How do we make healthy eating cool? Image courtesy of f_mafra.

People who immigrate to the United States from traditionally healthy cultures usually develop Western disease patterns within one or two generations. Since genetic changes cannot occur this rapidly, environmental factors, particularly diet, are considered to be primary the reason for the shift.

While it has been proposed that dietary changes are the result of having access to less healthy foods, new research suggests that poor food choices are often made not from preference but from pressure to fit in as an American.

In a new study to be published in the upcoming issue of Psychological Science, researchers from Stanford and UC Berkeley explored the eating choices made by Asian-American and white college students when put in situations that threaten their American identity.

The first part of the experiment asked students to write down their favorite foods, but first prefaced some of the students with the question, "Do you speak English?" All the students could speak fluent English, but of the Asian-American students that were asked the question 75% included a stereotypical American food in their food preferences, compared to 25% who had not been asked the question. There was no difference in preferences of white students with or without the question.

To test if cultural pressure affects eating habits directly, researchers performed a similar experiment but offered students dishes from typical American and Asian restaurants. Before the experiment, however, some students were told, "Actually, you have to be American to be in this experiment."

Asian-American students who were asked the question were more likely to choose the American food options than the students who were not asked the question. Subsequently their choices were less healthy and they ate an extra 182 calories in the meal.

Attitudes about food and social pressure can greatly impact eating habits, and this study is consistent previous findings that overweight people tend to have overweight friends. Bad eating habits aren't just individual choices, but reflect societal pressures and group psychology.

But the question remains, how do we make healthy eating cool?

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Shifting focus toward healthy habits and away from body size may be a more effective strategy for long-term health, but fat loss may still be a worthwhile target. Image courtesy of Kyle May.

The number one public health message today, as seen in the recent announcement of the new USDA Dietary Guidelines, is that we all need to lose weight. But a new review published in Nutrition Journal suggests that this message may be doing more harm than good.

Co-authors Linda Bacon, an associate nutritionist in the UC Davis Department of Nutrition, and Lucy Aphramor, an NHS specialist dietician and honorary research fellow at the Applied Research Center in Health and Lifestyle Interventions at Coventry University in England, argue that most of the assumptions made about the link between body fat and health are not substantiated, and that a more effective approach would be to emphasize healthy habits focused less on body weight.

“The weight-focused approach does not, in the long run, produce thinner, healthier bodies,” Bacon said in a press release. She suggests that while overweight and obesity are often linked to poor health outcomes, these ties are not as strong as most people assume and that the evidence suggests underlying bad habits cause both disease and weight gain. If this is the case, body fat itself may not be a cause but a symptom of poor health, and therefore targeting weight loss specifically may not be beneficial.

The authors note that evidence indicates that long-term weight loss is very difficult and often impossible to achieve for most people. They also point out that removing body fat without a change in lifestyle, as in cases of liposuction, create no measurable health benefits. Moreover, a focus on body weight instead of health changes can often lead to both physical and psychological problems.

“It's the unintended negative consequences that are particularly troubling, including guilt, anxiety, preoccupation with food and body shape, repeated cycles of weight loss and gain, reduced self esteem, eating disorders and weight discrimination,” says Aphramor.

The authors suggest that focusing on health instead of body weight does occasionally lead to a drop on the scale, but that health benefits are measurable even if no weight loss is achieved. They cite improvements in blood pressure, lipid profiles, self-esteem, body images and other markers of well-being. However there was no mention of diseases that are not tied to metabolism and cardiovascular health. Breast cancer, for example, is known to correlate with body size and is thought to be caused by the extra estrogen produced in fat cells.

It makes intuitive sense that shifting focus toward healthy habits and away from body size would be a more effective strategy for long-term health, but fat loss (rather than weight loss) may still be a worthwhile target.

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Sugar consumption among adolescents has nearly doubled since the 1970s. Image courtesy of e³°°°.

