As people streamed out of the Kara Walker installation “A Subtlety” on a recent Sunday afternoon to buy an ice cream cone from one of the trucks idling outside the old Domino Sugar Factory on the Williamsburg waterfront, I wondered how many thought about the jarring contradiction: paying homage to the bodily harms involved in the harsh industrial process inherent in refining sugar, then consuming the industrial concoction that is a Mister Softee-type ice cream cone.

Since so much of Ms. Walker’s work relies on the inherent contradictions that exist in contemporary American culture, especially as they relate to our brutal history, were the trucks, perhaps, even part of the exhibition? In a way, it felt like the perfect ending, punctuating her point.

In a similar vein, as (the mostly white) people posed in front of her giant sugar sphinx and took selfies with the statue behind them, something felt deeply wrong. People standing and smiling in front of this 35-foot-high and 75-foot-long sugar depiction of a black “mammy” — which renders the black female body in pure white and was made of 160,000 pounds of sugar — as if it were just another New York City tourist attraction added to the sense that something about the entire experience was seriously amiss.

And this feeling was enhanced by the smell that hits you upon entering the old Domino factory. At first, it’s just overly sweet, but the sweetness quickly deteriorates into a sickly, oppressive smell, making it difficult to stay in the space for long. That, combined with the molasses-coated sculptures of black children carrying oversized baskets that were in various states of decay or destruction (some smashed into pieces on the floor), and the factory walls stained with large swaths of dark reddish-brown drippings, created an overwhelming presence to the great violence that still laces sugar production, as it has for centuries.

This very sugar refinery was long notorious for its terrible working conditions, even well into recent history. Beginning in 2000, the plant was the site of one of the longest labor strikes ever in New York City: 286 workers protested wages and working conditions for 20 months. The owners of the Domino sugar empire — the world’s largest refiner of cane sugar that imports sugar from the Dominican Republic and elsewhere — have been accused repeatedly of labor exploitation. The United States Department of Labor lists Dominican sugar as being produced by children or forced labor, bringing into focus the fact that the legacy of unfree labor, exploitation and violence is at once part of our past and our present.

Sugar has a long and sordid history. Sugar plantations in the Caribbean and southern United States were the first large-scale monocultures for producing a highly profitable product — the prototype for our current industrial agriculture system. As the author and anthropologist Sidney Mintz puts it, even before capitalism had arrived as the dominant economic structure, the early plantation systems were “agro-industrial” due to “the combination of agriculture and processing under one authority…This was because neither mill nor field could be separately (independently) productive.” Mintz adds that “the combination of field and factory, of skilled workers with unskilled, and the strictness of scheduling together gave an industrial cast to plantation enterprises.”

The sugar plantation/factory also separated production from consumption and the worker from his tools, which helps to define the lives of these mostly unfree workers between the 16^th and late 19^th centuries in the New World. And while slave laborers were the first to produce sugar en masse for worldwide consumption, the working class found comfort in sugar, which became less a symbol of power and more a symbol of profit as it was transformed from an upper-class luxury into a mainstay and even necessity of the working-class diet. “The introduction of foods like sucrose made it possible to raise the caloric content of the proletarian diet without increasing proportionately the quantities of meat, fish, poultry and other dairy products,” writes Mintz.

Which brings us to today, when the people suffering most from diet-related illness brought on in large part by the overconsumption of sugar are poor people of color. Corporations which provide cheap calories that fill the belly while also providing pleasure effectively profit off populations with limited means. Diabetes (almost all of which is Type 2) is 66 percent higher among Hispanic Americans and 77 percent higher among African-Americans as compared to their white peers. African-American women suffer more from the disease than any other group: One in four women older than 55 has diabetes, and African-American women have the highest rates of two of the worst complications resulting from diabetes — amputation and kidney failure.

Sugar is particularly toxic for those with diabetes, and many Americans are eating tremendous amounts of it; the most recent estimate is three pounds of sugar per week, or 156 pounds per year. At this rate of consumption, sugar does previously unimaginable things to our bodies at increasingly younger ages, prompting the name-change of adult-onset diabetes to Type 2 diabetes — one in three children born in 2000 will develop the disease, and many children in this generation will not outlive their parents.

For most Americans, sugar is close to impossible to avoid — it laces the bulk of the processed foods that we rely on for nearly every meal. And we continue to import more than 200,000 tons of sugar a year from the Dominican Republic, despite the known labor violations.

This was the very sugar that Ms. Walker used for the exhibit. Domino donated 80 tons of it (she “only” used 40), highlighting the grotesque waste of resources in which we all partake. Beyond the human rights violations are the environmentally costly processes of production itself, from the chemical fertilizers and pesticides used to grow the sugar to the pollutants spewed into the environment as it is refined.

