Healthy Food & Healthy Living by Dr. Ayala

How to pick a whole grain product

White bread is out, whole grains are in, and ‘whole grain’ is one of the hottest selling health claims. The USDA’s 2010 Dietary Guidelines recommend that at least half of daily grains be whole, and school lunch programs are required to serve half of the grains offered during the school week as whole ones.

Why whole grain?

Whole grain foods have a higher content of micronutrients, polyphenols, ‘good’ fats and fiber. They also have a lower glycemic index. Whole grain food consumption is associated lower risk of heart disease, weight gain and diabetes. Whole grains are also preferred for what they’re not: refined grains have lots of pure carbs – plain sugars, which supply energy, but little else.

But how do we define a whole grain food?

You’d be surprised to learn that there’s very little standardization of the whole grain declaration. In the US, a food product can use the official whole grain health claim if it contains at least 51 percent whole grain ingredients by wet weight. But not all genuine whole grain foods carry the official claim, and a food can qualify for the whole grain claim despite containing lots of added sugar and trans-fat – so whole grain junk food certainly exists. Foods can boast “made with” and “contains” whole grains without any specifics about the percentage of such grains.

So when you’re standing next to the cereal isle, what do you look for? The Whole Grain Stamp on the front of the package? Whole grain flour as the first ingredient? Did you bring your glasses and a calculator?

Navigating whole grains

A new study from the Harvard School of Public Health in Public Health Nutrition identified 545 grain products from the virtual shelves of Wal-Mart and Stop&Shop, looked at them through 5 different whole grain criteria, and evaluated which criteria better measures the healthfulness of the product.

The 5 ways whole grains were assessed were:

• The Whole Grain Stamp: the icon created by the Whole Grains Council can be displayed if the products have at least 8 g of whole grain per serving. Companies pay $1000 to $9000 in annual dues be part of this program
• Whole grain as the first ingredient on the ingredient list
• Whole grain as first ingredient and no added sugars in the product
• The word ‘whole’ before any grain anywhere in the ingredient list
• A ratio of 10:1 or less of total carbohydrate to fiber: This is The American Heart Association’s strategy. 10:1 is approximately the ratio of carbohydrate to fiber in whole-wheat flour.

Useful criteria would be practical, identify foods that are healthier, and find enough of them to give customers (and schools) plenty of options to choose from.

The best guideline according to the authors, led by Rebecca Mozaffarian, was the 10:1 ratio. This method asks for a little bit of work: divide the total carbs by the total fiber on the nutrition label, for instance, one serving of Cheerios has 22 grams of carbs, and 3 grams of fiber, and without doing the exact calculation it’s clear that the ratio is less than 10:1 (it’s about 7), which puts this cereal in the satisfactory list. The 10:1 identifies foods with more fiber and less sugars (the neat point about this method is that if there were lots of added sugar it would add to the total carbs, changing the score for the worse).

One obvious loophole in this approach is that manufacturers can easily add bran to the product, upping the fiber content, and reaching a lower than 10:1. (Sugar-water with vitamins isn’t the same as fruit, and refined grain products with added fiber just aren’t whole grain – our body does know the difference.)

The industry supported Whole Grain Stamp helped identify products with more fiber, but many of them also had more sugar, and a higher caloric count, and many whole grain products don’t carry the stamp.

Whole grain as the first ingredient, which I think is quite popular among health conscious consumers, and ‘whole-anywhere’, were much less restrictive, and qualified more products, but they, too, failed to weed out foods with more sugar and more calories.

Whole grain as first ingredient and no added sugars was quite restrictive, and qualified only 17 percent of the tested products. Another downside is that this method requires a very careful read of the ingredient list – added sugars hide under many guises such as brown rice syrup and fruit juice concentrate, and our food label doesn’t give us any idea about how much sugar was added.

The take home message

This article will definitely make me look further into the 10:1 ratio, which, frankly, I’d never thought of before.

And it definitely sheds new light on the industry-supported Whole Grain Stamp. The symbol signifies the presence of significant amounts of whole grains, but consumers should know it looks at no other ingredients and factors affecting healthfulness.

No matter which guideline -- or combination of guidelines -- you use, you need to read the ingredient list, because as this study reemphasizes, the words ‘whole grain’ don’t necessarily mean this food’s wholesome, and in case you’re using the 10:1 ratio, make sure the product didn’t get there by adding fiber. Clearly, consumers could benefit from a clever food label makeover that can better assist them in whole grain product selection.

One of the best ways to eat whole grains is to make them yourself, and while I’m not suggesting you start baking your daily loaf from wheat you grew in your back yard, cooking brown rice, oatmeal (oatmeal is always whole grain), quinoa and wheat berries is practical, inexpensive and 100 percent whole grain!

Dr. Ayala

 

Study shows what foods supermarkets promote most

Advertisements sell and --- as much as we hate to admit it -- food ads do shape the way we eat. That’s why more than $7 billion are spent each year on food ads in the US.

Much has been said about the ubiquity of junk food and fast food ads on TV and their effect on eating habits, especially kids’ eating habits.

Newspaper and mailed circulars receive much less attention, despite the fact that they are an important advertising channel for food and grocery retailers, and food advertisers spend nearly $1.6 billion on these outlets yearly. Consumers pay quite a lot of attention to them, and a recent survey showed that shoppers change their meal plan according to which products are on promotion, with young people even more susceptible to eating-on-promotion.

A new study (published online ahead of print) in Appetite is among the first to evaluate the types of foods promoted by US supermarkets and compare them with current dietary guidance. The study analyzed sales circulars issued in 2011 by supermarket top chains and included a sample from each of the 50 states and Washington, D.C. The proportional ad area devoted to each food group was compared to the area allotted to that food group in the MyPlate icon.

Meat, soda and cereal

The most heavily promoted food group on the front page of supermarket sales circulars was meats: beef, poultry, and pork, and about 40 percent of ads were for these foods; MyPlate suggests 20 percent of the plate be devoted to ‘protein’.

Foods in the fruits and vegetables groups each were given about one-tenth of the sampled advertising space; compare that to the half-plate devoted to fruits and veggies on MyPlate.

Grains, half of these being breads, cereals, and crackers, occupied a fifth of the advertising space. This is pretty much in proportion with MyPlate.

A tenth of the ad space was allocated to sweets – mostly sugary drinks. These are not represented on MyPlate at all.

Selling soda to obesity stricken states

Supermarkets promote different foods in different regions, and the researchers looked to see how the obesity rate of a state correlated with foods on its supermarket circulars.

And indeed, in states with under 25 percent obesity (such as Massachusetts and Colorado) supermarkets devoted significantly more space to fruits than in more obese regions. (Shocking note: no state has an obesity prevalence of less than 20 percent.)

