“Food is symbolic of love when words are inadequate.”

By Sarah Stickley, MPH/RD student at UNC

heartAs a person who never knows the right thing to say at the right time, especially when someone is worried, grieving, or sick, I appreciated this quote by an author named Alan Wolfelt that I recently came across: “Food is symbolic of love when words are inadequate.”

While working in a hospital this summer, I discovered the truth of this statement firsthand. While families sat by their loved ones’ bedsides waiting for good news from the doctors, my first questions were always about what the individual had been eating recently. For husbands, wives, and children who felt helpless in the face of illness, these questions served as a lifeline, an opportunity for them to express how much they cared for the patient and the lengths to which they were willing to go to ensure that their loved ones received the sustenance they needed. By telling me what their loved one’s favorite foods were, recounting exactly how much breakfast they had been able to feed them, and describing the specific ways that they had tried to encourage continued healthy food intake when faced with illness that robbed the patient of an appetite, these families were more clearly communicating their love than any other words ever could have.

This lesson has become more personal for me in the past few weeks as I’ve spent time at home with my family and aging grandparents. It’s difficult to find the words to express exactly how it hurts to see my grandfather’s memory slip away or how much I wish I could bring back my grandmother’s strength and vitality. But, I’ve found that in my moments when I lack the right things to say, making them a home-cooked dinner or driving to the store to pick up the extra bananas and milk shows them how much I want to see them well-cared for and just how loved they are.

This communication of love through food doesn’t just take place in families, however. There are many incredible organizations in the community that use food as a means of showing love and support. For example, the Ronald McDonald House provides families whose children are long-term patients at local hospitals a place to stay and rest during a stressful time in their lives. Cooking and serving meals to families staying at the house is an incredibly important volunteer role that individuals and groups can fill on a weekly, monthly, or one-time basis. Meals on Wheels, which provides at-home lunch delivery to older adults, is another community organization that uses food to provide social support and to send a message of caring. Volunteers, preparing and delivering food to older adults who may not be able to leave their homes or cook for themselves, not only provide a warm lunch, but also provide a friendly face and social connection that is often lacking in their daily lives. If you are interested in volunteering with either of these organizations, you can visit their websites by following the links above to find opportunities near you.

Much Ado About Menu Labeling

By Sarah Lowe, MPH/RD student

covering eyesSo you’re at The Cheesecake Factory (you love cheesecake).  You open the menu to the dessert section.  Next to your favorite cheesecake, Chocolate Oreo Mudslide of course, is a number.  1,080.

At this point, you have a couple of choices.  You can order it anyway, since you just finished finals and you deserve it.  You can select a lower calorie cheesecake (which is still around 800 calories).  Or, you lose your appetite for cheesecake altogether.

What would you do?  Would knowing the calories affect what you ordered?  Would you be grateful for the number that narrowly saved you from eating 50% of your day’s calories in one go, or would you be cursing it for forever changing the way you think about your favorite dessert?

fast food streetThis dilemma is at the crux of the menu labeling controversy, which pits peace of mind vs. waistline and FDA vs. restaurant industry.  With most Americans consuming about 30% of their calories from food obtained outside the home, there’s a new focus on the ways in which the restaurant industry can become a part of anti-obesity efforts.

Don’t get me wrong, nationwide menu nutrition labeling is not going to be optional.  It was mandated by the Affordable Care Act, which was passed in 2010.  The FDA’s proposed requirements require restaurant chains with over 20 locations to post calorie amounts next to each menu item, although establishments such as bowling alleys, airplanes, and movie theaters would not be subject to these rules.

However, the FDA has not yet finalized or implemented these proposed requirements.   In this elapsed period of time, the issue has become rather controversial thanks to select research findings and the powerful influence of the restaurant industry.

A recent study published in the American Journal of Public Health indicated that labeling menus with calories actually led to increased calorie consumption by study participants.

RWJOn the other hand, a 2013 Robert Wood Johnson Foundation literature review paints a more comprehensive picture.  In survey-type studies, about 30% of participants indicated that seeing calorie information at restaurants influenced their purchase.  On the other hand, studies carried out in real-world restaurants or cafeterias have more conflicting results, with some showing a decrease in calorie consumption, and others revealing no change.

