Be an Ingredient Label Sleuth!

What’s the first thing you look at when you pick up a packaged item in the grocery store?  Maybe you scout out calorie count or grams of saturated fat or carbs.  Or maybe you’re drawn to claims about heart healthiness or anti-oxidant richness.  While all of this can be helpful information, it can also make healthy shopping a bewildering task.  Do I prefer higher saturated fat if it means I get more protein?  Is it better to up my fiber or lower my carbs?  What is an antioxidant and why do I care if pomegranate is such a great source? 

In the spirit of simplifying the shopping experience, let me suggest that the far more important, perhaps the only important, information on the label is contained in the words that make up the ingredient list.  Unless of course you’re buying something with no label at all, in which case you’re already Very Healthy!

So, about this list.  Here are some general tips, and below some ingredients to avoid.

• The first question to ask yourself is how long it is.  Are there just a few ingredients (say 3-5), or does the ingredient list itself require a full “paragraph?”
• Can you pronounce everything on the list?  Could your grade schooler?  If not, think about whether that's something you really want to consume.
• Is the first word what you’d expect it to be based on what you think you're buying (e.g. whole wheat flour on your 100% whole wheat bread)?
• How close to the top of the list is sugar?  (Ingredients are listed in order of predominance, with ingredients used in the greatest amount listed first.)

Here are my quick rules of thumb on ingredients to avoid.  If you’re not already a label sleuth in the grocery store, give it a whirl next time you have a few extra minutes!  My guess is you might be surprised (maybe even disgusted) by what you see…

Artificial color or flavor.  You don’t need it, it’s that simple.  Generally speaking, if you see “natural flavor” on the label, that indicates the flavor is derived from natural (as opposed to synthetic or chemical) sources.  That’s better, but if you’re eating good and whole foods, they shouldn’t need any added flavor. 

Aspartame.  This is an artificial sweetener that has been the source of much controversy.  The FDA regards it as generally safe, but many others beg to differ.  Since 1997, various countries and some US states have introduced legislation to regulate or ban its use, and the debate rages on about whether or not it’s safe.  For me, much better to just avoid it.  Common culprits include yogurt, soft drinks, gum, puddings and “sugar free” items.

Hydrogenated or partially hydrogenated oils.  Luckily, most of the trans (hydrogenated) fats are largely gone from our food supply due to the overwhelming evidence of its links to coronary heart disease.  But I’ve been surprised in the grocery store more than once to see hydrogenated oils sneak into foods, even some touting health like vegan cream cheeses and several popular peanut butters, so make sure that if you’re buying a spread of any sort you’re reading that label!  (I say spreads because this type of oil was first introduced to make oils spreadable and more stable on the shelf - enter margarine - and that's where it's still most commonly found).

High Fructose Corn Syrup.  Of late, The Corn Refiners Association has put a lot marketing money into convincing the public “it’s just sugar” and “your body can’t tell the difference.”  You’ve probably seen the ads on TV.  I won’t get into the political debate but if you’re interested in an opinion that is not political in nature, but is thought provoking, watch this video which is a fascinating presentation by Robert Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology and decide for yourself.  Regardless, high fructose corn syrup, in my opinion, is at a minimum a marker of a highly processed food, and you can usually find plenty of alternatives.  BBQ sauce, salad dressing, condiments, and soft drinks are some of the places it shows up, but it’s become rather ubiquitous.  See right where it shows up in "healthy" bread and big name ketchup.

MSG and its variants.  Many of us remember when Chinese restaurants starting banning the use of MSG.  That was because it’s known to cause reactions like migraine headaches, upset stomach, heart irregularities, and asthma.  But did you know MSG goes by many other names?  Well, technically, the processed free glutamic acid that causes these reactions goes by other names, but the outcome (side effects) is the same.  I was saddened to learn that one of the broths I formerly used contained MSG, but it wasn’t called “monosodium glutamate” on the label, it was called something else.  Look for glutamic acid, monopotassium glutamate, yeast extract, anything “hydrolyzed,” and autolyzed yeast, and avoid products that contain them.

Enriched flour.  We generally think of “enrichment” as a good thing.  In the case of these flours, typically found in breads and other grains, the health profile is actually worse than it is in whole, unrefined (e.g. not enriched) grains.  The grain refining process makes products more stable on the shelf, which is why food manufacturers like it.  To compensate for the fact that this refinement strips away many vital nutrients, enriched grains are then "fortified" with iron, B and some other vitamins.  But they remain higher on the Glycemic index, which means they quickly raise blood sugar (a bad thing, especially for diabetics), and they never get back the fiber they lost.  A later post will discuss the critical nature of fiber.  Look for “whole wheat” or “whole whatever grain” and skip the enriched!