On the other hand, sweets occupied significantly more ad space in the states with over 30 percent obesity, and significantly more space was given to sugary beverages in these states. 

The south regions of supermarkets tended to allocate more ad space to sweets, predominantly sugary drinks, which were given 2 to 6 times as much ad space when compared to other regions.

Can we affect supermarkets?

Although supermarkets promote the items that give them the best profit margins, they also sell what we consumers want to buy. This is evidenced by the difference this study saw between regions. I guess it’s harder to appeal to Connecticut customers and lure them into stores with a special on soda.

Ads affect our behavior – we’d like to think we’re immune to their influence but nobody really is – but our purchasing power also affects what’s on shelf and what’s on promotion. When consumers seek healthier foods it does often lead to a decrease in the price of those foods, and to chains making shelf space for better options.

As Michael Pollan often says, we get to vote with our fork 3 times a day. Each addidional vote has the potential to change the food-world around us.

Dr. Ayala

Looking for admiration? Serve some veggies!

I happen to be one of the people that can get seriously excited about a particularly fresh, colorful vegetable, prepared just right, or even served raw, sliced just so and dressed well. Most people aren’t as eager to eat their veggies – they’re looking forward to biting into a juicy steak, or whatever’s the ‘main’ dish. Veggies are at most a sideshow.

And since most people aren’t excited about eating veggies they don’t eat enough of them.  Although the five-a-day campaign has been successful in making Americans aware they should be eating more fruits and veggies, only 11 percent actually do so, and while My Plate, the new nutrition guide from the USDA, devoted half the plate to fruits and veggies, only 23 percent of Americans have any vegetables on their dinner plate.

So how do we convince people to put more veggies on the dish?

Brian Wansink Misturu Shimizu and Adam Brumberg from Cornell University’s Food and Brand Lab have a new argument that can certainly appeal to moms, dads and any other food provider who wants to be a hero: Putting veggies on the plate gives the perception of a loving, capable cook.

Serving vegetables makes you a 'good cook'

In their new study, to be published in Public Health Nutrition, Wansink’s group asked 500 American moms who had at least two kids at home to evaluate meals. The participants assessed the personality of women who either prepared -- or did not prepare -- veggies with a family meal, and rated four different meals that either included a vegetable or had no veggies. Respondents were asked to describe the cook and to evaluate the meal itself. 

They found that having a vegetable on the side made the main dish rate higher for taste: Steak with broccoli was favored over steak alone, or steak served with a starch.

This is something restaurant owners know. In professional menus sides help the main course look good – the side helps sell the main dish -- and chefs know that dishes have more appeal if served over, under and garnished with veggies.

But here’s the most interesting part: When asked about their perception of the cook that made the meal the participants selected descriptors such as “loving” “thoughtful”, “attentive” and “capable” to the meal preparers that included veggies. Mind you, preparing the veggies in the proposed meal was no more involved than heating up a bag of frozen green beans – how’s that for return on investment. The attributes selected for the cooks who served steak, chicken or pasta without veggies were more often “neglectful”, “selfish” and “boring”.

So this is what moms thought in a sterile study environment. Does it guarantee kids would see it the same way? It’s hard to say, but I find that eventually kids tend to adopt their parents’ habits and point of view regarding food.  Being admired by other grown-ups can’t hurt either.

Pleasure, not just health

Kids hardly care about health. Making an “it’s good for you” argument doesn’t carry much clout, and asking kids to eat their veggies for the thousandth time doesn’t make for interesting dinnertime conversation.

I found this study inspiring because it demonstrates that serving veggies for hedonic reasons alone makes sense and can have a positive impact. That’s in fact, how my mom got me to love my veggies. In the end, it’s the pleasure of the food and the experience around it that create good eating habits. 

And speaking of pleasure, can you guess which veggies are most favored? Broccoli tops the list for most family members, except for young boys who prefer corn and carrots to broccoli. Are you surprised?

You may want your family to eat veggies for their health and weight maintenance qualities, but who can resist some adoration? Do you need a better motivation?

Dr. Ayala

Silly diets, silly food inventions, and other 2012 follies

As this year comes to a close I look back with appreciation, and recognize that research and technology are generally moving us forward, and that we people are quite remarkable – despite our many flaws we strive to better ourselves and improve our world. 

There are of course plenty of exceptions, and this end-of-year post is devoted to some of the silliest food-related science and innovation that came my way in 2012.

Who wants a bride with no common sense?

There were many contenders for this year’s prize for stupidest diet. The desire to shed weight seems to breed an endless stream of particularly magical claims, supernatural devices and silly, dangerous plans. 

But I do have a clear winner. The K-E diet, or nasogastric diet was a hit among brides-to-be looking to shed 20 pounds in 10 days. The plan is simple. You put nothing in your mouth for the duration of the diet. Instead, you insert a feeding tube through the nose into the stomach, and through it a slow drip of carb-free nutrients supply your body with 800 calories a day. Since your body’s starving, and has no carbs to run on, you’ll be converting fat to ketones, which will make you stink. (Know that smell coming from hungry people? It can be described politely as sweet and fruity, and more accurately as rotting fruit mixed with nail polish remover – it’s not pretty.) You’ll also be constipated (avoiding fiber will do that) and look sick.

Don’t be surprised if you find your groom has a change of heart. I wouldn’t blame anyone who has second thoughts about sharing a life and raising kids with someone whose priorities and common sense are so, shall we say, unusual. Nasogastric tubes are an unpleasant medical necessity for patients who can’t eat, but I’m pretty certain most of us hope we’ll be able to introduce every morsel of food into our body the traditional – healthy -- way, through the mouth. Stephen Colbert already imagined an upgrade to the feeding tube diet: why stop at the stomach? Why not bypass the entire digestive tract and thread the tube all the way to the bottom? That would make any food you eat zero calorie and “You won’t just hit your goal weight, you’ll hit you birth weight”.

Why does coffee spill?

The silliest of research is celebrated yearly at the Ig Nobel awards.  The ceremony, held at Harvard University, spoofs the Nobel prizes and is presided over by real Nobel winners.   

One of this year’s coveted awards went to Rouslan Krechetnikov and Hans Mayer, who investigated one of life’s greatest mysteries: when you walk with a cup of coffee why does it always spill? Brownish trails in most office carpets will attest that the problem is epidemic and real: coffee always spills! 