It’s also interesting to note that the effect of menu labeling on food choices differs across sub-groups; women are often more likely to see and use calorie information than men.  Predictably, one’s level of dietary constraint (how careful you are with what you eat) also influences the effect of menu labels.

So what’s the conclusion?  As it often is in the world of public health research- the results are mixed!

Displaying calories on menus may decrease calorie consumption, and it may not.  So what’s the harm in trying?  The FDA says they’re hoping to approve the rules by the end of 2013, and begin implementing them 6 months later.  The holdup is centered around finalizing the exact establishments that will be covered under the rule, as well as the specific format of the posted information.


In a recent interview with the Associated Press, FDA Commissioner Margaret Hamburg said, “There are very, very strong opinions and powerful voices both on the consumer and public health side and on the industry side, and we have worked very hard to sort of figure out what really makes sense and also what is implementable.”

Hamburg also called this an “extremely thorny” issue, which realistically is probably a vast understatement.

This will be an interesting topic to follow through to implementation…so stay tuned!


Smartphones provide a window into Chinese eating habits

Lindsey Smith is a doctoral student in nutrition epidemiology at UNC, Chapel Hill. 

Public health and nutrition researchers need to know what people eat in order to evaluate how diet affects health and life, and to make recommendations about health policies. That should be easy, right? We in a world where 3-D printers print pizza and our phones tell us which taco truck has the best carnitas.
food apps

But, as anyone who studies nutrition epidemiology can tell you, collecting data on diet is a tricky business. Each assessment method is prone to a set of biases that make it difficult to get an accurate read on the type and amount of food people eat. For example, the 24-hour recall, the method that is used by major national nutrition surveys, asks people to remember and report everything they ate in the last 24 hours. The problem? People forget. It can be difficult to remember every bite of food that crossed your lips, and even more difficult to figure out exactly how much you had.

And even when people do remember, they often lie. Social desirability bias is the tendency of participants to give researchers answers that are socially acceptable, and leads to underreporting of unhealthful foods or stigmatized behaviors like smoking or drinking. What’s worse is that this type of bias is often stronger amongst those with the very conditions we’re hoping to study—like type 2 diabetes or obesity—making it even more difficult to determine the truth from the data.

Chinese Street VendorIn China, the picture gets even more complicated. The China Health and Nutrition Survey is an ongoing cohort study beginning in 1989 that was designed to how understand the rapid social and economic changes in China have impacted the demography, diet, and health of the population. Although the survey employs gold-standard techniques of collecting diet data, including multiple consecutive 24-hour recalls and household inventories of the food supply, capturing all foods and beverages people consume is exorbitantly difficult.

For one thing, in China, people tend to eat meals family-style, Chinese foodwhere a number of dishes are shared between diners who eat from the common dishes using chopsticks, making it difficult to figure out just how much any one person ate. Secondly, nutrition information on foods eaten away from home is lacking, which poses an increasing problem as a growing urban population eats out more and more at the street vendors, small shops, fast food restaurants, and convenience stores dotting every corner.

Because of these issues, it’s unsurprising that researchers recently noticed an odd quirk in the data. Despite the rapid proliferation Chinese Coca Colaof packaged beverages like soda and sports drinks, the diet data recorded only very low levels of consumption of these new drinks. Because China’s diet patterns are Westernizing so rapidly, capturing accurate information on processed packaged foods like sugar-sweetened beverages is essential to understanding the link between these new diet patterns and health.


Samsung smartphoneIn response to this dilemma, we created a new diet assessment methodology to see if we could improve our ability to accurately record the new types of beverages people are drinking and how much of it. In collaboration with Edmund Seto and Jenna Hua, environmental health researchers at the University of California, Berkeley, and the staff at the Shanghai Center for Disease Control, we developed a smartphone-assisted 24-hour recall. In this methodology, participants use a Samsung smartphone to take video recordings of everything they eat and drink for three days. At the end of each day, the participant reviews the video with an interviewer to help boost their memory of what he or she consumed. In addition, a special app on the phone prompts participants to respond to a short survey every few hours, asking if they had anything to drink since the last survey.  The phones also collect information about the participant’s location and physical activity, which allows us to assess their exposure to the food environment: what restaurants they encounter during their everyday life.

