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NYT > Fitness & NutritionNYT > Fitness & NutritionThe New Health Care: Sorry, There’s Nothing Magical About BreakfastPublic Health: You’d Be Surprised at How Many Foods Contain Added SugarScaling Back: A New Policy Disagreement Between Clinton and Sanders: Soda Taxes

http://www.nytimes.com/pages/health/nutrition/index.html?partner=rss&emc=rss http://www.nytimes.com/pages/health/nutrition/index.html?partner=rss&emc=rss https://static01.nyt.com/images/misc/NYT_logo_rss_250x40.png http://www.nytimes.com/2016/05/24/upshot/sorry-theres-nothing-magical-about-breakfast.html?partner=rss&emc=rss http://www.nytimes.com/2016/05/24/upshot/sorry-theres-nothing-magical-about-breakfast.html <div class=”image-container”><img src=”https://cdn1.nyt.com/images/2015/08/19/upshot/up-carroll-headshot/up-carroll-headshot-thumbLarge.jpg” alt=”Aaron E. Carroll”/></div> <p>Aaron E. Carroll</p> <p>THE NEW HEALTH CARE</p> <p class=”p-block”>I don’t eat breakfast. It’s not that I dislike what’s offered. Given the choice of breakfast food or lunch food, I’d almost always choose eggs or waffles. It’s just that I’m not hungry at 7:30 a.m., when I leave for work.</p> <p class=”p-block”>In fact, I’m rarely hungry until about lunchtime. So, other than a morning cup of coffee, I don’t eat much before noon. This habit has forced me to be subjected to more lectures on how I’m hurting myself, my diet, my work and my health than almost any other. Only a fool would skip the most important meal of the day, right?</p> <p class=”p-block”>As with many other nutritional pieces of advice, our belief in the power of breakfast is based on misinterpreted research and biased studies.</p> <p class=”p-block”>It does not take much of an effort to find research that shows an association between skipping breakfast and poor health. A <a href=”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797523/”>2013 study</a> published in the journal Circulation found that men who skipped breakfast had a significantly higher risk of <a href=”http://health.nytimes.com/health/guides/disease/coronary-heart-disease/overview.html?inline=nyt-classifier” title=”In-depth reference and news articles about Coronary heart disease.” class=”meta-classifier”>coronary heart disease</a> than men who ate breakfast. But, like almost all studies of breakfast, this is an association, not causation.</p> <p class=”p-block”>More than most other domains, this topic is one that suffers from publication bias. In a <a href=”http://ajcn.nutrition.org/content/early/2013/09/04/ajcn.113.064410.full.pdf”>paper</a> published in The American Journal of Clinical Nutrition in 2013, researchers reviewed the literature on the effect of breakfast on <a href=”http://health.nytimes.com/health/guides/symptoms/morbid-obesity/overview.html?inline=nyt-classifier” title=”In-depth reference and news articles about Obesity.” class=”meta-classifier”>obesity</a> to look specifically at this issue. They first noted that nutrition researchers love to publish results showing a correlation between skipping breakfast and obesity. They love to do so again and again. At some point, there’s no reason to keep publishing on this.</p> <p class=”p-block”>However, they also found major flaws in the reporting of findings. People were consistently biased in interpreting their results in favor of a relationship between skipping breakfast and obesity. They improperly used causal language to describe their results. They misleadingly cited others’ results. And they also improperly used causal language in citing others’ results. People believe, and want you to believe, that skipping breakfast is bad.</p> <p class=”p-block”><a href=”http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0029329/”>Good reviews of all the observational research</a> note the methodological flaws in this domain, as well as the problems of combining the results of publication-bias-influenced studies into a meta-analysis. The associations should be viewed with skepticism and confirmed with prospective trials.