Mayer and Krechetnikov are experts of fluid dynamics, and are the perfect pair to tackle this important question, and they systematically tried various walking speeds and coffee levels. Their analysis shows three competing motions at work in the walked-with-coffee-cup: side to side sloshing, forward-back sloshing, and up and down motion of the walker. All this adds up to a swirling around in the cup, as well as an up and down wave of coffee, resulting in spills. And what matters most is not the speed of walking, but how you get to that speed: your acceleration.

Bottom line: fill the cup a little less and put a lid on. Then, be ready for a spill. 

Your car as a mini kitchen

Drivers love fancy technology, and new safety features in cars are credited with large declines in accidents and fatalities on the road. 

But new technology has also made the car into a mini office, complete with text, email and phone calls. And if car food and drink were limited to pre-made options, this year’s hot innovations promise to transform the car into a mini kitchen.

The Handpresso Auto plugs into the 12V cigarette lighter, and promises a delightful, creamy cup of espresso, just add water, a coffee pod, press a button and wait a bit. Fiat’s new 500L model will include a built in espresso machine.

This sounds like a great idea. Until you ponder how often drivers stop in a safe place for their phone calls and texts. Since most drivers think they’re above average, how likely are they to park the car before making coffee? Remember how coffee always spills? How hot it is when it’s just brewed? Do we need another gizmo to occupy drivers while operating a heavy machine at high speed, a machine whose operation requires two hands, a clear head, and all our senses?

I’ll stop here, and invite you to share what fascinated you this year.

To a happy, healthy, progress filled 2013!

Dr. Ayala

To see my previous years' notable silly science choices go here, here and here.

Baked carrot, apricot and herb fritters in pistachio dill pesto

One of my favorite restaurants is Zaytinya in Washington DC, where Jose Andres offers an impressive array of Turkish and Lebanese mezze, each blasting with flavor. His Havuc Kofte – carrot fritters served in an amazing pistachio sauce – is a dish we always look forward to.

I tried to recreate this dish at home, and in one of the trials finished them off in three ways: fried the traditional way, and baked with either a brush of olive oil or a sesame seed topping. The unanimous vote was for the baked version, which surprised me – I don’t like frying and eat fried food infrequently, but my kids actually just thought baking really works well for this dish, and voted on flavor only. I wasn’t sure what to call these anymore: Are they still fritters? Fritters are usually fried, not baked. Whatever you call them (suggestions welcome!), they’re delicious.

I have a feeling Andres’s recipe is more involved and has a few more ingredients, while mine is pretty easy, and relies on the food processor as my little helper – we home cooks don’t have the manpower big kitchens do, so I welcome shortcuts.

The leftovers from the pistachio pesto can be used as a dip, bread spread or thinned into a salad dressing.

Ingredients:

For the fritters:

• 5 large carrots, cut into chunks
• ½ cup whole-wheat breadcrumbs
• 5 dried apricots, coarsely chopped
• 2 green onions, chopped
• 3 tablespoons pine nuts
• ½ teaspoon paprika
• ¼ teaspoon cayenne pepper
• ½ teaspoon salt
• ¼ teaspoon black pepper
• ½ cups parsley or dill, coarsely chopped
• 1 large egg
• Sesame seeds or olive oil for coating/brushing

For pistachio pesto:

• 1 cup toasted pistachio nuts
• ½ cup chopped dill
• 1 clove garlic
• Juice from one lemon
• ¼ cup extra virgin olive oil
• Salt and pepper to taste
• 2 tablespoons water

Preparation:

Fritters:

• In a medium pot steam carrots with a little bit of water until tender. Remove from heat and drain well
• Place carrots in food processor, and pulse until mashed
• Add the breadcrumbs, apricots, green onions, pine nuts, paprika, cayenne, salt, black pepper, parsley and dill and eggs. Pulse until bound together. Mixture should be moist but not too wet. If the mixture is too liquid add more breadcrumbs
• Roll into about 25 balls. Place balls in covered container and refrigerate until ready to bake. The balls keep well for a couple of days.

Pistachio dill pesto:

• Place all the ingredients in a food processor, and process together until the mixture becomes a sauce. Taste and correct with additional lemon juice or spices as needed.
• If you prefer a more liquid consistency add more water.

Baking:

• Heat oven to 400 °F (200 °C)
• Roll carrot balls in sesame seeds, or brush with olive oil, and place on baking sheet
• Bake for 20-30 minutes, until the balls develop a bit of a crust 

To serve:

Spread pistachio pesto on a plate and arrange baked fritters over the sauce.

Serves 4-6.

 

Enjoy,

Dr. Ayala

The more sugary drinks you drink, the more you eat

That drinking can make you overeat does sound a bit odd. We have one stomach, after all, and filling it with a caloric drink should reduce the amount we eat -- the drink takes its stomach share and supplies calories, right?

But that’s not the way it is, and accumulating evidence shows that our body has a hard time registering calories from beverages in the tally towards satiety.

When women were served water, diet soda, regular soda, orange juice, milk or no drink with lunch, those drinking caloric beverages consumed about 100 additional calories for that meal. In another study researchers proved that solid candy is better for your waist than soda: when they gave men and women 450 calories a day of either soda or jellybeans for a month, candy eaters ate less food, compensating for the extra calories, while soda drinkers did not, so they ate more calories than usual. Another study looking at the effects of food form (solid, semi-solid or liquid) on appetite, fed participants either a whole apple, applesauce or apple juice of equivalent caloric value. The apple juice reduced hunger the least, the whole apple reduced hunger the most and the applesauce response was intermediate  -- people who had apple juice where ready for their next meal almost an hour earlier than those that had a bitable apple. 

The more you drink the hungrier you get

Not only do drink calories go uncounted, some studies also show that when you drink calories you may add not just the calories of the drink, but even some extra food.

A new study in the American Journal of Clinical Nutrition looked at what 13,704 people drank over 24 hours, and what and how much these people ate.

The correlation was straightforward: people reporting higher caloric intake from sugary drinks also consumed more calories from food. They also tended to eat foods with higher caloric density, and eat more saturated fat, sugar and salt. This study also showed that the more calories people drank, the more snacking they did, and the longer their snacking episodes got.

This study further demonstrates that calories that you drink aren’t well compensated for: the people in this study who drank an average of 1000 calories a day ate an additional average of 22oo calories, bringing their total daily caloric intake to 1100 higher than people on the lower range of sugary drink intake – and 350 of these extra calories came from extra food.

Drinking and eating: a vicious cycle

This is a correlation. It seems like people who drink more calories (mostly from added sugars) eat more, and eat less healthfully, but does that mean that drinking leads to eating? This study can’t prove that. Maybe bad habits just cluster.

The authors speculate that while drinking more calories might lead to eating more food and eating poorly, it’s also possible that each bad habit begets the other -- drinking soda leads to eating a lot, and eating calorically dense foods leads to drinking more soda – a vicious cycle feeding itself.