In March of 2013, I traveled to Shanghai with Jenna to work with our CDC collaborators to test the new method in a small group of young adults living in and around the city. We knew that, like all field-based researchers, we should expect the unexpected; as we encountered challenges like the outbreak of the bird flu in our study site, or the difficulty in getting internet-based apps to run despite the proverbial “Great Firewall”, we were almost forced to shut down the study. Luckily, we were able to collect data on over 100 participants.

We’re only now analyzing the data, but our hopes are high that this new technology may lead to a more accurate reflection of what people eat and drink. It might not be as fancy that pizza-slinging 3-D printer, but at least it’s a step in the right direction.

Adolescent Nutrition in Uganda

For the past 2 months this summer I had the privilege of interning for a Community Based Organization in Uganda known as the “Kyetume Community Based Health Care Programme (KCBHCP).” It is a grassroots development organization that offers affordable health care services and also does numerous outreach programs with rural villages all over the district. I traveled here along with 2 other UNC undergrads through the organization Advocates for Grassroots Development in Uganda (AGRADU) under the Campus Y.

My main focus during my time here has been developing an adolescent nutrition program to be implemented at local secondary schools. Currently there is close to nothing taught about the basic science of nutrition within the academic curriculum for secondary schools. Furthermore, we noticed there are a lot of misconceptions regarding proper nutrition.

Healthy Plate gameOur project consisted of 2 school visits to a couple of secondary schools. During the first visit we reviewed basic principles of proper nutrition—such as a well-balanced diet, which food groups the common foods belong in, what a calorie is, macronutrients, and why physical activity is important. In an effort to engage the students and use a more visual tool, we played a game where 2 teams competed to correctly place common local foods into the categories of grains, protein, fruits, or vegetables.

We also wanted to encourage the students to be aware of their current nutrition status. To do this, we measured their BMI and did a diet analysis via a 24-hour recall. We discovered that the majority fell within the normal BMI range, and only a handful fell below. Eli from the MPH Nutrition program graciously helped us analyze the 24-hour recall and it was concluded that fruits, vegetables, and water were most significantly lacking from their diets. Another issue was repetition within the few vegetables the students would consume. For example, three vegetables that the students commonly consume are potatoes, cassava, and yams, which all essentially contribute the same nutrients.

The finished school garden at KAMDA Secondary SchoolOur second visit to the schools was dedicated to building a school garden (known as a “kitchen garden”) with the students. This type of garden is recommended by the USAID, and It includes a compost pile in the center, which utilizes food waste, waste-water, and manure to fertilize the surrounding plants. Our goal was to empower the students with the skills necessary to construct similar gardens at home as a way to take ownership of their dietary health. The students were given the responsibility of maintaining the garden and determining what needs to be grown to supplement their diets. Maintenance will be rotated among students to give them all a chance to learn the effective methods. The contents will be used by the school cook to prepare the lunches, so there is an added incentive for the students to choose wisely about what they choose to plant.

The village health leader (in green) demonstrates efficient cooking methodsAside from this project, we also had the chance to attend nutrition related outreach programs in rural villages such as child nutrition cooking demonstrations—which educate women on how to prepare food in a way that facilitates its digestion by children below 5—and kitchen garden demonstrations. I have been thoroughly impressed at how KCBHCP’s outreach programs are geared towards prevention through positive lifestyle changes. This attitude towards nutrition is at the heart of public health and is often lacking within NGOs that operate in third world countries.

Changes to the Farm Bill: fiscal responsibility or partisan politics?


Legislation affecting the U.S. food supply is the subject of fierce debate

Last week, the US House of Representatives made an unprecedented move: despite a decades-long trend of fewer and longer legislative bills, it actually split and shortened one of the most notoriously lengthy bills in Congress – the Federal Agriculture Reform and Risk Management Act of 2013 (aka the farm bill). 