Early signs of heart disease are reaching kids at younger ages every year. A new study published by the American Heart Association's journal, Circulation, suggests that added sugars may be the reason.

The study examined data from almost 2,500 adolescents ages 12 to 18 from the National Health and Nutrition Examination Survey (NHANES). Dietary questionnaires were used to divide the participants into 6 groups based on the percentage of calories from added sugar.

There were no differences in the amount of added sugar consumed among any demographic factors including age, gender, ethnicity, income or education level. Likewise, there were no differences between the amount of added sugars and physical activity or total calories. Higher sugar intake was therefore associated with less protein and, notably, less fat consumption.

The more sugar participants ate, the worse their blood lipid profiles. Healthy HDL cholesterol was significantly lower in those who ate the most sugar compared to those who ate the least. However, triglycerides and LDL cholesterol were both approximately 10% higher in those who consumed the most sugar.

Lipid profiles did not correlate with body weight, meaning high sugar intake was just as unhealthy for the slim kids as for the overweight kids. However, body weight did correlate with measures of insulin resistance, and in these cases high sugar intake was more dangerous for the overweight participants.

In 1986, the Sugar Task Force of the US Food and Drug Administration estimated that from 1977-1978 average sugar consumption among adolescents was between 62-84 g per day. In the current study, which measured data from 1999-2004, daily sugar intake increased to 119 g. Interestingly, the 1986 Sugar Task Force had concluded that sugar did not have an effect on heart disease risk.

UCSF pediatric endocrinologist Dr. Robert Lustig told CBS San Francisco, “Children are already showing signs of cardiovascular disease even during puberty.”

Lustig went on to say that “if nothing is done then we can expect an entire generation of cardiac cripples by the time they're 40.”

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In America, it has taken several documentaries, books and expert nutritional advice to help me choose healthy food – unlike cheeseburgers – to enjoy.

I just finished reading Omnivore’s Dilemma. It mysteriously appeared on my desk a few months ago; someone who still is anonymous thought I should read it. I remember my friends singing it praises a year ago and now I can see why. It also cleared up a confusion I had about some weight loss in England. When I was twenty-two, I lived in England for a year. I only changed one thing in my diet when I went abroad; I ate multi-grain bread instead of white. Yet I dropped two dress sizes all the while enjoying pints and chips covered in malt vinegar and wrapped in newspaper. Until this day, it was always a mystery to me how I could have lost weight on English fare.

But American fare and our way of eating is much more insidious. Corn is in everything manufactured. I didn’t believe this assertion in Omnivore’s Dilemma until I started reading labels. It’s in pasta, soda, yogurt and even ketchup. Surplus corn is synthesized into a variety of ingredients; for example high fructose corn syrup sweetens almost every soda and corn is synthesized into emulsifiers found in an assortment of frozen foods. We also do not have a culture of food, like the English, French, or Greeks. In England, Sunday constituted a big Sunday dinner. Either my flat mate or myself would cook and we would cook for about twenty friends. It was social, leisurely and incredibly enjoyable. Looking back on the year, we didn’t eat out very often. There were many shared dinners and meals were hardly ever rushed. I found it odd at the time but every meal and social engagement included some sort of tea. Even stranger, eggs and milk were left in the cupboard rather than fridge and people shopped on a daily rather than weekly basis. Canned and processed food did not list undistinguishable ingredients. I was tickled to find out that chocolate contained cacao, sugar and cream rather than the incomprehensible list of things found in Hershey bar.

It seemed the reason I lost weight in England was lack of highly processed corn in my diet. Since the weight came back fairly readily when I returned, it seemed the most obvious culprit. It wasn’t just Omnivore’s Dilemma that has educated me and made me a fan of European food and eating habits. Reading Superfoods has made me familiar with fourteen foods that can boost health. Watching the documentaries, Food Inc. and Obesity in America cemented in my mind that food doesn’t fit neatly into an industrialized or global definition. It is best when local. I have seen family members get diagnosed with diabetes and cancer; these ailments have always been coupled red flags in their food choices. I have also gone back to reading Andrew Weil and agreeing with him about his caveat that health is intimately linked to nutrition. My first time heralding this claim was when I changed my food in college. I was diagnosed with ADD at sixteen. In college, I went off meds and cut out simple sugars and carbohydrates in my diet. My ADD actually improved dramatically with the dietary change.