Watching what you drink can break that cycle, and that’s why all reasonable weight loss and healthy nutrition advice emphasize elimination or reduction of sugary drinks. Getting rid of the sugary drink’s calories is the first bonus, but for many people changing the sugary drink habit holds the promise of other positive eating behavior changes that can follow, much more easily.

Dr. Ayala

Full disclosure: I’m vice president of product development for Herbal Water, where we make organic herb-infused waters that have zero calories and no sugar or artificial ingredients. I’m also a pediatrician and have been promoting good nutrition and healthy lifestyle for many years.

 

 

 

Caffeine, coffee and type 2 diabetes

A new study of caffeinated drinks and type 2 diabetes caught my eye. I’m always on the lookout for studies on coffee, because – let’s admit it – I love coffee, and like many other coffee aficionados, I fear that someday this adored pleasure will be found a guilty one. And then what shall we do? Decide it’s worth the risk? Or convince ourselves we never really cared for this delicious, thought brightening, history-defining drink?

For coffee lovers most research news has been reassuring. Years of investigation have shown that coffee in moderation poses no threat to healthy adults – those worries about heart disease and cancer risks end up being unwarranted. What’s more, the coffee habit has even been shown to confer health benefits, and is associated with protection from Alzheimer’s and Parkinson’s disease, stoke, gallstones and liver disease.

Caffeine and diabetes

The new study, published in the American Journal of Clinical Nutrition (online ahead of press), observed a very large population of about 75,000 women and 40,000 men for more than two decades, trying to see if there’s an association between the caffeinated and caffeine-free drinks they consume and the development of type 2 diabetes.

The study looked at all types of typically caffeinated drinks: coffee, tea, sugary drinks and artificially sweetened drinks.

Over the years more than 10,000 of the people developed type 2 diabetes. There are many factors known to increase the risk of developing type 2 diabetes, such as obesity, family history of diabetes, hypertension and smoking. After controlling for those, the researchers set about to see whether caffeinated drinks made a difference.

Here’s what they found:

• Coffee, caffeinated or decaf, was associated with a lower risk of type 2 diabetes.
• Caffeinated tea was associated with a lower risk of type 2 diabetes.
• Sugary drinks, both caffeinated and caffeine free, were associated with a significantly higher risk of type 2 diabetes.

Are coffee and tea protective?

It’s impossible to conclude cause and effect from these kinds of studies. The authors describe a few plausible protective mechanisms in which coffee and tea can affect diabetes: both are rich in flavonoid antioxidants, which may help in reducing inflammation. It’s likely that it’s one of the multitude of compounds in coffee and tea – or several of them acting together -- that have positive health effects, and caffeine, which we treasure for its stimulating properties, has nothing to do with the other benefits.

On the other hand, the association between sugary drinks and diabetes is very suggestive of a direct biologic effect:  sugar and high fructose corn syrup are quickly absorbed and cause spikes in blood sugar and insulin. Several studies have shown that sugary drinks are linked with diabetes independently of the weight gain associated with these drinks.

What this study shows quite well is that it’s the sugars that are associated with the development of type 2 diabetes, not the caffeine. The caffeine content of soda seems irrelevant to the risk of diabetes.

So hurray for coffee – and tea – but before you go on a coffee binge, a few words of caution: most studies showing coffee’s benefits and lack of harm looked at people drinking coffee in moderation. Coffee in moderation is fine, but that doesn’t mean that coffee in large amounts is even better – quite the opposite!

That also doesn’t mean that caffeinated drinks are healthy – it seems that energy drinks can be quite unsafe.

And it doesn't attest to caffeine’s safety for kids. These coffee and caffeine safety studies were done with adults only, and kids’ physiology is quite different.

Dr. Ayala

Image: The shrub on the right, Coffea Arabica, carries coffee berries. On the left: the familiar roasted coffee beans, which are the seeds of the plant.

Full disclosure: I’m vice president of product development for Herbal Water, where we make organic herb-infused waters that have zero calories and no sugar or artificial ingredients. I’m also a pediatrician and have been promoting good nutrition and healthy lifestyle for many years.

13 lies dieters tell themselves

The worst lies are the ones we tell ourselves. Before the holiday season eating extravaganza is upon us here are a few common diet lies -- and how your better angel would react if he were awake.

Feel free to add your own in the comment section.

 

Olive oil is good for you

(it is; it also has 120 calories per tablespoon)

 

This pack’s only 100 calories

(that’s when you eat just 1, not 4)

 

It’s only 140 calories

(per serving! There were 3 serving in the pack – all gone!)

 

I’ll sweat this dessert off

(speed-walk for an hour, and it won’t make a dent)

 

It’s fat-free 

(yeah, but did you look at the sugar?)

 

It’s sugar-free

(did you look at the fat?)

 

It says no added sugar

(just evaporated cane juice and fruit juice concentrate. Who are you kidding?)

 

I found this miracle diet

(there are no miracle diets, silly)

 

Chocolate is good for your brain and can help you win a Nobel Prize 

(brain candy is still candy. BTW, who pays for these studies?)

 

Wine is good for your heart

(it’s also bad for your liver, and has 120 calories a glass)

 

It was a small portion

(smaller than a mountain, for sure)

 

After this, I’ll eat nothing ‘till tomorrow

(it’s 2pm!) 

 

But I skipped breakfast!

(skipping breakfast awards no prizes)

 

Final thought:

The scale and your old clothes won’t lie, and on the other hand, some feasts are well worth their caloric price.

Have a happy and healthy Thanksgiving.

Dr. Ayala

Healthy, Guilt-free Thanksgiving Side Dishes

Once you’ve got your main dish planned, it’s time to think healthy, colorful, plant-rich and whole-grain sides.

Here’s a collection of my favorite not-so-traditional, but perfectly seasonal and Thanksgiving-color-palette recipes. They’re all vegetarian, and avoid frying, high-fat, high-sugar treatments, so they offer a healthy way to the festive meal.

And with all these sides, who needs a main dish?

Enjoy, Dr. Ayala

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Crispy kale and fresh herb salad with sesame miso dressing

This salad combines my two favorite kale preparations: raw, very thinly sliced (see technique below), and baked to a crisp (or a chip). These two kale variations, combined with dried currant’s sweetness, delicate herbs’ freshness and the miso saltiness make a salad that explodes with flavor.

Which kale to choose? I like them all, but the flat leaf kale such as lacinato or Tuscan kale is much easier to chop than the curly variety.

