Archive for the ‘Obesity’ Category

Can a Simple Image Guide Good Nutrition?

Tuesday, June 7th, 2011

Image from

Last week, the USDA unveiled the new MyPlate image to replace the outdated food pyramid. When I first saw the new image, I felt a welcome relief at the simplicity of this concept. The plate seemed like the iPhone of the nutrition world. Simply and intuitively designed – replacing a complex chart of recommendations with something that even a busy person could use in their every day lives.

As an individual and as a parent, I have worked hard for the last 5 or more years to dramatically change the buying and eating habits in our household. We buy most of our food, at least during the months from May until November, at the farmer’s markets around town. We try to buy most of our meat, eggs and dairy products from local farms. For the food that we purchase from the supermarket or from restaurants, I make a conscious effort to buy mostly real foods that are not full of preservatives, additives or other unidentifiable ingredients. Despite these efforts, it can still be a challenge to make sure that my meals are nutritionally well rounded.

My favorite feature of the new design MyPlate is that it is accessible even to the youngest children. Most people in this country eat their meals off plates, or at least are familiar with them. The idea of how much food to put on the plate and in what proportions resonates with me. Perhaps this image will also have the secondary effect of acting as a wake-up call to any Americans who are currently eating their meals primarily on the go, in their cars, or as undefined snacks constantly throughout the day (“grazing” as my father used to call it in our house).

Secondary Benefit of the Plate Image? Perhaps People will Focus on Sitting Down to Meals

To me, the take home message in the new image is that the healthiest option is to eat real meals, sitting down, preferably with others. These meals should be loaded with vegetables and fruits, with the addition of grains and protein. I suspect that the new USDA plate does not look like the plates of most Americans today at the average meal. Many, myself included most of the time, eat meals with more grains or proteins covering the plate than vegetables or fruits most of the time. However, this seems like a very achievable change to make. As long as we can help people get access to vegetables and fruits (outside the scope of this post – but there have been plenty of things written about how much easier it is in this country to get cheap meats and carbs than fresh fruits and veggies), then it seems simple with this guide to adjust your plate to be half covered in vegetables and fruits each meal.

Easy Enough for Kids and Busy Parents

Image from

The other reason I like this image, besides its simplicity, is that it is easy. A child could easily use this as a template to fill their plate. Moreover, there are already a ton of children’s plates on the market that are easily divided…perhaps there should be similar plates for adults – I suspect someone is marketing this as I type. In case you were worried, someone has already developed the “Bacon My Plate” items. But, the point is that if you are a harried parent in today’s busy world, you may be searching for easy healthy foods for your kids. Well, perhaps the answer is here, just make sure that you fill the plate according to the guidelines and voila – dinner is ready.

Entire USDA MyPlate Website Devoted to Tips and Tools

What is less obvious from the media coverage in the last few days about the USDA MyPlate announcement is that the recommendations are not just in the image. The USDA has created a complete website and brochure that detail the recommendations much more thoroughly.  It also includes a number of interactive tools that help you evaluate the food group, calories and other details about particular foods. There are tools to help you plan meals, specific recommendations for toddlers and pregnant/nursing moms, advice for weight loss and other tips. A few of the other tips from the USDA brochure that I found especially important:

  • Make half your plate fruits and vegetables
  • Eat red, orange, and dark-green vegetables
  • Eat fruit, vegetables or unsalted nuts as snacks – they are nature’s original fast foods.
  • Switch to skim or 1% milk.
  • Make at least half your grains whole.
  • Vary your protein food choices.
  • Twice a week, make seafood the protein on your plate.
  • Use a smaller plate, bowl, and glass.
  • Stop eating when you are satisfied, not full.
  • Keep physically active.

These are just a few of the recommendations that accompany the new MyPlate image. There are lots more details available online. One of the recommendations that I was given when my son was a baby, just learning to eat finger foods, was to provide him with a rainbow of foods. Again, I think that the image works! If you feed your children (and yourself) a variety of different colored foods (and I am talking natural colors – think cherries, oranges, yellow peppers, spinach, blueberries, eggplant – not artificial colors…not fruit loops) throughout the day and week, you will provide a natural array of different vitamins and minerals without having to worry about reading labels.