So my food has changed once again in response to my research on the normal American diet. I started shopping at farmer’s markets rather than Safeway. I buy fruits and vegetables in season that are locally grown. I look at ingredients, if there is more than five I put it back on the shelf. I look for meat and eggs that haven’t come off an assembly line or are corn fed but rather comes from a local farm. What’s so funny is when I was in England, this is exactly how I shopped but I didn’t know it at the time. In America, it has taken several documentaries, books and expert nutritional advice to help me choose food healthy enough to enjoy. But the experience has opened me up to a world of taste and enjoyment that was seriously lacking in the processed food I used to eat.

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For most of us, avoiding these is just as important as the genes we inherit.

As someone who studies genes, I tend to give the environment short shrift. I have to watch out for that because it can cause a blind spot in how I think about biology. And how I live my life.

As readers of this blog might remember, I was recently diagnosed with metabolic syndrome just as I was undergoing DNA testing. This was a wake up call in a couple of different ways.

First off, it confirmed my belief that we can’t get a lot out of genetic testing for complicated diseases right now. I couldn’t look at my DNA and predict that I would end up with high cholesterol, triglycerides and glucose levels. We just don’t know enough yet about our genes to be able to figure this out from any available DNA test.

But I could have guessed this might be a problem from my lifestyle and family history. All four of my grandparents developed Type 2 diabetes which put me at a pretty high risk. Of course I thought I could beat the odds and so lived a life filled with couch sitting, Haagen Dazs, and Double Western Bacon Cheeseburgers (cue Homer Simpson drool). Until my diagnosis.

Then I decided to see if all this talk of diet and exercise actually can have a significant impact on me. Or was I destined to high cholesterol, triglycerides and glucose levels because of the genes I got from my parents.

The doctor told me to lose weight, exercise more and eat better. So I did.

I lost 30 pounds by changing my diet and walking 30 minutes a day. This dropped my body mass index (BMI) from overweight (27.8) to normal (23.5).

I also stopped eating most sweets, and cut my saturated fats down to 15 grams per day. And the effects on my blood work have been amazing.

Here are a few of the stats:

As you can see, everything is now in the normal range except for glucose which is still a bit worrisome. Now I just need to maintain this regimen which, in America, won’t be easy.

I probably panicked and went overboard anyway. I should have tried to just add exercise and see if that was good enough. If not, then cut back on sweets and saturated fats. I did bad science on myself by changing too many variables at once.

I think what I can conclude is that my set of genes makes me particularly susceptible to my lifestyle choices. Some lucky people are born with genes that let them get away with poor diet and no exercise.

I am not one of those lucky ones. Although perhaps more lucky than those people who make these changes and still have these health issues.

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Bring it on! A healthy dose of epicatechin, serotonin, caffeine, theobromine, phenylethylamine, and polyphenols

As seen in our QUEST story, "The Sweet Science of Chocolate," UCSF’s Mary Engler conducted a clinical trial that showed that a plant-based flavonoid, epicatechin, helped to promote healthy blood flow in healthy patients.

Other researchers in the late ‘90’s, such as Adam Drenowski at the University of Washington, found that chocolate helps trigger the release of endorphins, while Daniele Piomelli of UC Irvine, conducted research on cannabinoids found in chocolate.

And recent research suggested that chocolate could even be good for your memory. There are other compounds present in chocolate which may have beneficial effects on your mind and body, such as serotonin, caffeine, theobromine, phenylethylamine, and polyphenols. Who knows what future chocolate research may yield, but in the meantime– no joke here– you might even be pumping chocolate-based fuels into your gas tank!

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