</p> <p class=”p-block”>Few randomized controlled trials exist. <a href=”http://ajcn.nutrition.org/content/early/2014/06/04/ajcn.114.089573.full.pdf”>Those</a> that <a href=”http://ajcn.nutrition.org/content/55/3/645.full.pdf”>do</a>, <a href=”http://www.sciencedirect.com/science/article/pii/S0031938414002601″>although methodologically weak</a> like most nutrition studies, don’t support the necessity of breakfast.</p> <p class=”p-block”>Further confusing the field is a 2014 <a href=”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095657/”>study</a> (with more financial conflicts of interest than I thought possible) that found that getting breakfast skippers to eat breakfast, and getting breakfast eaters to skip breakfast, made no difference with respect to weight loss. But a <a href=”http://www.ncbi.nlm.nih.gov/pubmed/1550038″>1992 trial</a> that did the same thing found that both groups lost weight. A balanced perspective would acknowledge that we have no idea what’s going on.</p> <p class=”p-block”>Many of the studies are funded by the food industry, which has a clear bias. Kellogg funded <a href=”http://seattlecentral.edu/faculty/jwhorley/Breakfast_BMI.pdf”>a highly cited article</a> that found that cereal for breakfast is associated with being thinner. The Quaker Oats Center of Excellence (<a href=”https://www.washingtonpost.com/news/wonk/wp/2015/08/10/the-science-of-skipping-breakfast-how-government-nutritionists-may-have-gotten-it-wrong/?version=meter+at+2&amp;module=meter-Links&amp;pgtype=article&amp;contentId=&amp;mediaId=&amp;referrer=&amp;priority=true&amp;action=click&amp;contentCollection=meter-links-click”>part of PepsiCo</a>) <a href=”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4473164/?version=meter+at+2&amp;module=meter-Links&amp;pgtype=article&amp;contentId=&amp;mediaId=&amp;referrer=&amp;priority=true&amp;action=click&amp;contentCollection=meter-links-click”>financed a trial</a> regarding consumption of oatmeal or frosted cornflakes (if you eat it in a highly controlled setting each weekday for four weeks), and found that only the no-breakfast group, which lost weight, experienced an increase in <a href=”http://health.nytimes.com/health/guides/nutrition/cholesterol/overview.html?inline=nyt-classifier” title=”In-depth reference and news articles about Cholesterol.” class=”meta-classifier”>cholesterol</a>.</p> <p class=”p-block”>Many studies <a href=”http://www.karger.com/Article/FullText/348878″>focus on children</a> and <a href=”http://onlinelibrary.wiley.com/doi/10.1111/ijpo.12082/full”>argue that kids</a> who eat breakfast are also thinner, but this research suffers from the same flaws that the research in adults does.</p> <p class=”p-block”>What about the argument that children who eat breakfast behave and perform better in school? <a href=”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737458/”>Systematic reviews find</a> that <a href=”http://journals.cambridge.org/action/displayFulltext?type=6&amp;fid=6845720&amp;jid=NRR&amp;volumeId=22&amp;issueId=02&amp;aid=6845716&amp;bodyId=&amp;membershipNumber=&amp;societyETOCSession=&amp;fulltextType=RV&amp;fileId=S0954422409990175″>this is often the case</a>. But you have to consider that much of the research is looking at the impact of school breakfast programs.</p> <p class=”p-block”>One of the reasons that breakfast seems to improve children’s learning and progress is that, unfortunately, too many don’t get enough to eat. Hunger affects almost <a href=”https://www.washingtonpost.com/news/wonk/wp/2016/01/27/obama-administration-announces-plans-to-increase-access-to-school-meal-programs/?tid=a_inl”>one in seven households in America</a>, or about 15 million children. Many more children get school lunches than school breakfasts.</p> <p class=”p-block”>It’s not hard to imagine that children who are hungry will do better if they are nourished. This isn’t the same, though, as testing whether children who are already well nourished and don’t want breakfast should be forced to eat it.