And so Ms. Walker’s “A Subtlety,” which closed this past Sunday, connected in so many critical ways the issues of racial and sexual oppression with the industrial processes that go into much of our food supply. Indeed, we are all increasingly made of sugar, and our consumption of it makes us complicit in the violence and destruction that Ms. Walker rendered visible in her sugar sphinx — yet at the same time we are victims of this damage, borne out in our own bodies.

This also appeared in The New York Times

Last week I did two interviews both relating to how the industrial food system loves to tell us how its products will help us lose weight and be healthier. Tuesday, I was on Chef Erica Wides' show Let's Get Real on the Heritage Radio Network to talk about vegan and vegetarian "foodiness" products, as she calls them. Wides defines foodiness as fake food, made to look like real food that often makes some kind of (false) health claim. When it comes to vegan and vegetarian foods, people often think they are eating better simply because they don't eat meat. The trouble is, people often resort to the packaged and processed versions of vegan or vegetarian food. As an example of how these foodiness products are worse than the read thing, take a look at the ingredients for two products we discussed on the show:

Toffutti Pizza:

WHEAT FLOUR (UNBLEACHED), CRUSHED TOMATOES, WATER, SOYBEAN OIL, SUGAR, SALT, YEAST, FOOD STARCH-MODIFIED (CORN), OREGANO, BLACK PEPPER, GARLIC. The dairy-free cheese contains the following: WATER, EXPELLER PRESSED PALM OIL, MALTODEXTRIN, NON-GMO (TOFU, SOY PROTEIN) NON-DAIRY LACTIC ACID BLEND OF NATURAL GUMS (LOCUST BEAN, GUAR, CELLULOSE, XANTHAN AND CARRAGEENAN), ORGANIC SUGAR, POTATO FLAKES, VEGETABLE MONO AND DIGLYCERIDES, SALT.

Veja-Links:

Click here to listen to the full half hour episode.

On Friday I went on Huff Post Live for a segment called "Myths and Facts about Weight Loss." I am sometimes reluctant to do these types of interviews because the focus on weight loss and obesity is a bit misguided. I think we need to focus on the consolidation of the food supply and the way in which the industrial food system is at the root of our collective health and weight problems. Which is why I always emphasize that the solution to weight loss is to eliminate industrial foods from your diet as much as possible. This perspective shifts the blame from the people stuck in an industrial food paradigm to the horribly skewed food system pumping out terrible products. The best way to do this is to emphasize the important of eating real, whole foods. So, what are real, whole foods?

• Fresh vegetables and fruits (preferably organically grown)
• Fresh meats like beef, poultry, pork (preferably pasture-raised, if possible)
• Dairy products like milk, yogurt, cheese, butter (preferably from grass-fed animals)
• Beans and legumes
• Nuts and seeds
• Whole grains
• Herbs and spices
• Plenty of filtered water

What's the rest of what you see on grocery store shelves, in fast-food restaurants, and on TV? Packaged and processed foods. If you eliminate these foods from your diet, I guarantee you will lose weight. But even more importantly, you are refusing to participate in an industrial food system that has proven to make people sick, devastate the environment, and exploit people, animals, and natural resources. Once you commit to taking a stand against that, the weight loss seems like an added bonus. For more, you can watch the whole interview here and the two minute version here.

If we knew that there was epidemic among our children that would cause them to die at increasingly younger ages and if we also knew that this disease was entirely preventable, wouldn't we do everything in our power to eradicate it?

In fact, we do have an epidemic and it's largely driven by our reliance on highly processed, cheap convenience foods. The United States is hardly alone on this front, but our food culture is distinct from most other industrialized nations in a crucially important way -- we have virtually no regulation for advertising food and drink and we require very little in the way of labeling.

In a few weeks, Californians will decide if genetically modified foods (GMOs) should be labeled. Labeling GMOs will force greater transparency on the part of food producers and it represents a potential shift for consumers to regain a measure of control over their own food. But the US will still lag far behind many European countries, which not only have been labeling GMO foods for years but in some cases, also require warning labels for junk foods and have strict regulations on the types of foods and beverages advertised, particularly to children.