Image:As a result the bill, described by the Public Health Law Center as “arguably the single most important piece of legislation affecting the nation’s food environment,” might be seeing some major changes. Congress has until September to agree on those changes, or else portions of the bill will expire, potentially endangering the nation’s agricultural economy.

The farm bill covers such extensive topics as food safety regulation, crop subsides, nutrition education, SNAP, land conservation, ethanol production, agricultural research, foreign food aid, and commodities marketing – so why does its fate hang precariously in the balance? The short answer is politics and money.

gridlockIn June, the Senate passed a version of the farm bill that included modest cuts in funding to SNAP (aka food stamps, used by the nation’s poor to purchase groceries) for the sake of deficit reduction. A few weeks later, the House of Representatives voted on a version of the farm bill which included amendments – introduced by the House’s conservative majority – with more drastic cuts to SNAP. In a surprise outcome, the House was unable to get sufficient support to pass this bill for the first time in the farm bill’s 70+ year history; to many, this was emblematic of the inefficiency that results from highly-partisan gridlock. Most Democrats did not support the bill because they believed the level of funding cuts to SNAP was too great, whereas our most fiscally conservative representatives opposed the bill because the cuts weren’t deep enough.

The bill’s failure to pass was an embarrassment to the House, whose Republican leaders then decided that the only way to recover from the defeat was to separate the bill’s major topics (agriculture and SNAP) into two independent bills and get at least one of those bills passed. Last week, the agricultural portion of the split bill was passed by the House’s conservative majority – without a single Democratic vote. No corresponding bill on SNAP has yet been put up for a vote, leaving many people concerned about the fate of the nation’s poor.

Activists Protest House Farm Bill Plan To Cut Food Assistance Program

How do changes in the farm bill affect the public?

In order to understand the bill’s influence on the economy, the land, and the public’s health, it helps to have some historical context. The farm bill dates back to the 1930s, when mechanization of agriculture led to large surpluses and falling prices. In 1938, Congress sought to aide suffering farmers and ensure that the food supply remained steady by passing legislation that funded crop insurance, price supports, and marketing quotas. 

Population shifts in the following decades, when people moved toward cities and farm communities shrank, led the agricultural interests served by the farm bill to worry about its longevity. Therefore, in the 1970s, rural legislators representing the bill’s agricultural beneficiaries included funds in the bill for the food stamp program – this attracted the support of legislators representing the interests of the urban poor. Today, the food stamp program known as SNAP is considered to be one of our nation’s most important safety nets, especially crucial in times of economic distress. The Center on Budget and Policy Priorities notes that it is one of our most effective anti-poverty programs, and reports from the Census Bureau indicate that SNAP lifted 3.9 million people above the poverty line in 2010, decreasing the nation’s poverty level by over 8%.


The SNAP portion of the farm bill currently represents a large percentage of the bill’s total expense; if Congress were to pass a new farm bill like the one that has been in place since 2008, it would cost approximately $1 trillion over the next decade, and 80% of that money would go toward SNAP. The agricultural portion of the bill has also been greatly expanded since 1938; it now includes a labyrinthine set of agricultural subsidies. Additionally, the farm bill now includes various small funds for conservation projects, food aid, etc. To sum up: today’s farm bill is vastly different from the original farm bill.

The original 1938 legislation established that the farm bill must be reviewed approximately every five years. If at the five-year mark it is not renewed with up-to-date policies, the bill reverts back to the policies set in 1938. Until recently, the farm bill passed smoothly at every 5-year-renewal. Some people considered it to be an ideal example of bipartisanship and cross-party collaboration, because it has gotten passed even in times of great political conflict on Capitol Hill. But in today’s political climate of deep budget deficit and fiscally conservative legislators, the renewal process is no longer smooth sailing; members of Congress can’t agree on the level of funding cuts, and they might fail to renew the bill by its due date. The bill’s subsidy policies have evolved so much over time that if a reversion to the 1938 policies were to occur, it could cause great unplanned upheaval of the economy. Many legislators are currently calling for a return to the bipartisan days of yore when ruralists and urbanists, liberals and conservatives alike cooperated to renew the farm bill without hassle.