</p> <p class=”p-block”>It has been found that children who skip breakfast are more likely to be overweight than children who <a href=”http://onlinelibrary.wiley.com/doi/10.1111/ijpo.12127/full”>eat two breakfasts</a>. But that seems to be because children who want more breakfasts are going hungry at home. No child who is hungry should be deprived of breakfast. That’s different than saying that eating breakfast helps you to lose weight.</p> <p class=”p-block”>The bottom line is that the evidence for the importance of breakfast is something of a mess. If you’re hungry, eat it. But don’t feel bad if you’d rather skip it, and don’t listen to those who lecture you. Breakfast has no mystical powers.</p> <div class=”corrections” readability=”10″> <p>Correction: <span class=”correction-pubdate”>May 26, 2016</span></p> <p>An earlier version of this article misstated the result of a study by the Quaker Oats Center of Excellence. It showed that a no-breakfast group had higher cholesterol levels, not that those eating oatmeal or frosted cornflakes had lower cholesterol levels or lower weight.</p> </div> <p><em>This article passed through the Full-Text RSS service – if this is your content and you’re reading it on someone else’s site, please read the FAQ at fivefilters.org/content-only/faq.php#publishers.</em><br />Recommended article: <a href=”https://theintercept.com/2016/12/29/the-guardians-summary-of-julian-assanges-interview-went-viral-and-was-completely-false/”>The Guardian’s Summary of Julian Assange’s Interview Went Viral and Was Completely False</a>.</p> Mon, 30 May 2016 07:45:53 +0000 AARON E. CARROLL http://www.nytimes.com/2016/05/24/upshot/sorry-theres-nothing-magical-about-breakfast.html?nytmobile=0 en text/html http://mobile.nytimes.com/2016/05/24/upshot/sorry-theres-nothing-magical-about-breakfast.html Diet and Nutrition Children and Childhood Lunch and Breakfast Programs Weight Obesity Food http://www.nytimes.com/2016/05/22/upshot/it-isnt-easy-to-figure-out-which-foods-contain-sugar.html?partner=rss&emc=rss http://www.nytimes.com/2016/05/22/upshot/it-isnt-easy-to-figure-out-which-foods-contain-sugar.html <p class=”p-block”>You may know there’s added sugar in your Coke or cookies. But did you know that it’s in your salad dressing, pasta sauce and bread?</p> <p class=”p-block”>The Food and Drug Administration <a href=”http://www.nytimes.com/2016/05/21/health/fda-nutrition-labels.html”>came out</a> Friday with its new template for nutrition labels. One big change was the addition of a line for “added sugar,” to be placed below a line for total sugar. The change is designed to distinguish between sugars that are naturally occurring in a food — like the milk sugar in a plain yogurt — and the sugars that food manufacturers include later to boost flavors — like the “evaporated cane juice” in a <a href=”http://www.chobani.com/products/kids#strawberry-tubes”>Chobani Kids strawberry yogurt</a>.</p> <p class=”p-block”>A team of researchers at the University of North Carolina conducted <a href=”http://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00419-2/abstract”>a detailed survey of the packaged foods and drinks</a> that are purchased in American grocery stores and found that 60 percent of them include some form of added sugar. When they looked at every individual processed food in the store, 68 percent had added sugar. Some of those products are more obvious sugary foods, but not all. The list includes many sauces, soups, fruit juices and even meat products.</p> <p class=”p-block”>You might think it’s easy to figure out whether the food manufacturer added sugar to your food, but it isn’t always so. While some foods include “sugar” in their ingredients, many use different words for products that are nutritionally similar. Most of us have heard of high-fructose corn syrup, a sugar made from processing corn. But there are also things like the “evaporated cane juice” in the yogurt, and “rice syrup” and “flo-malt,” which are less obvious and amount to the same thing.