There's good reason for this. Studies show that Big Food corporations aggressively market unhealthy foods to children and in some cases children exhibit "brand recognition" and brand loyalty before they can even speak. A forthcoming study in the journal Social, Cognitive, and Affective Neuroscience, found that toddlers identify the golden arches for McDonald's before they even know the letter M. After looking at more than 100 brands, researchers at the University of Missouri-Kansas City and University of Kansas Medical Center study found that children are more likely to choose foods with familiar logos and that the majority of these foods are high in sugars, fat and sodium. Even more alarming, researchers found that seeing an advertised logo trips the pleasure and reward regions of children's brains -- areas of the brain that are also implicated in obesity and various types of addiction, including drug abuse, researcher Dr. Amanda Bruce said.

Another recent study suggests that highly processed foods are addictive. Researchers in the journal Current Biology report that when they fed M&M candies to hungry rats, their levels of enkephalin (an opiod with similar effects to other drugs in this class) increased. The more the rats' enkephalin went up, the faster they ate the M&Ms. The researchers reported that the rats would not stop eating the M&Ms until the candies were taken away.

But that's not all -- the food industry is actively shaping the palates of our children. While the food industry insists that it only advertises to children "to influence brand preference," a study published in the journal Appetite found that the industry works to "fundamentally change children's taste palates to increase their liking of highly processed and less nutritious foods." This study dovetails with Dr. Bruce's findings since researchers found that the awareness of fast food brands was a significant predictor of what they call the "Sugar-Fat-Salty" palate preference in children.

Data is also surfacing that obese children are less sensitive to taste. Researchers in Germany found that on the intensity scale, obese children rated all flavor concentrations lower than did those in the normal-weight group. They believe this may be due to the fact that leptin, the hormone that regulates appetite and makes us feel full, might also affect the sensitivity of taste buds. It is suspected that people who are obese or overweight are resistant to leptin, making them feel hungrier and driving them to eat more.

Not only does obesity or overweight affect taste, but it also affects memory and learning. A study in Pediatrics found that teenagers with metabolic syndrome (a precursor to diabetes, which includes having high blood levels of glucose, low levels of "good" cholesterol, high triglycerides, abdominal obesity and high blood pressure) had lower scores on tests of mental ability and significantly lower academic performance in reading and arithmetic. MRI scans of these children also showed reduced volume in the hippocampus, a part of the brain involved in forming and storing memories.

The picture emerging from these recent findings is that children are becoming hooked on highly processed foods at a very young age. This changes their palate preferences for salty, fatty, sweet foods, leads to weight gain and metabolic syndrome, affects brain processes -- and ultimately, perpetuates a vicious cycle.

So what is to be done? European countries, which have lower rates of obesity and diet-related disease, provide some answers. In 2007, the French government ordered all food advertisements to carry warning labels urging consumers to stop snacking, exercise, and eat more fruits and vegetables. The warning label also reads, "Consuming these foods may be harmful to your health." In Sweden and Norway, all food and beverage advertising to children is forbidden. In Ireland, there is a ban on TV ads for candy and fast food and the ban prohibits using celebrities to promote junk food to kids.

It's time for American politicians to address the lack of regulation for Big Food and the advertising industry. We now have the science to prove that the content of highly processed foods coupled with the marketing of them to children and toddlers is amounting to a national health crisis.

Over the past 15 years, the percentage of new cases of Type 2 diabetes, formerly known as adult-onset, has skyrocketed among children -- from three to 50 percent. Approximately 12.5 million of children and adolescents aged two to 9 years are obese and since 1980, obesity prevalence among children and adolescents has almost tripled.

Diabetes, along with high cholesterol, high blood pressure, and heart disease are becoming shockingly common in children and adolescents. We know these conditions arise primarily from poor diets and are driven by our consumption of ultra-processed foods.

A startling USDA report from 2006 states that since the percentage of children who are overweight has doubled and the percentage of adolescents who are overweight has more than tripled, "If we do not stem this tide, many children in this generation of children will not outlive their parents." To put that another way: If trends don't change, the surge in diet related disease among children means that many parents will watch their children die. That was the prediction from experts six years ago and we have yet to see any substantive action from Washington.

Our leaders must get tough on these corporations and stop insisting that it comes down to choice and personal responsibility. This is a myth perpetuated by the food and advertising industries so they can continue to harm our children and threaten the health of our nation with impunity. In what other circumstance would we allow an epidemic of such grave proportions debilitate our children unchecked? We've long been looking for the smoking gun — it seems we've found it.

Originally published on The Huffington Post

Image: FastFoodHealth.org via Babble.com

My latest radio interview with Dr. Robert Zieve on Healthy Medicine Radio. We discuss deceptive marketing by Big Food corporations, how a 'calorie isn't a calorie' and how obesity could be caused by malnutrition.