What are your tips for healthy eating? Do you like this new image? Do you think that it will make any impact on the obesity crisis?

Related Posts:

Does Nutrition Info on Fast-Food Menus Really Make a “Choice” Difference?

Decreasing Obesity Risks in Children: Another Benefit of Breastfeeding

Can Religion Make You Fat?

Can religion make you fat?

Friday, April 1st, 2011

Last week this blog addressed the issue of obesity and the possibility that it could be reduced with breastfeeding. Continuing with the topic of obesity, there is a recent study put out by the American Heart Association (and reported by Medical News Today) that is sure to stir up some controversy. The authors of that study claim there is a link between religious activities during young adulthood and obesity later on in life.  While I am usually reluctant to belittle medical research, this study really has me scratching my head and asking, “Who cares?” Before anyone decides to skip church this weekend, let’s look at the details of the study.

The study was actually a long-term study with a high number of participants, which generally tends to give clearer answers than short-term studies with fewer participants:

The study, involving 32,433 individuals from the longitudinal CARDIA (Coronary Artery Risk Development in Young Adults), aged from 20 to 32 years initially, were monitored for 18 years.

However, even with a high number of participants, I am very leery of the results of this study and what it has to do with our health. In terms of what the study found, the authors claim that “those who attended at least one religious event per week had almost twice the risk of becoming obese between early adulthood and middle age compared to those who had no religious commitments.” As everyone knows, obesity is just one factor that can impact a person’s overall health and life expectancy. As the authors of the study recognize, there are a number of factors that can influence heart health – blood pressure, obesity, smoking status, diabetes, high cholesterol. Obesity was the only factor that appeared to be linked to religious activity. The other factors did not appear to have any link.

Why just obesity? It is impossible to answer. Personally, I have a difficult time understanding any possible link between religious activities and obesity, and the study does not actually answer the question of what it is about religious services that may lead to obesity. They theorize that perhaps church activities tend to be more sedentary (more so than watching television or playing computer games?) or that perhaps it is the church get-togethers that have an abundance of fatty foods. However, sedentary activities and poor food choices permeate our entire society and are not restricted to religious people. So why would religious activity be associated with obesity? The authors don’t say, which leaves a gaping hole on the question of what are we supposed to do with this information. Are the authors suggesting it would be healthier to skip that once-a-week church event?

Recognizing that the study’s claim could be construed that church is causing people to get fat, the authors point out that overall, religious people are quite healthy (is anyone surprised?). Furthermore, the authors don’t actually advocate skipping church to lose weight.

The investigators stress that their study does not prove in any way that going to church, attending mass or other religious services makes you fat.

If that’s the case, then I wonder what is the purpose of reporting the study. Usually a medical study into an aspect of health will carry some recommendation of a behavioral change, e.g., avoid saturated fats, get more Vitamin D, etc. With this religion study, there is no recommendation for a change in behavior and there is no explanation for why religious activity would be problematic in terms of health. So all we’re left with is a possible statistical association with no answers as to why and no call for a change in behavior. Which takes me back to my original thought — who cares? If a study has no answers and no recommendations, then perhaps the study didn’t need to see the light of day.

I would also point out that other studies have looked at the link between religion and health and found that regular religious activity actually improves health and leads to longer life expectancy. However, that study also could not explain the specific reasons for its conclusions. Such studies are notoriously difficult to conduct because they are observational only rather than studies where the researchers can control external factors. There are so many factors that go into one’s overall health that it is difficult to single out any one activity as being blame-worthy, especially one as nebulous as attending a church activity once per week.

One encouraging — if simplistic — aspect of the study is that it may cause some churches to include a message of nutrition and exercise for their congregation. But did we really need a long-term study with thousands of participants to tell us that? We should all eat better and exercise more, regardless of our religious affiliation or preferences.

I would be curious to hear from our readers whether they think this claim has any merit or not, and what the reason for the alleged link may be. And the choir said, Amen! What say you?