Ingredients:

For the salad:

• 20 leaves of kale, stems removed
• Olive oil for brushing
• Salt and pepper to taste
• 2 cups thinly sliced stemmed kale (*directions below)
• 1 cup finely chopped parsley, cilantro or dill, or combination of tender fresh herbs
• 3 tablespoons dried currants
• 2 tablespoons finely grated Parmesan
• optional: 1-2 tablespoons toasted pine nuts

For the dressing: 

• 1 tablespoon mild yellow miso paste
• 2 tablespoons rice vinegar
• 1 tablespoon mirin
• 2 tablespoons toasted sesame oil

Preparation:

Heat oven to 250°F (120°C)

Brush kale leaves with olive oil and season with salt and pepper, and arrange in single layer in 2-3 baking sheets

Bake until kale is crisp, 15-25 minutes

Whisk the dressing ingredients.

Mix the chopped kale, currants, Parmesan and parsley (and toasted pine nuts if using) with the dressing

Add the crisp kale, crushed to bitesize pieces, right before serving 

Serves 4-8

* Kale is rather tough and chewy, but this preparation renders it tender and almost delicate: Break or cut off the tough stems.  Wash thoroughly and dry well in a salad spinner or a towel.  Roll a bunch of leaves tightly, jelly-roll fashion. Slice crosswise as thinly as you can, chiffonade style and separate into strips. 

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Butternut squash and chestnut soup with mulling spices

 

This is a terrific fall soup, perfect for the Thanksgiving holiday. It’s easy to make, and requires no pre-prepared soup stock. The aroma of the mulled spices is festive and somewhat surprising in a soup.

Ingredients:

• 2 butternut squash, peeled, halved lengthwise and cored
• 1 large onion
• 1 tablespoon canola oil
• 1 pound peeled roasted chestnuts (you can find peeled chestnuts sold in jars)
• 1-2 tablespoons honey
• Salt and freshly ground pepper to taste

For the mulling spices:

• 2 cinnamon sticks
• 1 teaspoon whole allspice 
• 1/2 teaspoon whole cloves
• 5 cardamom pods, bruised
• Orange peel zest (the outer colorful skin of the orange peel)--about half an orange

Preparation:

Preheat the oven to 400 degrees F.

Place the squashes, cut-side down, on a baking pan and bake until tender, about 30-40 minutes. Cut into large chunks.

Gather the mulling spices into a muslin bag, tea ball or cheesecloth pouch. (The orange peel and cinnamon sticks can be allowed to roam free in the pot; they’ll be easy to fish out.)

In a large soup pot, over medium-high heat, sauté onions until translucent.

Add the chunks of roasted squash, honey, salt, pepper, and half the chestnuts.

Add water to cover by 1.5 inch and bring to a boil, then lower to a simmer.

Add the mulling spices, including the orange peel and cinnamon sticks.

Simmer over moderate heat for 20 minutes. Remove from heat. Remove the mulling spices, orange peel and cinnamon sticks.

Puree the soup with an immersion blender. (This is an inexpensive kitchen tool that saves a lot of cleanup. Immerse the blender into the pot in which the food has been cooked, and easily puree it with a switch of a button. If you don’t have an immersion blender you can use a blender or food processor.)

Crumble the remaining chestnuts into the pureed soup.

Taste and correct seasoning by adding ground cinnamon, more salt or some more freshly ground pepper.

To serve:

Garnish with freshly toasted pumpkin seeds (an excellent source of omega 3), and/or a cinnamon stick.

Serves 8-10.

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Roasted red and golden beets, with reduced balsamic vinegar

 

Beets are easy to find, especially between spring and fall. They make for a very simple, delicious, healthy dish that epitomizes fall color to me.
If you can find golden beets, they make for a delightful color contrast with the red beets. They also taste really great.

Ingredients:

• 3 medium red beets, rinsed, not peeled
• 3 medium golden beets, rinsed, not peeled
• 1/2 cup balsamic vinegar for reduced balsamic glaze
• Fresh herbs to garnish (chives, parsley or tarragon)
• Salt and freshly ground pepper to taste
• Optional - fresh goat cheese (chèvre)

Preparation:

Preheat the oven to 400 degrees F.

Wrap each beet in aluminum foil and place in pan in the oven.

Roast until tender and easily pierced with a fork, about 45 minutes to 1 hour.

Remove from the oven and let cool.

When beets are cool enough to handle, peel and slice them. (Red beets can be peeled and sliced in advance. Golden beets change color when exposed to air, so slice just before serving.)

To make reduced balsamic glaze: In a small pan over high heat, bring vinegar to a boil, then reduce heat to medium, and evaporate balsamic until quantity halves and turns to a light syrup.

Drizzle reduced balsamic over the beets.

Season with salt and freshly ground black pepper.

Garnish with fresh herbs, and add goat cheese if desired.

Serves 8-10 as a side dish.
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Herbed brown rice  

Ingredients:

• 2 cups vegetable stock
• 1 cup parsley
• 1 cup cilantro
• ¼ cup mint leaves
• 1 ½ cup brown rice
• 2 tablespoons olive or canola oil
• 2 large onions, diced
• 1 teaspoon paprika
• 1 teaspoon salt
• Black pepper to taste

Preparation: 

Bring the vegetable stock to a boil

Wash the herbs, remove the large stems leaving mostly leaves (you can cheat a little, since it’s all going into the food processor)

Place herbs and ½ a cup of the warm vegetable stock in a blender or food processor and process until you have a smooth chunk-less puree.  Add the puree to the rest of the stock

Wash the rice in a sieve under cold water

In a medium pot heat the oil on medium high, and sauté the onions and the paprika and salt for a few minutes until translucent

Add the rice, and toss around until the rice is aromatic and coated with oil

Add the herbed broth, bring to a boil, and then reduce to a low simmer

Cook rice according to directions – mine cooks for about 1½ hours

Fluff the rice, check seasoning, and serve with a few leftover sprigs of herbs for garnish.

Serves 8-10 as a side dish.

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Wheat berry salad

 

The trick with hard wheat berries is to plan ahead and soak them overnight. These grains are very hard indeed, and will require a very long cooking time if they’re not pre-soaked.

Ingredients:

• 1/2 cup wheat berries, soaked overnight
• 1 large ripe mango (can be replaced with oranges or persimmon), cut into cubes
• 3-4 celery stalks, (fibery outer parts peeled) diced
• 10 dates, pitted and finely chopped (can be replaced by another dried fruit) 
• A handful of dry cranberries
• A handful of nuts, such as roasted almonds, candied pecans or walnuts 

Dressing: 

• 1 tablespoon of a fine sweet and interesting marmalade. I use organic Adriatic fig spread (sold at Whole Foods) 
• 2 tablespoons extra virgin olive oil
• 1 tablespoon balsamic vinegar
• 1 sprig of thyme, finely chopped

Preparation:

Cook the wheat berries by covering them with two inches of water, then bring them to a boil, lower the temperature to simmer, and cook until chewy—about 20-30 minutes. Drain and let cool.