Healthy Medicine #143: New Thinking on Weight Control

Dr Zieve talks with author Kristin Wartman about how much obesity could be caused by malnutrition and her article "The Obesity Paradox."

http://healthymedicine.org/html/popups/hmr1-143.html

Recently, the U.S. Food and Drug Administration (FDA) announced a ban on the use of bisphenol A, or BPA, in baby bottles and children’s cups. BPA is an estrogen-mimicking chemical that has been used in hard plastics, the linings of cans, food packaging, and dental fillings, among other places, for years. We’ve reported about the dangers of BPA on Civil Eats here, here, and here. This move essentially made official a practice that many manufacturers of baby bottles and cups already follow in response to growing pressure from consumers.

Questions of safety remain when it comes to the use of any plastic products that come in contact with our foods. The FDA ban is raising concern and creating headlines about what manufacturers will substitute in place of the BPA. A 2011 study published in Environmental Health Perspectives found that all plastics contain estrogenic activity (EA) and in some cases, those labeled “BPA free” leached more chemicals with EA than did BPA-containing products. The study’s authors write, “Almost all commercially available plastic products we sampled—independent of the type of resin, product, or retail source—leached chemicals having reliably detectable EA, including those advertised as BPA free.”

EA interferes with our endocrine system, a complex signaling network that is made up of glands (the thyroid) as well as glandular tissue and cells within organs (testes, ovaries, pancreas, etc). Our endocrine systems use hormones that send signals to our various organs and tissues that work over minutes, hours, weeks, and years. The processes these hormones regulate include metabolism, growth and development, and sexual reproduction. As hormones travel in the blood to reach each body part, the specific molecular shape of each hormone fits like a key-in-a-lock into receptors on target tissues. Endocrine disrupting chemicals may interfere with, block, or mimic the action of our hormones. As a result, EA and endocrine disruptors have been linked in hundreds of studies to brain development problems, breast and prostate cancer, birth defects, learning and behavioral problems in children, early onset of puberty, and obesity.

Manufacturers are now flaunting their “BPA free” versions of products as though they are safe and free of toxins—but it turns out BPA is possibly just the tip of the iceberg. Bisphenol S, or BPS, is another chemical that manufacturers are using to replace BPA and it may be just as harmful. In a study this year in Environmental Science and Technology, researchers wrote, “As the evidence of the toxic effects of bisphenol A (BPA) grows, its application in commercial products is gradually being replaced with other related compounds, such as bisphenol S (BPS). Nevertheless, very little is known about the occurrence of BPS in the environment.”

In this study, the authors found BPS present in 16 types of paper products, including thermal receipts, paper currencies, flyers, magazines, newspapers, food contact papers, airplane luggage tags, printing paper, paper towels, and toilet paper. The thermal receipt paper samples contained concentrations of BPS that were similar to the concentrations of BPA reported earlier and raised alarm for some scientists. BPS was also detected in 87 percent of currency bill samples. The authors write that several other related compounds are also used to replace BPA: bisphenol B, bisphenol F, and bisphenol AF. BPA and BPS are found in high concentrations in canned foods, BPF has been found in surface water, sewage sludge, and sediments, and BPB was found in human serum in Italy. “Limited studies have shown that BPS, BPB, and BPF possess acute toxicity, genotoxicity, and estrogenic activity, similar to BPA,” the authors write, adding that, “The environmental biodegradation rates of BPS and BPB were similar to or less than those of BPA. Although considerable controversy still surrounds the safety of BPA, the potential for human exposure to alternatives to BPA cannot be ignored.” The researchers also note that people may be absorbing BPS in much larger doses—19 times more than the BPA they absorbed when it was more widely used.

Bruce Blumberg, professor of developmental and cell biology and pharmaceutical sciences at the University of California, Irvine, wrote in an e-mail, “There are emerging data to show that BPS is an estrogen but relatively less on the other chemicals. Therefore, it is hard to say with certainty at the moment whether the BPA replacements lack estrogenic activity. BPA free means simply that—that the product is stated to be BPA free.”

I asked Diana Zuckerman, president of the National Research Center for Women and Families if she was concerned about the substitutes being used in place of BPA. “We are very concerned that BPA could be replaced with products that are just as risky, or even more risky. The federal government is not doing what is needed to protect the American public, either in their regulation of BPA or any of these potential substitutes.”

But the FDA continues to insist that BPA is still safe. In a recent New York Times article, Michael Taylor, deputy commissioner for foods said that the agency, “has been looking hard at BPA for a long time, and based on all the evidence, we continue to support its safe use.”

Zuckerman added that part of the problem lies in the heavy influence that industry has on members of Congress and the FDA. “Whenever the FDA does something to improve patient safeguards, Members of Congress get lobbied by the industry involved and some of those Members pressure [the] FDA to back off,” she wrote in an e-mail. “This has happened for years but the last few years have been even worse than usual.”