For more tips, I recommend Michael Pollan's "Food Rules".  It’s a quick read, a good laugh, and a great reminder to eat real food. 

Valentine’s Day chocolate: why you should spend more and eat less.

Whether you love Valentine’s Day or prefer it go back to Hallmark for good, it’s a day during which chocolate is likely to cross your mind.  So when it does, I want you to go there.  Go there, fully into the realm of chocolate, and then get yourself some!  But just one piece please, and make it a good one...

If you saw my post on brownies and ice cream then you know some of the health benefits of real chocolate.  Raw, unprocessed, nothing-added cocoa powder is an incredibly powerful antioxidant.  Even though you already know, let’s quickly recap what antioxidants are and why we care.  I like the NIH's explanation for its simplicity so I’m quoting it directly: “Antioxidants are substances that may protect your cells against the effects of free radicals. Free radicals are molecules produced when your body breaks down food, or by environmental exposures like tobacco smoke and radiation. Free radicals can damage cells, and may play a role in heart disease, cancer and other diseases.”  Antioxidant substances include: beta-carotene, lutein, lycopene, selenium, and vitamins A, C and E.

As is often the case, I feel that it is best to get antioxidants from food, not supplements.  It’s easy to do because antioxidants are abundant in fruits, vegetables, green tea, nuts, grains, chocolate, and even coffee, so you have plenty of delicious options for getting them every single day.

So, back to chocolate.  My husband and I decided to limit our Valentine’s Day spent to $10 each this year.  With that limit in mind, I hit the Ferry Building in San Francisco, which is full of local shops and eateries, to select some quality chocolate.  $17 later, I caught myself wondering whether I should have just bought the Reese’s.  But no, I should not have.  The key to eating chocolate is, according to me, spend more and eat less! 

Shopping Tip:  When you’re out shopping in health food stores, look for bars that are 70% or higher dark chocolate.  Most, but not all, will have sugar.  Besides the chocolate, other ingredients you might see that you can feel good about are cocoa butter, nuts, sea salt, vanilla, and some maybe some natural flavors if you trust the company (but never artificial colors or flavors!)

I feel somewhat badly doing this because I used to love these little guys, but for comparison purposes, let’s have a look at the ingredients in a Snickers bar: milk chocolate (sugar, cocoa butter, chocolate, lactose, skim milk, milk fat, soy lecithin (see disclaimer below), artificial flavor (eek!)), peanuts, corn syrup (why?), sugar, skim milk, butter milkfat, partially hydrogenated (eek!) soybean oil, lactose, salt, egg whites (huh?), and artificial flavor (eek!)…

Very healthy:

• One Lucky Duck – raw, vegan, organic, really really really expensive but you’ll feel justified.  WARNING: they don’t add sugar, so this is pure, unadulterated cocoa…it’s bitter, not sweet, and it’ll knock your socks off.
• Skout Trailbars - organic Chocolate-Peanut Butter.  Impeccable ingredient list.  Go.  Eat one.  That is all.
• Dip fruit in chocolate – go back to the ice cream recipe, make it but don’t freeze it, and then use it as a drizzle over fresh fruit!  You can always feel good about homemade treats, and when they're delicious it's that much more gratifying.

Almost healthy (for those who just can’t kick it with bitter):

• Bug Bites - organic, small, and have a cute little bug factoids on each wrapper 
• Garden of Life – chocolate raspberry greens bar.  These are amazing, and packed with greens and probiotics to boot, but they’re down here in “almost healthy” because the first ingredient listed is honey. 

  Disclaimer: I can't fully endorse eating most chocolate bars on any regular basis.  That is in part because most of them contain sugar, but most also contain soy lecithin, which is an emulsifier that helps hold the bar together.  As is the case on many topics I discuss in this blog, the jury is out on whether soy lecithin is bad for us or not, but I don't think it's doing us any good either.  That all being said, I can and do fully endorse LIVING LIFE to the fullest, and if that for you includes eating chocolate on Valentine's Day, then by all means do so, just follow some of the tips above to make sure you're helping, not harming, your body during your indulgence! 

The Sun and Vitamin D.