Add all other salad ingredients besides the nuts.

Combine dressing ingredients.

Add the nuts and dressing right before serving.

Serves 6-8 as a side dish.

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Black rice with roasted butternut squash

Black rice

Ingredients:

• 2 cups black rice (I use “Forbidden Rice” from Lotus Foods, sold at Whole Foods in small packages) 
• 2 and 1/4 cups water (this does not conform to the package instructions.  I find that using less water results in better flavor and texture)
• 1-2  tablespoons canola oil
• 1 large onion, diced
• 1 teaspoon salt or to taste
• Optional: chopped fresh parsley or cilantro.

Preparation:

Rinse rice in a strainer under cold running water for 30 seconds

Heat the oil in a medium pot, over medium-high heat 

Stir in the onion and sauté until golden 

Stir in rice and toss around until coated with oil and fragrant

Add salt and water and bring to a boil

Reduce heat to low, cover, and simmer for 30 minutes. By the time the water is absorbed the rice should be done

Garnish with freshly chopped parsley or cilantro and serve hot.

Roasted butternut squash

Ingredients:

• 1 medium butternut squash, seeded and diced to 1/2’’ cubes
• 1 tablespoon maple syrup 
• 1 tablespoon olive oil
• Salt and pepper 
• Optional: chopped sage.

Preparation:

Preheat oven to 400 degrees F

Toss butternut squash cubes with the rest of the ingredients

Spread the cubes out on a baking sheet and roast in the oven until they are tender and slightly caramelized. This will take 25-35 minutes.

Finishing touches:

You can combine the rice and butternut squash, or (my preference) serve them in a large platter where the rice creates the outer circle, and the squash is placed in the center. I like this presentation visually, and it also allows each diner to choose how much of each of the platter components he wants to eat.

Serves 8-10 as a side dish.

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Roasted French string beans with toasted sesame

 

Ingredients: 

• 1 pound French string beans, both ends removed
• 2 tablespoons olive oil or toasted sesame oil
• 2 tablespoons sesame seeds
• Freshly ground black pepper and salt to taste
• A pinch or two of red pepper flakes (optional)

Preparation:

Preheat the oven to 400 degrees F with the oven pan in the oven.

Toss the string beans with the oil and spices.

Spread the beans in one layer on the pre-warmed oven pan.

Bake for 3-5 minutes, until beans become slightly brown and are sizzling, but are still very crunchy and vibrant.

Correct the seasoning by adding salt or pepper.

Serve hot, or at room temperature.

Serves 8-10 as a side dish.
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Roasted root vegetables and pearled barley soup recipe

After Superstorm Sandy (I hope you all have power, and are safe and warm!) and a stormy election season, I thought it would be nice to share a comforting, earthy soup.

Root vegetables become magical when they meet the high heat of the oven. They develop caramelized and mellow flavors, and are so much richer. This soup is the perfect little meal on a cold day.

Ingredients:

• 2 sweet potatoes, diced
• 4 potatoes, diced
• 5 carrots, diced
• 2 parsnips, diced
• 3 tablespoons olive oil, divided
• 1 tablespoon honey (optional)
• 1 large yellow onion, diced
• 8 cups vegetable stock
• 1 teaspoon paprika
• 1 teaspoon dried dill
• 2 tablespoons tomato paste
• 1 cup pearled barley
• Salt and pepper to taste
• 1 cup parsley, finely chopped

Preparation:

• Preheat oven to 400°F (200°C)
• In a large baking sheet, toss sweet potatoes, potatoes, carrots and parsnips with 2 tablespoons olive oil, honey, and some salt and pepper
• Bake for 30-40 minutes, stirring the veggies occasionally, until the vegetables are soft but still chewy and slightly caramelized
• In a large pot, over high heat sauté the onion and the 1 tablespoon of olive oil until golden
• Add the roasted vegetables, vegetable stock, paprika, dill, tomato paste, pearled barley and some salt and pepper, cover the pot, and bring to a boil
• Reduce heat to a simmer and continue cooking until the barley is soft (about 20-30 minutes)
• Add the parsley and correct seasoning

This soup is now ready to serve, but will taste even better the day after, and will keep in the fridge for 5 days.

Yield: serves many (10-12 easy).

Enjoy,

Dr. Ayala

Pediatricians advise on organic food

Do you consult your pediatrician about food? Nutrition evaluation is part of what doctors are supposed to cover in well-child visits, and I’m sure many pediatricians are asked for advice concerning food choices in general, and organic foods in particular.

To that end, the American Academy of Pediatrics gathered the relevant research comparing organic foods to conventionally produced ones, and prepared a report that’s published in the November issue of Pediatrics. There’s no new research here; the report analyses existing studies (many of which have been widely reported), weighs the evidence, and concludes with some advice.

I was glad to see that this report included environmental impacts in its analysis. Not only are environmental issues important in and of themselves, but also we’re kidding ourselves if we think that impacts on the environment will not end up affecting our health. There might be a long delay in that effect, but no insult on the environment goes scot-free.

Here’s what the report finds:

Organic food exposes eaters to fewer pesticides

There’s no doubt that pesticides are toxic. Acute poisoning from pesticides is reported among farm workers regularly, and several studies have shown that chronic exposure to pesticides is associated with health problems, such as breathing problems, skin disorders, neurologic deficits and cancer.

Kids who don’t work on a farm are exposed to pesticides mainly through their food. Organic food has consistently been shown to have fewer pesticides and to reduce exposure. The report cites a study that looked at kids that ate conventional produce, and showed that just 5 days on an organic diet reduced their urinary levels of pesticides to undetectable.

The report also informs that washing reduces some pesticides, but isn’t proven to decrease human exposure. 

But can we undeniably prove that exposure to pesticides in small amounts is harmful? We can’t, and we definitely can’t prove it’s safe; I doubt excellent large prospective studies putting kids on a pesticide residue diet and a pesticide-free one will ever be performed.

Nutritional differences seem minimal

The report finds flaws in many of the studies comparing the nutrient content of conventional and organic produce, and declares the results conflicting. It concludes that although studies show more vitamin C and phosphorus in organic food, for now: “there does not appear to be convincing evidence of a substantial difference in nutritional quality of organic versus conventional produce.”

Meat

Conventional growers feed animals routinely with antibiotics. Of all antibiotics used in the US 40-80 percent goes in animal feed, and animal and human antibiotics are pretty much the same. This leads to antibiotic-resistant bacteria spread through people and food, which the report sees as a reason to prefer organic.