</p> <div class=”related-asset article-interactive p-block embedded” readability=”6.5″> <div class=”image-container”> <img src=”https://cdn1.nyt.com/images/2016/05/20/upshot/sugar-words-1463773103191/sugar-words-1463773103191-mediumThreeByTwo225.png”/></div> <div class=”text-container” readability=”33″> <p class=”image-caption”><span class=”asset-title”><span>Interactive Feature |</span> Words That Really Just Mean ‘Added Sugar’</span> A list of words that are synonymous with added sugar.</p> </div> </div> <p class=”p-block”>Barry Popkin, a professor of nutrition at the University of North Carolina, and one of the paper’s authors, said that the wide variety of sugars is not always meant to confound consumers. Instead, he said, the many sugar types are chosen by food scientists to give their products the best flavor and texture. Some sugars are better for baked goods, while others are better in soft drinks. Some are also cheaper than others. Sugar tariffs and import laws make it expensive to bring in too much foreign sugar. But not all of the sugar formulations count toward the laws’ quotas.</p> <p class=”p-block”>There’s also the matter of fruit juice concentrates, which are juices that have been stripped of nearly everything but sugar and evaporated. A lot of seemingly natural foods include ingredients like “apple juice concentrate.” That’s sugar. That will be a lot clearer when the labels are updated.</p> <p class=”p-block”>“It’s going to really surprise people who go to organic and whole foods stores, when they find that all this natural food they’ve been buying is full of added sugar,” Mr. Popkin said. “It’s full of fruit juice concentrates, and they thought it was all good stuff.”</p> <div class=”related-asset article-interactive p-block embedded” readability=”6.5″> <div class=”image-container”> <img src=”https://cdn1.nyt.com/images/2016/05/20/upshot/juice-list-1463779230113/juice-list-1463779230113-mediumThreeByTwo225.png”/></div> <div class=”text-container” readability=”33″> <p class=”image-caption”><span class=”asset-title”><span>Interactive Feature |</span> Words That Really Just Mean ‘Added Sugar’</span> A list of words that are synonymous with added sugar.</p> </div> </div> <p class=”p-block”>The emphasis on added sugar comes from <a href=”http://well.blogs.nytimes.com/2016/01/07/new-diet-guidelines-urge-less-sugar-for-all-and-less-meat-for-boys-and-men/”>new nutrition guidelines</a> that urge Americans to consume a “healthy dietary pattern” containing certain types of foods. According to <a href=”https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-11867.pdf”>the regulation</a>, hidden added sugars make it difficult to understand whether the food you are eating is part of that healthy pattern. Medical evidence shows that high sugar consumption is linked to obesity, diabetes and tooth decay — though not all of that work distinguishes between added sugar and total sugar.</p> <p class=”p-block”>Many of the big food industry trade groups and lobbyists were satisfied with the new label rules, as <a href=”http://www.nytimes.com/2016/05/21/health/fda-nutrition-labels.html”>my colleague Sabrina Tavernise recently wrote</a>. But the sugar industry and the corn refiners are upset. Critics of the policy argue that the difference between natural and added sugars is not nutritionally meaningful, and that the <a href=”https://www.sugar.org/the-sugar-association-raises-concerns-about-lack-of-scientific-justification-for-added-sugars-labeling-in-comments-to-fda/”>science establishing health harms from added sugar is weak</a>. The new label will kick in for large food companies in 2018, and for smaller companies a year later.</p> <p class=”p-block”>The U.N.C. research used its master list of sugar code words to measure how many grocery store foods include sugar. But measuring the precise amount of sugars that are added with the current label is quite difficult. Mr. Popkin said consumers would be surprised by recent research from his team revealing the large amounts of added sugars in products that are generally thought of as healthy — foods like infant formula, protein bars and yogurt.