Bipartisanship or logrolling? Criticisms of the farm bill

But not everyone agrees that an effortless bipartisan process should be the goal. The flip side of the bipartisanship coin is one of the most bemoaned features of the American legislative system: logrolling. For decades, Washington outsiders have opposed the trading of votes between urban and rural legislators – which essentially allows each side’s interests to be served without great scrutiny. Leading nutrition advocates attribute the agricultural subsidies to the rise in obesity and chronic diseases such as diabetes, foreign policy experts and humanitarians identify the “foreign aide” portion of the bill as a food dumping scheme that benefits the US rather than the international recipients, and environmental advocates blame the bill’s promotion of agricultural consolidation for the unsustainable porkbarrelpoliticstrend of monoculture. Some of these criticisms have been allayed by pots of funding for nutrition education, conservation programs, and the like – but this has the effect of making the farm bill look like a big barrel of pork.

For better or worse, the splitting of the farm bill into its respective components for separate rounds of voting would mean that each funding pot must be individually approved by a majority of the legislature, which leads us to the big question of the day: which programs/policies actually have enough support to get passed on their own? The answer might be “none,” in which case we have to consider the consequences of losing the programs, or it might depend on the political climate of the moment. If legislators are truly going to scrutinize each farm bill program at every five-year renewal, large shifts in agricultural policy and food stamps might be more likely to occur on a five-yearly basis. Whether the potential economic turbulence caused by shifting of the political winds could be outweighed by improved agricultural and food aid legislation remains to be seen.

What is best for the nation’s health?

Considering the farm bill’s effects on various elements of American life, public health advocates might find themselves considering a major philosophical question: which is more important, the reduction of agricultural subsidies which support an unhealthy food supply, or increases in funding for positive public health programs? Even more broadly: will people be healthier if the government just steps out of the way, or if it provides support in the face of detrimental economic and/or corporate pressure?

Unfortunately, the House appears reluctant to do either of the above. Though some critics have referred to the splitting of the bill as a “divide and conquer” method through which fiscal conservatives would reduce funds allocated both to agriculture and to nutrition, the reality is that the agricultural portion of the bill which was passed last week had few drastic changes. The main difference between it and the agricultural portion of the 2008 farm bill is that money was re-directed from a subsidy system of agricultural support to a crop insurance system of agricultural support.


In fact, the Environmental Working Group believes it will be the costliest farm bill in history, and conservative think tank the Heritage Foundation has criticized House Republicans for their support of the “bloated” agricultural bill. No, the majority’s goal was not to reduce funds from every aspect of the farm bill, but specifically to reduce funding for SNAP. Fiscal conservatives point to the recent rises in SNAP expenditure as evidence that the program is ballooning out of control, but the rise in expenditures during recessionary times is an expected outcome of a program specifically aimed at alleviating financial hardship; changes in policy could be considered short-sighted or even, as  some political opponents claim, a sign of the party’s hatred for the urban poor.

However, right now it looks as though the goals of the House’s conservative majority will not come to pass. Though the House may yet pass a very whittled-down SNAP bill, the potentially huge cuts to SNAP are not likely to endure the House’s conference with the Senate. If large cuts are sustained or SNAP is simply left out, the White House has threatened to veto the final bill.

Given the shake-up of the bill’s renewal process, and the fact that the agricultural section and the SNAP section of the bill may now be considered separately, legislators will likely be keeping an ear to the ground regarding their constituents’ views on each. It is a good time to make your opinions known.

Please share your thoughts as nutritionists, public health advocates, and citizens!

Focus on Fluid – Staying Hydrated in the Summer Heat

By Sarah Stickley, MPH/RD student at UNC

Hot summer weather is officially here to stay in North Carolina! As you (hopefully) enjoy lots of outdoor adventures and afternoons by the pool, staying hydrated can often be the last thing on your mind.  Here’s a run-down of why hydration is so important and how you can make sure you stay ready for more summertime fun.


So What If I’m Dehydrated?

Dehydration can lead to more than just being thirsty. While some of the consequences, like dry mouth and sluggishness, are unpleasant but not particularly dangerous, others are a bit more worrisome. — dehydration can lead to weakness, dizziness, fainting, fever, and vomiting.

