bagged walnuts or almonds, frozen berries, Brita water filter packs, and various vitamins and supplements.

Sam's Club still has a limited selection for dieting or health-conscious consumers. In many cases, items I frequently purchased are no longer carried or in stock e.g., a twin pack of Roman Meal Superseed bread, lavash flat breads, dried black beans, or a multi-pound bag of whole wheat pasta.  [In contrast, I used to shop at BJ's Wholesale Club, and they carried (at least at one point) ground buffalo and ostrich and multi-packs of sardines. It would be nice to see grass-fed meats carried, at least in limited quantities.] I would also like to see a wider variety of lower-calorie, lower-sodium, whole-grain, higher-fiber, lower-carb/lower-sugar and/or lower-fat units or packs of salad dressings, chili (e.g., turkey chili), nut butters, juices, snacks and other assorted grocery items.

Breakfast: Why I Think Marion Nestle is Wrong

Liz Wolegmuth of US News &; World Report published a post Wednesday entitled "What a 'Power' Breakfast Really Looks Like". Her subtitle succinctly defines the theme of the article: "The only sure thing is that there's no one breakfast route to success."

What I found particularly interesting is Ms. Wolegmuth's discussion of New York University nutrition program professor Marion Nestle, whom has written some widely cited popular nonfiction books, in particular What to Eat and Food Politics.

[I have not read these books and will reserve any substantive comment until I have reviewed them. But a brief reading of reader reviews online indicates that Dr. Nestle has rather conventional advice in terms of diet and exercise: eat less; exercise more; and eat more fruits and vegetables. She also is critical of the meat industry (in terms of energy-intensive production and inadequate regulation, e.g., questionable use of antibiotics) and the food industry in general, which has a vested interest in promoting the consumption of high-margin, questionable nutritious foods and drink (e.g., soft drinks and snack foods).

I will avoid any ideological judgments about industry management or value judgments regarding meat producers. I will say that the typical response, e.g., of the fast food industry, is that healthier offerings, e.g., McDonald's Big & Tasty burger, do not sell well. Indeed, there is much to be said about how customers flocked to the nutritionally appalling McGriddle. Still, McDonald's has discovered when it has smartly packaged and marketed more nutritionally virtuous premium salads, it dramatically increased sales with professional women, including talk show host Oprah Winfrey. I am also encouraged by steps to market milk (versus soda) and fruit slices in children's combo meals.]

Dr. Nestle says that she herself is rarely hungry when she gets up, and she doesn't believe it's a good idea for an adult to eat when he or she is not hungry; she will often opt for typical lunch fare around 11AM or so. Ms. Wolegmuth notes at the end of her articles that Dr. Nestle was startled by how many readers have responded emotionally to her simple defense of adults skipping breakfast during her book tour for What to Eat. [It really didn't surprise me that people react emotionally to deeply held beliefs about meals. A few years back I found myself personally attacked in a low-carb forum for advocating a more nutritionally balanced lower-carb lifestyle; this one mother argued that the ketogenic (high-fat) diet (very similar to the Atkins diet) worked for her epileptic child, and what I was doing, by venturing an opinion on diet and nutrition for healthy Americans (without special medical conditions, such as organ disease), was the logical equivalent of practicing medicine without a license.]

I do not like the idea of simply waiting until you're hungry or thirsty to eat or drink. I think that those urges are lagging indicators and inefficient (e.g., if your urine is darkly colored, you most likely have not had enough water or liquids to drink; if the signals were efficient, a person would always be properly hydrated and never have dark urine); I also note that there is often a lag before the brain gets the message that one has eaten enough, and hence one can eat more calories than are necessary for your own lifestyle (again, if the signals were fully efficient, a person would never eat more than he or she needs to eat).

In many cases, people have not eaten for 10 to 12 hours or longer when they get up; this contrasts with maybe a handful of hours between meals in a typical 3-meal day. I do grant that most people are sedentary during the evening and while sleeping, with metabolism not requiring as many calories to burn. Assuming it is important to eat (but to control how much one eats), what do you eat? I go in part to my referenced lower-carb background: protein and fats are essentially dietary components, and vitamins are water- or fat-soluble. Eggs are a wonderful, if not the most perfect food. Probably my favorite self-prepared meal is to scramble an egg, load in some vegetables (e.g., fresh mushroom and jalapeno peppers), cover it with a slice of nonfat cheese, put it in a low-carb, whole-wheat tortilla (e.g., La Tortilla Factory or Tumaro's Low in Carbs), covered with a generous helping of picante sauce. (Sometimes I'll sprinkle on some chia seeds or Garden of Life Super Seed.) I'll also look for a way to supplement my meal with foods containing soluble fiber (a departure from my lower-carb preferences), such as a serving of fresh berries in season. The reason I particularly focus on lower-glycemic/lower-carb foods is that fats promote a feeling of satiety and proteins (and whole-grains) tend to be more absorbed more slowly.

As I read through all the yuppie alternatives to a power breakfast in Wolgemuth's column, I identify most closely with Flickr cofounder Caterina Fake, whom eats eggs, cheese and toast and avoids carb-laden alternatives like pastries or cereal (which she feels dulls mental acuity).

I have not conducted scientific research in the area of nutrition, and I would often give deference to an expert in the field of nutrition, like Professor Nestle, as a matter of academic courtesy. But I think that the old saw about breakfast being the most important meal of the day is more than just an old wives' tale:

Breakfast is the most important meal of the day for everyone. Many studies have found a relationship between eating breakfast and learning ability, attention span, and general well-being. The American Dietetic Association (www.eatright.org) reports that adults who eat breakfast have an easier time losing weight. Children who regularly eat breakfast think faster, clearer, solve problems more easily, and are less likely to be irritable.

Breakfast is important for all ages, not just children. Other studies point to a connection between skipping breakfast with weight gain and memory impairment in young and older adults.