Health advocate warns of diets rich in sugar, fat

By Wanda A. Adams
Advertiser Food Editor

JACOBSON: Teens are loading up on sugar How to reach the center Center for Science in the Public Interest's primary budget comes from grants and sales of its widely praised Nutrition Action Newsletter (introductory price, 10 issues for $15). Address: 1875 Connecticut Ave., N.W. Suite 300, Washington, D.C. 20009 Phone: (202) 332-9110 FAX: (202) 265-4954 E-mail: cspi@cspinet.org

But when co-founder and executive director Michael Jacobson preaches to the choir — in this case members of the Hawaii Dietetic Association at their spring conference last week — his message is more sophisticated, more sobering and more severe.

In his talk at the Ala Moana Hotel meeting site, Jacobson, whose 30-year-old organization is based in Washington, D.C., toted up the costs to society of diet-related illnesses in deaths and productivity.

He outlined a successful pilot project to cut the fat in diets in West Virginia, where many people are poor, overweight, hypertensive, alcoholic, diabetic and artherosclerotic.

He showed how milk consumption in teens has gone down as soda consumption has gone up, and how that's depleted the nutrients in the diets of young people.

He talked about new proposals in food labeling that would further inform grocery shoppers.

He told the dietitians what they were up against: the vast budgets of food producers, fast-food chains and others, spent to push products and resist such proposals as informative food labeling. In fighting back, he urged dietitians to enlist the help of "a tremendous resource": Sen. Daniel K. Inouye, whose membership on the Senate Appropriations Committee gives him tremendous power, including the ability to channel money in the direction of nutrition education and nutrition labeling efforts.

Lastly, he chided the organization's national parent for being so closely tied to the food industry that its message is often watered down, designed not to offend. He challenged members to protest when studies reported in organization newsletters don't make clear ties that researchers may have to food producers or the restaurant industry.

But he also had one simple suggestion for dietitians to offer their clients: "If you boiled down all the advice we've ever given, it would be, 'Move toward a more plant-based diet,' " Jacobson said. He hastened to note that he didn't mean a "stupid" plant-based diet— "not Twinkies and soda pop."

A "smart," largely plant-based diet would be one in which the individual ate only low-fat or nonfat dairy products, avoided animal foods or ate them in small portions and not every day, used oils in place of solid fats, drank lots of water and no soda and got a significant portion of calories from fruits, vegetables and nonmeat protein sources such as beans.

Jacobson said rates of heart disease and stroke are down, although only partly because of changes in diet; other factors include the newer cholesterol-lowering drugs and surgical procedures. But rates of overweight and obesity are up in every age group, including children. (Obesity is the medical term for people who rate 30 or more on a measure called the Body Mass Index.) A study by the RAND think tank indicates the cost of health problems related to being overweight is higher than that of alcohol abuse or smoking.

The primary culprits are animal foods, too many soft drinks and a "sneaky" form of fat called trans fatty acids, found in margarines and other foods. These excesses are combined with a diet short on fruits, vegetables and whole grains.

Jacobson said back in the 1970s, concerns about sugar "fell off the table, nobody thought it was important compared to the concerns about saturated fat." But in the meantime, consumption of refined sugar has risen 30 percent, primarily because of one product: soda. Twenty-five percent of teens are getting 25 percent or more of their calories each day from refined sugar. "Using the USDA's food guide pyramid, when you drink one can of Coke, you've used up your limit of sugar for the day," Jacobson said.

A 1999 study by Shanti Bowman at the USDA showed that the more calories teenagers consumed from refined sugar, the fewer key micronutrients they were getting — primarily because soda has replaced milk, fruit juices and even water in most teens' diets.

Jacobson said one solution is simple, clever marketing of the nutrition message.

In Clarksburg, W. Va., the Center joined with the state to produce and air hard-hitting TV ads designed to move people from whole or 2 percent milk (low fat) to 1 percent (skim) or nonfat. The core statistic: The fat in one glass of whole milk is equivalent to that of 5 pieces of bacon. After seven weeks, consumption of both types of milk was up so significantly that stores were selling out; consumption dropped off only slightly when they checked back in six months. The total cost of the program — $61,000 — was less than the cost of two coronary-bypass operations ($90,000) and a fraction of the

$1.1 billion-with-a-b that McDonald's spends annually on marketing. He'd like to see similar campaigns developed by each of the states targeting the key nutritional problems in their regions. (The center offers information kits for how to mount a 1 Percent Or Less campaign at cspinet.org.)

Jacobson daydreams about one, simple symbol that could be placed on any food meeting healthful criteria. "Imagine being able to say to your kids, 'You can buy anything in the store — anything! — so long as it has this symbol,' " Jacobson said.

His other prescriptions for improving nutritional health:

• Remove soda machines and fast-food outlets from schools.
• Labeling for fast food — even if it only took the form of putting the calorie count next to each item on the menu board.
• Tax junk foods, soft drinks and snack foods; a tax of 2 cents a can could generate $15 million in Hawai'i alone, and that money could be earmarked for nutrition education.
• In cafeterias of schools, hospitals and government buildings, raise prices for nutrition-poor foods to subsidize the availability of healthier dishes.