How Do I Know If I’m Dehydrated?

Being thirsty is a good sign that you need to drink some fluids. But, you can’t always rely on thirst because your body needs water even before you start feeling thirsty. One quick way to gauge your hydration status is (YES, I know this sounds gross…) to check your urine color.  Clear to light yellow (think lemonade) usually means you are adequately hydrated while darker yellow (like apple juice) is a good sign that you need to increase your fluid intake.

 So What Can I Do About It?

If you’re spending time outside without any strenuous activity, keep a water bottle with you and sip on it throughout the day, even if you don’t feel particularly thirsty. Drink larger amounts at meal times and remember to take breaks inside or in the shade. If water really isn’t your thing, try adding some lemon or lime juice for a little flavor. Any liquids, except for alcohol, will help you stay hydrated, although sugary drinks like soda, sweet tea, or juice drinks can add unnecessary sugar and calories.

If your summertime habits include outdoor endurance exercise, or any activity where you end up sweaty, you will need to be a little more vigilant to prevent dehydration. Here are some guidelines from dietitians that specialize in sports nutrition: 1. Drink 1-2 cups of fluid (water or a sports drink) an hour before exercising,  2. Drink during exercise, 4-6 oz every 15 minutes. If your exercise time is less than an hour, water should be sufficient. But, if you are exercising for over an hour, a sports drink may be better to help replace both the fluid and the electrolytes you are losing. 3. Track your sweat loss by weighing yourself before and after exercise. Drink 2-3 cups of fluid for every pound you lost.

Enjoy the summer and stay cool!

The Mystery of the Serving Size

 By Sarah Lowe, MPH/RD student at UNC

cartoon_detectiveTYou know when you think you have it all figured out, but then it turns out that you really don’t?

That happens to me all the time, but most recently thanks to a most unlikely culprit- serving sizes.  I used to think, “I’m a nutrition student.  I know how to read a Nutrition Facts label.  Obviously I know what a serving size is.”

And as it turns out, I didn’t.  What about you?

Would you say a serving size is the amount of food that is recommended from a food group, the amount of a food that people actually eat, or the reference quantity listed on the Nutrition Facts label?  Or, all of the above?

It’s amazing how thinking twice can suddenly transform a simple term that we all “understand” into a conundrum worthy of Sherlock Holmes.  If you’re confused, the good news is that you’re not alone.  The bad news is that nobody seems to agree on exactly what the term means, or how it should be used.

Let’s take a look at what some experts within the health field have to say:

eat right squareThe Academy of Nutrition and Dietetics says, “A serving is the amount of food recommended in consumer education materials such as MyPlate”.

The American Heart Association says, “A serving size is the amount of food listed on a product’s Nutrition Facts”.

The National Heart, Lung, and Blood Institute says, “A serving is the unit of measure used to describe the amount of food recommended for each food group.  It is the amount of food listed on the Nutrition Facts panel on packaged food or the amount of food recommended in the Dietary Guidelines for Americans.”

Well, that doesn’t help much.  As you can see, even reputable sources of health information paint a puzzling picture.

According to the FDA, which establishes and regulates serving sizes on food labels, a serving size is defined as “the amount of food customarily consumed per eating occasion”, and is mainly based on data derived from 1977-1978 and 1987-1988 USDA Nationwide Food Consumption Surveys.

label magnifying glassSo, technically, a serving size is the quantity of a specific food that people four years of age and over generally consumed at one time in the late 70’s and 80’s. 

I bet you didn’t see that one coming.

Food companies are required to conform to FDA’s standard serving size amounts established for each food category, such as breakfast cereals, pie etc.  So, if you feel cheated by a cheddar cheese label’s 30 gram (1.7 cubic inches) serving size, don’t blame Kraft, blame the survey participants who likely underreported their food consumption 30 years ago.

So how do serving sizes factor into USDA’s MyPlate model and the Dietary Guidelines for Americans, two of the principal “go to” sources for information about nutrition recommendations?  Well, they don’t.

myplate squareThe 2010 Dietary Guidelines for Americans don’t use or even define the term “serving size”, but rather frame their recommended amounts in terms of “food choices”.  Similarly, MyPlate, which is based on these guidelines, has not a “serving size” in sight.