You may already know that Vitamin D is important for bone health.  If you follow health news, then you’ve also heard a lot lately about the many other benefits that touch health concerns ranging from asthma to cancer.  But did you know that despite all of these benefits, most Americans are deficient in Vitamin D? 

Vitamin D 101:

Vitamin D helps the body absorb calcium from food, so we’ve long known its association with bone strength and osteoporosis.  But today we know a lot more about the benefits of Vitamin D, and they are vast.  It’s now associated with lower risk of heart disease, high blood pressure, diabetes, and cancer.  It’s also showing promise in preventing or curing Crohn’s disease, in improved memory function and potentially in decreasing the risk of heart attack and stroke.  For a full fact sheet from the NIH, click here.

We are a deficient nation

The Recommended Daily Allowance (RDA) for children and adults is currently 600 IUs of vitamin D per day, though I’ve heard talk of that recommendation increasing which I think would be great.  Nevertheless, let's assume that's the right number.  By that standard, 60-75% of Americans are Vitamin D deficient.  Recently, a study showed that for trauma patients with broken bones or fractures, that number reaches 77%.  

 

One of the leading hypotheses on the reason for our deficiencies is our obsession with sunscreen.  We have done a great job reducing skin cancer risk, but we’ve inadvertently “protected” ourselves from the essential rays of the sun that allow our own bodies to create vitamin D.  In fact, sun light is our primary source of the vitamin!  To learn more about how sunlight is used in your body to create vitamin D, click here.

So what do we do now??

Easy Tips to Protect Yourself:

1. Eat food that contains Vitamin D.

As with any vitamin, I think it’s best to get all you can from food as opposed to supplements.  For vitamin D, the best sources are fatty fish (think salmon, tuna), but mushrooms, beef liver, cheese, egg yolks and several others also contain small amounts.  See the table below for more foods that contain vitamin D.  If you've read my other posts, you know I would not vote for the dairy sources of food to get your vitamin.  Why not dress up your eggs with leafy greens for breakfast?  One of our favorites!

2. Take a high quality supplement.

You'll notice as you peruse the table below that it's VERY hard to get enough vitamin D from food alone unless of course cod liver oil is your weakness, in which case, drink on, brave soul!  If you also live in a place where you don’t get year round sun (man, that’d be nice), then you probably need to take a supplement.  Some multi-vitamins now have 1000 IUs of vitamin D, which is great.  Otherwise, you can pick up a high quality Vitamin D3 supplement from your local store.  Try to take it with food that contains fat (olive oil, eggs, nuts, etc) since it is a fat soluble vitamin and doing so will help you absorb more.  

3.  Get some sun!

The guideline is to get 15-20 minutes of direct sun exposure every day if you can to help ensure you reap all of the health benefits discussed above.  It's hard in places with very long winters to get that much direct sun exposure, so supplementing is especially important in winter months.  If you live in a place with year-round sun, then direct sunlight will give you all you need - no supplementing for you! But remember, after you get your 15-20, go inside and apply sunblock.  

4. Talk to your doctor.

Vitamin D levels can easily be tested in your blood.   Simply ask your doctor to run the test for you.  This is especially important if you’re older, or at a higher risk of bone fracture.  If you are deficient, your doctor will likely prescribe you a high dose (e.g. 50,000 IU) supplement to take weekly for a month and you’ll be back to good in no time!  Just remember to keep supplementing with normal doses (or food, sunlight) after that.

Table from the National Institutes of Health:  Selected Food Sources of Vitamin D
Food	IUs per serving*	Percent DV**
Cod liver oil, 1 tablespoon	1,360	340
Swordfish, cooked, 3 ounces	566	142
Salmon (sockeye), cooked, 3 ounces	447	112
Tuna fish, canned in water, drained, 3 ounces	154	39
Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies)	137	34
Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup	115-124	29-31
Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV)	80	20
Margarine, fortified, 1 tablespoon	60	15
Sardines, canned in oil, drained, 2 sardines	46	12
Liver, beef, cooked, 3 ounces	42	11
Egg, 1 large (vitamin D is found in yolk)	41	10
Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV)	40	10
Cheese, Swiss, 1 ounce	6	2

* IUs = International Units.

** DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration to help consumers compare the nutrient contents among products within the context of a total daily diet. The DV for vitamin D is currently set at 400 IU for adults and children age 4 and older. Food labels, however, are not required to list vitamin D content unless a food has been fortified with this nutrient. Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet.

Source: http://ods.od.nih.gov/factsheets/vitamind/