Milk

The report surprised many by declaring that they find no clinical difference between organic and conventional milk. Conventionaly raised cows are supplemented with growth hormones and estrogen, but the Academy claims the former breaks down and isn’t active, and the latter’s quantities are too small to matter.

Environmental impact

The report states that:

“Many believe that organic farming is less damaging to the environment because organic farms do not use or release synthetic pesticides into the environment, some of which have the potential to harm soil, water, and local terrestrial and aquatic wildlife.

In addition, it is thought that organic farms are better than conventional farms at sustaining diverse ecosystems, including populations of plants, insects, and animals, because of practices such as crop rotation.

When calculated either per unit area or per unit of yield, organic farms use less energy and produce less waste.

Organically managed soil has been demonstrated to be of higher quality and have higher water retention, which may increase yields for organic farms in drought years.”

What’s a parent to do?

The report is aimed for pediatricians, so it’s a little technical, but if you care to read through the sections describing the use of growth hormones and sex steroids in conventional agriculture you’ll be introduced to some of the common practices of conventional animal treatment. For example, animals are treated with a range of growth hormones and sex steroids (injected as estrogen pellets under the skin) to increase yields. The report reassures us through studies that the hormone levels found in our food are low, or irrelevant, but I doubt you’ll find it a reassuring read. 

The report suggests pediatricians emphasize the importance of eating lots of fruits, vegetables and whole grains, and respond to the question of “should we go organic” with the facts presented by the report, and admit that in some areas evidence is lacking.

So this is the American Academy of Pediatrics’ advice. What’s yours?

Dr. Ayala

 

A revised food label that isn’t a dream

In a recent opinion piece in the New York Times Mark Bittman dreams about an improved front-of-package food label. “Right now, the labels required on food give us loads of information, much of it useful. What they don’t do is tell us whether something is really beneficial, in every sense of the word,” he writes.

What Bittman proposes is an upgraded traffic light model (green: great choice, yellow: eat sometimes, red: eat sparingly or never), but his fantasy label takes into consideration not only dietary guidelines, but includes also grades for the way each particular food affects the earth, the farm workers, animals and the air we breathe.

Bittman’s proposed label has a 15-point scoring scale. The score is divided to 3 categories, and a food can score up to 5 points in each (see illustrations and examples here):

Nutrition: things such as trans-fat, saturated fat, sugar, vitamins and fiber affect this score

Foodness: assesses whether the food is real, or so processed it can hardly be called food

Welfare: scores how well the animals, factory and farm workers, the land, waterways and air are treated.

How realistic is the Bittman label?

The Institute of Medicine recommended in its 2011 report a single, standardized front of package symbol system that can be easily understood and that would appear on every product.

It's not easy: Getting food producers to agree on front-of-package guidance, guidance that would label many of their foods ‘red’, is a huge undertaking.

But adding a welfare key is a wild dream. Bittman admits it’s the trickiest part, and I think the problem isn’t just a logistical and resource one. Measuring carbon footprint is hard and expensive, and assessing pesticide and herbicide’s pollution of water and air is even harder, but trying to get to an agreement about what animal welfare standards should be is impossible. It is a personal-view kind of question, with moral, religious and subjective subtexts, and I think the Republicans and Democrats will unite on the role of government and abortion before vegetarians agree that organic, grass-fed veal gets a 5 for welfare.

Loads of information, but important information’s still missing

While the package’s guiding system continues to be debated, and Bittman’s dream label is a distant aspiration, there are two information pieces still surprisingly missing from the nutrition panel itself:

- Added sugar: Total sugar is listed in the nutrition panel, but there’s no distinction between the naturally occurring sugar present in, let’s say, fruit, and added sugar in its many forms (including sucrose, HFCS, dextrose, dehydrated cane sugar, fruit juice concentrate and a dozen others) put into so many products by food makers.

Current dietary recommendations call for limiting the amount of added sugar in our food. Scientific studies have shown that added sugar has negative health outcomes – such as heart disease and high level of triglycerides and cholesterol -- and leads to obesity.

So stating the amount of added sugar would be useful and is long overdue. But is such labeling feasible?

According to a recent paper by Jennifer Pomeranz in the American Journal of Public Health, providing the added sugar information is both important and doable. The manufacturers already know how much sugar they’re adding, and random sampling in order to check the accuracy of the manufacturers declaration is technically realistic because each sugar source has unique, traceable, sugar isotopes.

- Genetically Modified Organisms (GMO): While the debate about GMOs effect on agriculture, environment and health continues, many consumers believe they have a right to know if a food item contains them in order to make informed purchases.

GMO labeling is required in more than 60 countries, including Italy, Spain, France, Germany, the UK, Japan, China, Russia, Brazil, Mexico and Saudi Arabia.

The California Right to Know ballot initiative is up vote November 6^th, and if passed will mandate that all foods containing GMOs sold in California be labeled.

If this ballot initiative passes, this might be a precursor to mandatory labeling in other states, so the outcome of the vote goes well beyond California.

Understanding the label leads to better choices

I don’t think that reading the ingredient list is such an arduous task that we have to dumb down nutrition information to a traffic light system (although a clever, straightforward one could potentially help).

I believe that people need to have minimal nutrition knowledge in order to make the right decisions for themselves, based on their personal set of needs and values. Nutrition literacy is key to living in our obesogenic environment. Minimal medical literacy determines how well you’ll be able to care for yourself and to advocate for loved ones, and in much the same way nutrition basic knowledge promises you will be able to navigate your way to healthy food in an ocean of junk.

A de-cluttered front of package, free from misleading health claims and false promises, would give the average person a chance to turn the package around, and quickly read the ingredient list and nutrition facts. I’m always amazed at kids' deep knowledge of sports’ statistics, and the number of player's names they remember. Reading and understanding an ingredient list after a short introduction to food should be quite revealing, and exempting us from reading the label by the instant gratification of a traffic light code makes us less informed and more open to manipulation by food marketers.

And if you’re looking for a good packaged food grading system, based on nutrition facts and ingredient lists, try Fooducate’s (free) app.

Dr. Ayala

 

The unhappy truth about sugary drinks

Happiness in a bottle, or a disease promoting source of gloom? The Center for Science in the Public Interest (CSPI) released a new animated film, repositioning soda and other sugary drinks as obesity and illness causes, and stating a few (well supported) facts. The film features an original song by Grammy-award-winning singer songwriter Jason Mraz.

The bears are not that happy, but the video is quite entertaining. What do you think? 

 

Dr. Ayala

Do lots of choices make you happy or just fat?