</p> <p><em>This article passed through the Full-Text RSS service – if this is your content and you’re reading it on someone else’s site, please read the FAQ at fivefilters.org/content-only/faq.php#publishers.</em><br />Recommended article: <a href=”https://theintercept.com/2016/12/29/the-guardians-summary-of-julian-assanges-interview-went-viral-and-was-completely-false/”>The Guardian’s Summary of Julian Assange’s Interview Went Viral and Was Completely False</a>.</p> Sat, 21 May 2016 14:26:33 +0000 MARGOT SANGER-KATZ http://www.nytimes.com/2016/05/22/upshot/it-isnt-easy-to-figure-out-which-foods-contain-sugar.html?nytmobile=0 en text/html http://mobile.nytimes.com/2016/05/22/upshot/it-isnt-easy-to-figure-out-which-foods-contain-sugar.html Food and Drug Administration Labeling and Labels (Product) Sugar Food Diet and Nutrition http://www.nytimes.com/2016/04/23/upshot/a-new-policy-disagreement-between-clinton-and-sanders-soda-taxes.html?partner=rss&emc=rss http://www.nytimes.com/2016/04/23/upshot/a-new-policy-disagreement-between-clinton-and-sanders-soda-taxes.html <p class=”p-block”>Hillary Clinton and Bernie Sanders have a new issue to disagree about: the wisdom of a soda tax.</p> <p class=”p-block”>A tax on sugary soft drinks, like the one proposed in Philadelphia and endorsed by Mrs. Clinton last week, divides the left. It can be seen as achieving an admirable public health goal of less sugar consumption or as a very regressive tax that falls more on the poor than the rich, since the poor tend to drink more soda.</p> <p class=”p-block”>While not the biggest issue the two candidates have tussled over, it is one that may reverberate across the country in coming years as more cities and states use the tax to raise revenue or improve citizens’ health.</p> <p class=”p-block”>Last week, Mrs. Clinton became the first presidential candidate to explicitly endorse a tax on sugary drinks. At a Philadelphia event Wednesday, she said a proposal there to <a href=”http://www.nytimes.com/2016/04/04/upshot/making-a-soda-tax-more-politically-palatable.html?_r=0″>use a soda tax to fund universal prekindergarten</a> was a good idea.</p> <p class=”p-block”>“It starts early with working with families, working with kids, building up community resources,” Mrs. Clinton said, <a href=”http://www.cnn.com/2016/04/21/politics/hillary-clinton-soda-tax-philadelphia/index.html”>according to a CNN report</a>. “I’m very supportive of the mayor’s proposal to tax soda to get universal preschool for kids. I mean, we need universal preschool. And if that’s a way to do it, that’s how we should do it.”</p> <p class=”p-block”>Mrs. Clinton’s framing of the issue as she campaigns in the Pennsylvania primary echoes that of Mayor Jim Kenney of Philadelphia, who has emphasized the soda tax as a way of funding education. Mr. Kenney talks about the tax not as a way to drive down soda drinking, but as one to help fight poverty in his city. In truth, it would probably do some of both. Higher soda prices, the likely result of such a tax, would discourage people from buying as much soda. Public health reformers think such a function of the tax is desirable, since soda consumption has been linked to obesity, diabetes and tooth decay.</p> <p class=”p-block”>But there’s another way to view soda taxes: as measures that hit the poor harder. Lower-income Philadelphians, like other lower-income Americans, tend to drink more soda than their richer neighbors. That means that they may get stuck paying a disproportionate share of the bill.</p> <p class=”p-block”>“Making sure that every family has high-quality, affordable preschool and child care is a vision that I strongly share,” Mr. Sanders said, in a written statement. “On the other hand, I do not support paying for this proposal through a regressive tax on soda that will significantly increase taxes on low-income and middle-class Americans. At a time of massive income and wealth inequality, it should be the people on top who see an increase in their taxes, not low-income and working people.” Over the weekend, Mr. Sanders continued to express opposition to the tax, at <a href=”http://www.instagram.com/p/BEgcRfQzgn4/”>campaign events</a> and on <a href=”http://www.nbcnews.com/feature/meet-the-press-24-7/meet-press-april-24-2016-n561251″>Meet</a> <a href=”http://www.nbcnews.com/feature/meet-the-press-24-7/meet-press-april-24-2016-n561251″>the Press</a>.