The bottom line is that the USDA’s recommendations and Nutrition Facts label serving sizes are referring to completely different things.  The Nutrition Facts label references an arbitrary quantity of food that is (or rather, was) commonly consumed, and should be used only to inform consumers about the calorie and nutrient content of a product.

On the other hand, guidelines such as MyPlate are referring to ideal quantities to consume from each food group per each day or week, and have nothing to do with Nutrition Facts serving sizes.  While sometimes the quantities coincide, often they don’t.

groceryfail_thumbIf this dichotomy is confusing for nutrition students or professionals, can you imagine how befuddling it must be for the average consumer?

The issue comes down to the fact that the term and/or concept of “serving size” is used by different agencies, to refer to different amounts of food, for different purposes.

It’s admirable that the Dietary Guidelines are attempting to distance themselves from processed foods and outdated food label serving sizes.  However, when the term “serving size” and its various synonyms are not clearly distinguished by traditionally reliable sources of information, it’s the consumer who gets caught in the crossfire.

Ironically, I found the best “layman’s terms” explanation of what a Nutrition Facts label serving size actually is on ShopRite’s website (a grocery store chain).  Wikipedia wasn’t bad either.

It’s startling to think that a grocery store conveys a clearer definition of an ambiguous nutrition term than professional or government health organizations.  To me, this points to a need for clarification, as well as collaboration between agencies and nutrition educators to present a consistent message.

What do you think?


Grocery Shopping Without Breaking the Bank

By Sarah Stickley, MPH/RD student at UNC

cheap-grocery-shopping-02Saving money is at the top of everyone’s priority list. And, if you’re a student trying to do your own grocery shopping and cooking for the first time, you know just how hard it can be to feed yourself without breaking the bank. Here are some tips for navigating your next trip to the store:

  •  Make a plan and a list: Before you leave home, think about what you’d like to eat for the week and make a list of everything you’ll need.  Planning ahead and sticking to your list will cut down on impulse buys and unnecessary purchases that increase your bill. (Don’t forget to stock up on some healthy snacks to avoid buying them at a higher price at local convenience stores. Here’s a post from UNC Student Wellness to help you out!)
  • Compare prices: Once you’re at the store, check out the price difference between name brand and store brand products. If they are different sizes, make sure to look at the unit price listed at the bottom of the price tag (like price per pound or ounce).
  • Get the store’s discount card (think VIC or MVP): Most stores’ cards are free and the discounts add up.
  • Don’t shop when you’re hungry: You’ve heard it a million times and it’s probably true. Chips and candy bars look ten times more inviting when you’re starving.
  • Explore frozen and canned fruits and vegetables: These options last longer than fresh and can be just a healthy. If you buy canned foods go for low-sodium options or rinse them before cooking and avoid fruit in heavy syrups.
  • Be adventurous in the kitchen: Less processed foods are usually cheaper than pre-prepared ones. So, if you have access to a kitchen, try cooking regular chicken breasts instead of buying them pre-cooked or make soup from some beans and vegetables in place of buying lots of cans. Here are some quick and cheap meal ideas.
  • Don’t buy in bulk unless you’ll be able to use it all before the expiration date: Yes, bulk foods are often cheaper per pound, but if you can’t use it all, you’re throwing away money.

With these tips and a little trial and error, buying your own groceries and cooking for yourself can be a great way to have fun, be healthy, learn new skills, and save money in the process!

The high social costs of cheap fast food

Wednesday, May 8th: Fast food workers in St. Louis Missouri demand higher wages, safer working environments, and the right to unionize

Wednesday, May 8th: Fast food workers in St. Louis Missouri demand higher wages, safer working environments, and the right to unionize

This post was written by guest blogger Esther Giezendanner, a 2nd-year UNC Chapel Hill MPH/RD student with an interest in global nutrition issues. 