Decreasing Obesity Risks in Children: Another Benefit of Breastfeeding

Friday, March 25th, 2011

Image from

In the United States today, one of the major health problems is obesity. The CDC reports that “[i]n 2009, only Colorado and the District of Columbia had a prevalence of obesity less than 20%.”  The number of both adults and children who are obese is huge and continues to rise dramatically.  The CDC website provides maps that show just how prevalent this problem is in our country. Particularly troubling is that “[t]hirty-three states had a prevalence equal to or greater than 25%; nine of these states (Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, and West Virginia) had a prevalence of obesity equal to or greater than 30%).  This represents an enormous number of people in our country who are at risk for major health complications, such as “cardiovascular disease, certain types of cancer, and type 2 diabetes.”

While there has been an emphasis in our country on various ways to decrease these obesity statistics (including improving nutrition and increasing exercise), I wonder whether additional emphasis should be paid to children being given a great start to health. A recent article in the Baltimore Sun caught my attention. The article explains how diabetic moms, including those who had gestational diabetes during pregnancy but are not otherwise diabetic, are both more likely to give birth to a larger than average baby and also how their child is “more likely to become obese in childhood.”  The good news, the article explains, is that:

…a new study says that if you breastfeed your baby for at least six months, your child will be no more likely to put on weight than those whose moms are not diabetic.

This is just one more example of how breastfeeding for at least six months can dramatically improve your child’s chances of lifelong health.  Through breastfeeding alone, these moms can erase the increased risk that these children will become obese.

What they found appears to be a real advantage for breastfeeding: If the babies had been breastfed for six months or more, children born to diabetic moms looked nearly the same as the children of non-diabetic moms. And they were no more likely to be obese.

On the other hand, children who were breastfed for less than six months — and who had been exposed to diabetes in the womb — had significantly higher BMIs, thicker waists and stored more fat around their midsections than the other children in the study.

While I was excited to read about one more reason to support breastfeeding, I was concerned about whether this is a realistic choice for many families in our country.  Many moms who are committed to breastfeeding their children and who are successful at the start, do not continue breastfeeding for at least six months. The CDC Breastfeeding Report Card for 2010 says that “…3 out of every 4 new mothers in the United States now starts out breastfeeding… However, rates of breastfeeding at 6 and 12 months as well as rates of exclusive breastfeeding at 3 and 6 months remain stagnant and low.”  The national average is that while 75% of moms have breastfed, only 43% are breastfeeding at all at 6 months and only a mere 13.3% are exclusively breastfeeding at 6 months.  At 3 months, a time when infants would not have started solid food, only 33% of moms are still exclusively breastfeeding.  This means that there is a large drop off from what moms do when their babies are born and what they are doing by the time their babies reach 3 months.

However, the study about diabetes found that at least six months of breastfeeding was essential in protecting these kids from the increased risks of obesity. From both personal experience and anecdotal evidence, I suspect that many families are facing hard decisions about employment and breastfeeding. I suspect that a significant part of the large drop off between the numbers of moms’ breastfeeding at birth and those breastfeeding exclusively at 3 months has to do with employment. Given that the US lags so far behind other countries in paid parental leave, most moms have no choice but to go back to work full-time by the time their infants are 3 months (if not earlier).  Many moms face no choice at that point but to stop or severely limit breastfeeding, as few employers offer the time, space or scheduling to truly make moms successful at the difficult job of trying to pump while working.

I believe that the health care costs of treating individuals with obesity and all of the associated health problems should be examined against the costs of providing more complete support to new families.  What do you think?  Could employers better support breastfeeding in an attempt to increase the number of healthy children whose risks of obesity are lowered? Do you think that lack of paid leave or increased support in the workplace for breastfeeding is really the reason for decreased breastfeeding or are there other factors at play?



Lap-Band (Weight Loss) Surgery: is it for you? FDA clears new Allergan system and opens door to more patients

Monday, February 21st, 2011

The FDA recently approved Allergan’s Lap-Band weight loss surgery (which is a form of what is known as bariatric surgery). By its 8-2 vote, the FDA cleared the way for patients who are significantly less obese (BMI of 30) than those who would have qualified for weight loss surgery before this recent approval.