</p> <p class=”p-block”>The proposed Philadelphia tax would be 3 cents for every ounce of sugary drink sold by distributors, making it the highest soda tax proposed anywhere in the country. That means a tax of $4.32 on a 12-pack of soda, which typically costs between $3 and $6 at the grocery store. It would come to 60 cents of tax on a 20-ounce bottle, which usually retails for about $2. It’s not yet clear whether distributors will absorb some of that tax or simply pass all of it on to consumers, but the city budget department expects big price increases in retail stores.</p> <p class=”p-block”>Mr. Sanders also says Mrs. Clinton’s support violates her pledge not to raise taxes on those earning less than $250,000.</p> <p class=”p-block”>Mr. Sanders’s argument is in line with that of many soda tax opponents. And there’s most likely some truth to it. Tobacco taxes, in many ways the model for soda taxes, have tended to fall largely on low-income people, <a href=”http://www.nytimes.com/2014/03/25/health/smoking-stays-stubbornly-high-among-the-poor.html”>who remain more likely to smoke</a>.</p> <p class=”p-block”>But tobacco is highly addictive. In Mexico, where a big, national soda tax went into effect in 2014, soda drinking <a href=”http://www.nytimes.com/2015/10/13/upshot/yes-soda-taxes-seem-to-cut-soda-drinking.html”>declined the fastest</a> among the poor, who felt the tax’s effects in their budgets most acutely. Consumption among the poorest Mexicans <a href=”http://well.blogs.nytimes.com/2016/01/06/mexican-soda-tax-followed-by-drop-in-sugary-drink-sales/”>fell</a> by 17 percent by the end of the year, compared with 12 percent in the population nationwide. As Barry Popkin, a professor of nutrition at the University of North Carolina puts it: The rich paid the tax, and the poor reduced their soda drinking. If something like that happens in Philadelphia, the poor may suffer in the form of less choice or enjoyment, but they may not bear the brunt of funding city preschool.</p> <p class=”p-block”>Republicans appear to be nearly united in their opposition to the measure, both as a tax increase and a “nanny state” intrusion on personal choice. Several prominent Republicans cheered Mr. Sanders’s anti-tax stance, including Grover Norquist, the president of Americans for Tax Reform, and an influential anti-tax advocate. But conservative opposition to soda taxes <a href=”http://www.nytimes.com/2016/03/17/business/international/britain-budget-brexit.html”>is not true</a> world over. In Britain, the Conservative government just proposed <a href=”http://www.nytimes.com/2016/03/29/upshot/how-britains-soda-tax-plan-could-spur-new-low-sugar-drinks.html?_r=0″>a hefty soda</a> <a href=”http://www.nytimes.com/2016/03/29/upshot/how-britains-soda-tax-plan-could-spur-new-low-sugar-drinks.html?_r=0″>tax</a>, which is expected to become law.</p> <p><em>This article passed through the Full-Text RSS service – if this is your content and you’re reading it on someone else’s site, please read the FAQ at fivefilters.org/content-only/faq.php#publishers.</em><br />Recommended article: <a href=”https://theintercept.com/2016/12/29/the-guardians-summary-of-julian-assanges-interview-went-viral-and-was-completely-false/”>The Guardian’s Summary of Julian Assange’s Interview Went Viral and Was Completely False</a>.</p> Fri, 22 Apr 2016 16:10:14 +0000 MARGOT SANGER-KATZ http://www.nytimes.com/2016/04/23/upshot/a-new-policy-disagreement-between-clinton-and-sanders-soda-taxes.html?nytmobile=0 en text/html http://mobile.nytimes.com/2016/04/23/upshot/a-new-policy-disagreement-between-clinton-and-sanders-soda-taxes.html Soft Drinks Sales and Excise Taxes Presidential Election of 2016 Clinton, Hillary Rodham Sanders, Bernard Philadelphia (Pa) Taxation Sugar

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