It’s hardly a secret that fast food is cheap. Many food writers and public health experts attribute that fact to the use of subsidized ingredients and mass-produced meal components – but there’s another side to the issue. Much of the cost of retail food isn’t the food itself, but the labor, and that labor is being paid for as cheaply as possible with minimum wage. Unfortunately, minimum wage isn’t necessarily a living wage. Compounding the situation, some food service workers can legally be paid less than minimum wage on the assumption that the difference will be made up by tips (which may or may not materialize).  Recently, food service workers (and their compatriots in retail) have decided to draw attention to the problem and demand increases in minimum wage.  Campaigners are targeting a $15-per-hour wage, well above the current federal minimum wage of $7.25 per hour.

Fast food workers in New York staged a walkout on April 4 to demand the wage raise and the right to organize without fear of reprisals. One inspiration for these demonstrations appears to be the Black Friday strikes at WalMart last November, which hit 100 cities, and was followed a week later by a fast food workers strike in New York on November 29. Now, protests have moved beyond New York: food service and retail workers in the Chicago Loop went on strike on April 24th. Most recently, fast food workers joined retail workers in a St. Louis Missouri strike to protest low wages and unsafe working environments, and demand the opportunity to form a union without intimidation.


Whether the strikes and walk-outs will continue spreading, geographically or across sectors, remains an open question but it does seem clear that the issue is not going to go away. This is especially true since mid-wage occupations have had much lower growth than lower-wage jobs since the 2008 recession, decreasing opportunities to move out of food service into better paid jobs.

So will workers get the $15 raise they’re asking for? It seems unlikely that wages will double, although moderate gains are possible. But that doesn’t mean the strikes will fail: if nothing else, they show that even the lowest-paid workers in America can and will make their voices heard and demand that the nation listen. And they are a timely reminder that food service practices have socioeconomic impacts well beyond their direct nutritional implications.



The Socially Acceptable Crash Diet

By Liz Sanders, MPH/ RD Student

juicing-detoxJuice cleanses and “detoxes” have been popular for years. The makers of these cleanses are masters of marketing and they prey on individuals (mostly women) who want to “supercharge their metabolism” and “flush toxins from the body.” Like any other quick fix for weight loss, there is no scientific basis or proof for these claims. This New York Times article shows why the vast majority of dietitians and medical professionals (with the exception of Dr. Oz) will not endorse these “magic” cleanses. Despite the mountain of evidence (be it scientific or common sense) AGAINST cleansing, the list of celebrity cleans-o-philes is still long and illustrious: Gweneth Paltrow, Blake lively, Beyonce, etc….

Unfortunately, socialites and celebrity doctors obscure the sad truth: cleanses are just socially acceptable crash diets, and they can give way to unhealthy patterns of restrictive eating behavior.

A recent article in Marie Claire (not the most illustrious scientific journal, I know) has shed light on this lesser-known danger of cleansing. Cleanses have actually led some adherents to slip into full-blown restrictive eating disorders (e.g. anorexia nervosa) and they are especially dangerous for individuals who have a history of restrictive eating behavior. Any type of cleanse drastically reduces the amount of calories you consume. For example, the “Master Cleanse” forces its followers to live on a mixture of water, lemon juice, maybe syrup, and cayenne pepper.  The sense of control provided by the restrictive eating pattern is addictive for some individuals. Instead of just “cleansing” for one or two weeks, they keep going and can slip into a lifelong pattern of unhealthy calorie restriction.

Cleanses also encourage people to draw a hard line between “good” and “bad” foods. Thinking of foods as inherently “bad” (and not as “sometimes” foods) can lead people to restrict those foods from their diet altogether. This is a common symptom of restrictive eating disorders.

dr-oz-01-1011-298x232A quick trip to the Dr. Oz show’s website reveals just how popular the concept of “cleansing” has become. Under their healthy façade, Dr. Oz’s clips on cleansing do far more harm than simply propagating confusing and meaningless terms like “toxins.” These clips show how our society has created a culture of body shame, and then used this culture to its advantage to sell us quick fixes for unwanted fat or even normal signs of aging.  Furthermore, these clips tout terribly restrictive eating plans (“cleanses”) as healthy weight loss methods.

So think twice next time you see a photo of Blake Lively leaving the gym with a bottle of green goo, or Dr. Oz hugging a juicer. When it comes to cleanses: don’t believe the hype.