Knowing that this controversial clearance vote was on the horizon, major news networks aired stories on the pro’s and con’s of “broadening the base” of patients, who would now qualify. Here’s a report by ABC News’ Diane Sawyer in December 2010. (Sorry about the lead-in ad. If it were not a good report, I would have found something “ad-less” to present the issue!)

With the FDA’s announcement came somewhat of a firestorm of criticism. As reported locally in the Baltimore Sun (actually written by Thomas H. Maugh II of the Los Angeles Times), the approval has raised “concerns” by many in the medical community, who fear that this surgery will now be seen as a “quick fix” to the obesity plague in this country.

“I’m very concerned,” said Dr. Ted Khalili, former director of bariatric surgery at Cedars-Sinai hospital and founder of the Khalili Center for Bariatric Care in Beverly Hills. “You can’t be driving down a street and have a flashbulb go off and think that this will be an easy fix.”

What Dr. Khalili seems to be referring to is a marketing drive that directs patients to clinics that perform the procedure using the Allergan device. Here’s (to the right) a photo that shows exactly what this is all about.

Patient deaths following procedure lead to litigation in California

Maugh reports in his piece in the LA Times that four patients have died following the Allergan lap-band procedure. Lawsuits have followed. In a related article by another Los Angeles Times reporter, some details emerge.

Laura Faitro of Simi Valley died July 26, 2010, five days after surgery at Valley Surgical Center in West Hills. Three other patients have died shortly after surgery at an associated center in Beverly Hills, relatives have alleged in lawsuits and interviews.

Supporters speak out as well

While there are many who have decried the FDA’s approval and the lowering of the qualification standards to undergo this new lap-band procedure, there are certainly those who are in support of its potential therapeutic effects:

For those with Type 2 diabetes, the Lap-Band could be an immediate fix. “This operation takes about an hour, and two days in the hospital, and these people go off their diabetes medication. It’s unbelievable,” Dr. Walter J. Pories, a professor of surgery at East Carolina University and a leading researcher on weight-loss surgery, said in this L.A. Times report.

All surgery – including this new lap-band procedure – has significant risks

Whether one should consider taking advantage of this new procedure is a matter between the patient and his/her surgeon. After advising that not all risks or complications of undergoing this new procedure are listed in its website overview, the product’s manufacturer, Allergan, provides the following information:

Placement of the LAP-BAND® System is major surgery and, as with any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient’s ability to tolerate a foreign object implanted in the body.

Band slippage, erosion and deflation, obstruction of the stomach, dilation of the esophagus, infection, or nausea and vomiting may occur. Reoperation may be required.

Rapid weight loss may result in complications that may require additional surgery. Deflation of the band may alleviate excessively rapid weight loss or esophageal dilation.

While many people seem to be intrigued by a “quick fix” surgical method of weight loss, some necessary clearance hurdles stand in the way – and should! Allergan is requiring all surgeons who want to order and perform surgery with the manufacturer’s new device “to first complete a comprehensive proctorship and training program, have advanced laparoscopic skills and (we believe this is key) have the staff and resources needed to comply with the long-term follow-up requirements of obesity procedures.”

I would add here that in our experience of handling lawsuits involving catastrophic injuries and death claims following bariatric procedures, issues relating to selection of proper surgical candidates and post-procedure follow-up and compliance have many times been at the core of these cases.

Not a “quick fix” replacement for exercise, diet and possible medication

As anyone who has been involved in any manner with issues relating to bariatric, weight-loss surgery, this is not the first step to be taken toward losing weight. Sure, it sounds enticing to go into a clinic or hospital, have a one hour procedure, and all your weight issues are a thing of the past. First of all, that is not how this works at all. Pre-procedure clearance does and must be taken seriously and not be a mere sham.