When I was a young university student I used to stop by the open-air market for fresh fruit and veggies and take my time selecting what I thought would be the absolute best produce in the pile.

“You’ll never find a husband,” one vendor said to me.

Happy to say he was wrong. I did find love. And I also did feel I selected some of the best apples in town.

But now, when I stand in front of a supermarket isle with 50 different toothpastes to choose from I often feel I’ll never be able to pick the best one, and I have no fun looking through all the options. I know my apples and enjoy handling them, but I’m just looking for ordinary toothpaste, you know, the kind that cleans teeth and tastes like toothpaste. 

How does the enormous choice we have in food affect us?

Variety is the spice of overeating

A summary of 39 studies concludes that having many choices makes us eat more, especially when the extra variety is from energy-dense, tempting foods.

Research also suggests satiety is relative. You may be too full to eat another bite of salad, but when offered dessert you’re hungry enough – and that’s because dessert offers a new, pleasurable, sensory experience.

Most of the studies suggest that the tendency to overeat in reaction to greater variety of food is dependent on the food’s energy density and potential sensory pleasure; offering a greater variety of lettuce, broccoli and oranges doesn’t cause overeating, but presenting a great variety of sweet, fatty and salty options, each with their own taste and mouth feel, does.

Variety is the spice of life, but too much variety is the spice of overeating. It’s hard to stop eating the box of chocolates when you’re excited to find out what comes next.

Back to the supermarket shelf, the one with 100 types of cereal. Why does looking at that selection make me sad? Why does a buffet with 20 kinds of pastry leave me with sense of regret?

What’s wrong with choice?

Psychologist Barry Schwartz explains the suffering caused by over-choice in his book The Paradox of Choice: Why More Is Less.

With too many choices, it’s hard to choose at all. You put the choice off.

Even if you make a choice, you’re less satisfied with your choice. It’s easy to imagine a better choice. With every decision there’s chance for regret and disappointment.

Because when there are lots of alternatives there are lots of lost opportunities and paths not taken.

With ample choices there’s also escalation of expectation -- our expectations go through the roof -- and it becomes difficult to have a pleasant surprise.

That’s why many high achievers opt to simplify their lives by reducing the amount of decisions and choices they need to make. Michael Lewis describes in his recent Vanity Fair profile President Obama’s voluntary simplicity: To maximize his ability to make the right choices, the president creates an environment where he eliminates trivial choices, including what to eat for breakfast or what to wear each day — all of his suits are blue and gray, for example.

A simpler pantry

Some choice is good. Too much isn’t. There’s a secret magic number and we have to figure out what that number is for us. 

Limiting the variety of tempting, high-calorie foods has the potential to help prevent overeating. Increasing the variety of healthy foods might be an easy way to give us the satisfaction of choice without the downside of overindugance.

One of the things I do when I’m in the presence of plenty is to completely ignore the multitude of options. I’ll eat just what I usually eat at home instead of falling for the generous breakfast buffet offerings. I know that might sound boring, but eating the same breakfast every day brings me a sense of calm – and keeps me from tasting it all.

How do you handle endless choices?

Dr. Ayala 

Exercise isn’t the solution

Physical activity is incredibly important to our health.  Exercise improves almost all aspects of physical and mental health, and people who are physically active are also usually thinner.

But that doesn’t necessarily mean that exercise will make you shed extra fat.

The makers of junk and fast food are sponsors of exercise, from backyard games and pee wee leagues to the World Cup and the Olympic Games, and suggest that in this little imbalance we have between caloric intake and caloric expenditure we shouldn’t lay the blame on eating too much but rather on exercising too little.

And it would have been nice if we could go for a brisk walk and forget about inconvenient eat-less guidance. I, too, would like to believe that. But is it true? 

Exercise as a weight-loss tool

A new study in the British Medical Journal (BMJ) looked at 30 randomized controlled trials in which kids were assigned an intervention aimed at promoting exercise. What’s special about this analysis is that the review includes only studies in which physical activity was objectively measured using accelerometry devices (accelerometers measure body movement, and are an unbiased way to sum up activity – they’re much better than asking people how active they’ve been over the day).

The results were disappointing. Kids on exercise regimens added on average only a tiny and negligible amount of active time – about 4 minutes -- to their daily tally compared to controls. These extra 4 minutes would amount to about 15 extra calories burnt. Definitely not enough to justify the sports drink or a fast food meal many kids are rewarded with after they exercise.

How come adding several extra hours of physical activity at school ends up adding close to nothing? Well, one of the explanations the authors offer is that the exercise interventions simply replaced equally intense exercise that would have taken place after school – instead of running in the playground kids were exercising at school. Our natural instinct might be to regulate activity around a set point, and when we expend more than our usual energy we follow that activity burst with inactive periods of rest.

The authors conclude:

“Physical activity interventions have little effect on the overall activity levels of children, which may explain, at least in part, why such interventions have had a limited effect on body mass index or body fat. The outcome of this meta-analysis questions the contribution of physical activity to the prevention of childhood obesity.”

Are we less active than our ancestors?

Kids need plenty of physical activity. Current recommendations are that kids get 60 minutes a day of any activity that makes their heart race and gets them breathing hard – they need to sweat. Only a third of US kids get that much.

On the other hand, while obesity rates have doubled and tripled over the past few decades, physical activity levels have been quite stable over that time period, and studies have shown that kids today move no less than when the obesity rates were much lower. TV was invented a long time ago.

A neat recent study in PLoS ONE further debunks the notion that our sedentary lifestyle is the culprit in the obesity crisis. The study quantified daily energy expenditure (by measuring carbon dioxide production) among the Hazda people of Tanzania, one of the few remaining populations of traditional hunter-gatherers. The researchers found that despite covering many miles a day in search of food, the number of calories that the Hadza burned was pretty much the same as that of typical adults in Europe and the US.

How could that be? The researchers think that the Hadzas’ bodies have adjusted to the higher activity levels required for hunting and gathering by saving energy on other activities. Our bodies spend energy even when we seem not to move much, and their guess is that these ‘background’ activities can be done more efficiently when energy is spent elsewhere.

That doesn't mean that ecercise is a waste of time. Exercise will make you healthier, and is a key habit change that can open the door to healthier eating and other good habits, some of which can also help with weight loss and weight maintenance.

But there’s very little support for the idea that exercising more without eating less can change your weight.

It’s the food; it really is! We’re getting fat because we eat too much and too much of the wrong things. Our food is tempting and sweet and plentiful.

Leading a sedentary lifestyle is another major health issue, one that should be addressed because physical activity is a wonder power for wellbeing.

But addressing physical activity alone will do close to nothing to obesity rates.

Dr. Ayala