There is no doubt that there is a financial benefit for the providers of this procedure; it is reported that it will cost approximately $25,000 for the device, surgeon and operating room costs. It is also said that many insurance policies may cover all or part of this cost. That being said, even Allergan cautions that this is not a drive-by way to achieve weight loss. Read its Lap-Band System Fact Sheet and Lap-Band Labeling and Safety Information if you are interested in knowing more about the indications, alternatives, risks, benefits and advantages of this newly approved system. In addition, make certain that the surgeon you are consulting meets the qualifying standards of the manufacturer. Ask questions – it’s your body, your life.

As a side note, in case you are wondering if your BMI qualifies you for consideration of this procedure, here’s a handy BMI calculator made available online by the National Heart Blood Lung Institute – Calculate your BMI.

Know anyone who has had this or other forms of weight loss surgery?

If you or someone you know has undergone a procedure involving this new device by Allergan, share your story with our readers. If you or someone you know has undergone bariatric surgery, we also invite you to please share your story of how this worked for you or those you may know. Has it changed your or their life? If so – for the better or worse?

Body Image, Ideal Body Weight and Overall Health – A Message from the Nutcracker’s Ringer and Macaulay Fiasco.

Friday, December 31st, 2010

Jennifer Ringer

After the season of over-indulging, during which most Americans gain 5 to 15 pounds, there is usually the New Year’s resolution to lose 10 to 15 pounds (or more!).  Television commercials switch from luscious desserts to weight-loss products, the ab-roller and the amazing Bow-flex personal gym.  Department stores advertise every possible gym and exercise apparel as being “on sale” to cash in on the hype. It goes on and on; every year it’s the same.  For gym-goers, the gym is much more crowded than ever with increased wait-times for treadmills, elliptical trainers and exercise bikes.  One New York critic, however, wasted no time in telling a professional ballerina that she needed to cut back on her eating!

Alastair Macaulay, writer and critic,  attended and reviewed George Balanchine’s “The Nutcracker” at the New York Ballet.  His comments regarding Jenifer Ringer, the prima ballerina who portrayed the sugarplum fairy, stimulated much press, outrage and commentary.  Mr. Macaulay stated that Jenifer Ringer “…looked as if she ate one too many sugarplums.”  Miss Ringer appeared on the TODAY show on December 13th, and, if anyone saw the interview, she is far from being overweight! Just Google images for Jenifer Ringer, and one would be hard-pressed to criticize this beautiful young lady for being overweight.  It takes a lot of stamina, muscle strength and skill to perform in such a role as this ballerina, qualities that cannot be present when one is “starved”, anorexic or obese! Dr. Rebecca Puhl, clinical psychologist and Director of Research at the Rudd Center for Food Policy and Obesity at Yale University, wrote a blog for Medscape addressing this very issue.

So what is this stereotype? Did it actually start with Barbie dolls?

Some would say it did. The Barbie doll, marketed by Mattel, provides an image to very young girls of the “ideal” body type. Well, medical research has proven that not all body types are the same, and despite hours of exercise and regimented eating, some will never achieve the “Barbie-body.” One of the problems is that some young women actually die trying to achieve this ideal.  Anorexia and bulimia are both psychiatric conditions that have serious negative impacts on the body and its major organ systems.  Many models, and even ballerinas, struggle with body image as driven by the media and critics like Mr. Macaulay.  But so do many high school and college women!  The National Eating Disorders organization estimates that nearly 10 million women and 1 million men struggle with eating disorders in the US. For many of these individuals, it is a life-long battle with life and death! is a government source for women’s health topics, of which “body image” is a serious topic.  The site discusses issues such as cosmetic surgery, dieting, over-eating, and over-exercising.  The site also offers additional sources for being kind to your body and fact sheets related to the various eating disorders.

In the United States, there is currently an epidemic of obesity.  It is much publicized, and changes are being made both nationally through Congress and in local school systems where healthier options are provided for school childrens’ consumption.  Some school systems have even limited the number of birthday parties and treats allowed on a monthly basis.  This is NOT a bad thing!  When one considers the complications of morbid obesity alone, the burden on healthcare and the morbidity and mortality of the associated conditions is staggering!  Diabetes, congestive heart failure, respiratory failure and cirrhosis from fatty liver disease all come to mind. Then, apply some of the surgical procedures available today (namely gastric bypass) with the associated morbidity and mortality of these procedures, and the statistics related to surgical complications and even death rise even more rapidly.

So, what is the bottom line?


Maintaining an ideal body weight is very important to overall health, but overall health cannot be achieved through diet alone. One must exercise routinely.  This is what should be taught in schools and in the home! Binge exercising in January as part of a New Year’s resolution, only to lose one’s way as the year progresses and life gets busier, is not much different than binge-eating or binge-dieting. We are talking about lifestyle changes that incorporate healthier food choices and routine exercise on a daily basis. Given that we are all creatures of habit, this is a change that is not an easy one!  It needs to start as early as possible and be maintained as long as possible.

We also need to stifle the comments of the Mr. Macaulay’s of this world; critique the performance, not the poundage of an ideal body weight ballerina who is in excellent physical condition!  We, as a society, cannot continue to promote thinness, per se.  Promote ideal body weight, physical conditioning (including flexibility) and healthy diets, and it must start at home!

What did you think of Mr. Macaulay’s comments? Do you know someone who suffered with this body image problem? How did they work their way out of this nightmarish existence?

Related Posts: Alistair Macaulay speaks out after the firestorm he created.

Kicking Off Diabetes Awareness Month – Prevention Saves Lives!

Tuesday, November 2nd, 2010

November marks Diabetes Awareness Month. Most people believe diabetes to be a benign disease, one that does not cause high risk complications and is easily managed through proper insulin administration.  However, diabetes is the seventh leading cause of death in the United States and increases one’s risk for high blood pressure, heart disease, stroke, kidney disease, blindness, nervous system damage and amputation.


Diabetes is a chronic condition that impairs the body’s ability to use food for energy.  The hormone, insulin, made in the pancreas, is a hormone that allows glucose (sugar) to enter cells and be converted to energy. When diabetes is not controlled, glucose and fats remain in the blood and, over time, damage vital organs.  There are several types of diabetes: Type I, Type II, prediabetes and gestational diabetes.

Type I – usually diagnosed in children and young adults. Type I diabetes can be caused by genetics, environment or an autoimmune disorder. It affects 5% of the diabetic population and there is no known way to prevent this type.

Type II – is linked to obesity and physical inactivity. It is also associated with older age, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, race, and ethnicity. This type of the disease affects 90-95% of the diabetic population.

Prediabetes- is a condition in which a person has blood glucose levels higher than normal but not high enough to be classified as diabetes. An estimated 57 million American adults had prediabetes in 2007. People with this condition have an increased risk of developing type 2 diabetes, heart disease, and stroke.

Gestational Diabetes – is a form of glucose intolerance diagnosed during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanics/Latinos, and American Indians. It is also more common in obese women and women with a family history of diabetes. Gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. Women who have had gestational diabetes have a 35%–60% chance of developing diabetes during the 10–20 years following their pregnancy.


Diabetes is a costly disease with $1 out of every $10 spent on health care going towards diabetes and its complications. Total costs (direct and indirect) of diabetes are $174 billion annually. Furthermore, people with diagnosed diabetes have medical expenditures that are about 2.3 times higher than medical expenditures for people without diabetes.


If current trends continue, 1 in 3 Americans will develop diabetes sometime in their lifetime, and those with diabetes will lose, on average, 10–15 years of life.The United States saw a 136 percent increase in the number of people with diabetes between 1980 and 2007. Now, nearly 24 million Americans have the disease. However, research has shown that Type II diabetes, which affects the majority of diabetics, is preventable.  Lifestyle changes, including weight loss and an increase in the amount of physical activity per week, can reduce the rate of onset of type 2 diabetes by 58%. Further, disability and premature death are not inevitable consequences of diabetes. People with diabetes can prevent premature death and disability by controlling their blood glucose, blood pressure, and blood lipids and by receiving other preventive care in a timely manner through proper medication administration and lifestyle changes.

Making those lifestyle changes with regard to diet and exercise are not easy. However, the health costs and risks for not making those changes is enormous. So – let’s raise the level of awareness for this disease so we can prevent future cases and help those already afflicted with the disease to better manage their symptoms. As part of our pledge to stop diabetes, Nash & Associates will be posting periodic fitness tips, statistics and maybe an occasional recipe or two for healthy alternatives to some of our favorite not-so-good for you dishes.

If you have a health tip or dietary trick to share in support of Diabetes Awareness Month, please post a comment below! Tell us your story of how this horrible disease has affected you, a family member or a friend or and share with all of us some great stories of how you, a family member or friend beat this dreaded disease.

For more information about diabetes, you can always visit the American Diabetes Association website.

Does nutrition info on fast-food menus really make a “choice” difference?

Thursday, October 14th, 2010

On the website –, I came across an interesting piece today about a component of the Obama health-reform bill. The bill calls for fast-food chain restaurants nationwide to provide nutritional information on menu boards. The posting says that this policy is expected to be “fleshed out and implemented over the next few years.”

Putting aside the obvious discussion of why it takes “the next few years” to figure this out and get it done, I couldn’t help but wonder whether, as a person ambles up to the counter staring at the menu board to decide on today’s choice of “a heart attack in a wrapper,” this type of information would really make any difference in people’s eating habits.

Lo and behold, it turns out that studies have actually been done – albeit on a limited basis – but nonetheless some results are in.

Dr. Pooja Tandon of Seattle’s Children’s Hospital designed a implemented a prospective cohort study designed to see if menu labeling in King County, Washington, made a difference in consumer choice. King County had passed a mandatory menu labeling law. The survey/study was done to measure the difference, if any, before the new law went into effect and after as well. San Diego – where no menu labeling is required – was the “comparator group.” (No, I didn’t take statistics! Too busy studying more exciting stuff like torts).

The details of the study are set-out in’s posting.

According to one website, which defines obesity rates as the percentage of the population with a Body Mass index (BMI)  over 30, using data from 2003 for the most part, we, in the United States, can claim we are No. 1 in the world, just ahead of places like Mexico, the United Kingdom, Slovakia and Greece. If it’s any solace, according to more recent data from the World Health Organization (2008), U.S. males over the age 15 rank 5th – behind (no pun intended) the Cook Islands, Tonga, Nauru and Samoa. U.S. females in the same age group rank 8th in female obesity. With a slight shift in position for the leaders in the male population, Egypt, Iraq and the Seychelles beat out our women.

It comes as no surprise that obese people are at significant risk for developing conditions such as diabetes mellitus, cardiovascular diseases and hypertension (think stroke). When it comes to pregnancy, obesity is a known complicating factor for problems such as increased risk of complications during pregnancy and delivery, infertility and miscarriage. Increased risk of preterm delivery and stillbirth have also been shown by some studies to exist in the obese obstetric population. Do we really need to list the potential complications of surgery for obese patients?

Back to Dr. Tandon’s study -

“Parental awareness of nutrition did seem to have an impact on what parents bought for their children, especially if their children were overweight,” Tandon said. “And in parents who reported seeing nutrition information [for the first time], the number of children’s calories went down.”

You wonder what’s in those “children’s meals”?

Strikingly, average calories in the children’s meals ranged from about 820 in Seattle up to 920 in San Diego—staggering numbers for kids whose average age was eight in this study. According to the 2005 Dietary Guidelines for Americans: Adequate Nutrients Within Calorie Needs, a moderately active eight-year-old requires about 1400 to 1600 calories per day.

Here’s hoping that it doesn’t take a “few years” for legislators to (got to love the word from the quote) flesh out and implement this program. Even if it causes some percentage of the population to pause before ordering that luscious little treat for their child, it’s a healthy start.

What appears to be evident to some degree is that “media attention and general awareness [of fast food calories]” will be the best tool in the arsenal to make people aware of what they are doing to their bodies and those of their family when they belly-up to that counter the next time. The “counter” they should be thinking of is the one on the wall – the menu with the nutrition info – hopefully sooner rather than later.

Got to go now – need to do some sit-up’s and jogging in place before I file a few more lawsuits.