At Mother Jones, Tom Philpott points out that the heavily monied interests behind BPA are none other than the chemical giants Dow and Bayer who produce the bulk of BPA. Frederick S. vom Saal, curators’ professor at the University of Missouri-Columbia and BPA researcher told me that BPA represents a $10 billion a year industry. It’s important to note that the recent FDA ban comes at the behest of the American Chemistry Council, an industry trade group that denies any negative health effects from BPA. Why would they have done this? “[The American Chemistry Council’s] petition to the FDA puts it plainly: ‘All Major Product Manufacturers Have Abandoned the Use of Polycarbonate’ (BPA). In other words: Go ahead and ban it—it’s already been phased out and a ban gives the appearance of strict oversight,” Philpott writes.

By creating the ban, the FDA at least acknowledges that babies and children should lessen their exposure to BPA. But what about the rest of the population? “BPA remains in millions of food and beverage containers that affect the BPA levels of pregnant women, children of all ages, and all adults,” Zuckerman wrote to me in an e-mail. “The impact on the developing fetus and young children, and on breast cancer patients undergoing chemotherapy, are of particular concern to our Center. One study indicates that BPA may interfere with the effectiveness of chemo for breast cancer patients.”

The FDA should concede that if BPA is a risk for babies and children, it is most likely a risk to all of us. And what about the various substitutes that will be used for BPA and the numerous other toxins lurking in the plastics and other containers that package our foods and drinks? “FDA’s decision is a step in the right direction, but it is a baby step,” Zuckerman said. “They have done the minimum.” Blumberg added that the answers to all of these questions are complex. “We do not know nearly as much as we need to know,” he said. “I think that it is prudent to reduce our consumption of packaged foods of all sorts for a variety of reasons, including reducing exposure to contaminants from the containers.”

Recently, I wrote here on Civil Eats that it may not be long before the food industry will be proven wrong about their two favorite messages: All calories are created equal, and it’s all about personal responsibility. Well, it appears that science may be one step closer to proving at least half of that equation wrong and that in fact; all calories are not created equal. The latest study, published in The Journal of the American Medical Association (JAMA) this week, found that when it came to weight loss and maintaining weight loss, those who ate a low carbohydrate, high fat diet kept more weight off than those who were on either a low glycemic diet or a low fat, high carbohydrate diet.

While all participants in the study ate the same number of calories, the types consumed varied. The low fat diet contained 60 percent carbohydrates, 20 percent protein, and 20 percent fat. The low glycemic diet contained 40 percent carbs, 40 percent fat, and 20 percent protein (with a focus on minimally processed foods). The low carb diet had 10 percent of calories from carbs, 60 percent from fat, and 30 percent from protein.

Compared to those on the low fat diet, those following the low carb diet burned 350 calories more per day and those on the low glycemic diet burned 150 calories more per day.

The most compelling part of this study is that it calls into question the long-held belief in the scientific and medical communities that all calories are created equal. This is a message the food industry has also seized on since it means they can continue to pump out ultra processed nutritionally void foods and tell Americans to “eat them in moderation.” If all calories are created equal, the food industry says, then there are no bad foods.

But this message doesn’t just come from the food industry, Marion Nestle, a long-time critic of Big Food, has spoken about calories in a similar way. She wrote on her blog that the JAMA study was too small (it had 21 participants) and that more research was needed outside of a controlled setting. She’s quoted in USA Today saying:

Longer studies conducted among people in their own environments, not with such controlled meals, have shown “little difference in weight loss and maintenance between one kind of diet and another.” More research is needed to show that interesting results like these are applicable in real life, she says. “In the meantime, if you want to lose weight, eat less.”

I disagree. As a nutrition educator, I think that telling people to “eat less” is largely ineffective and continues to place the burden on the consumer as part of the personal responsibility credo. On the other hand, telling people to eliminate processed, refined carbohydrates and sugars, while eating plenty of high quality fats, proteins, and vegetables seems to be a more workable solution to stimulating weight loss. Part of the reason this may be so effective is because simple carbohydrates and sugars actually stimulate appetite and cravings, while fats, proteins, and complex carbohydrates like vegetables, beans, and legumes satiate and stabilize blood sugar.

A recent report put out by the World Public Health Nutrition Association found that processing does matter, noting that ultra processed foods are “habit-forming and some would say often at least quasi-addictive. They do displace healthy meals, dishes and foods and thus are liable to cause obesity or else at least mild malnutrition.”

The addictive factor of these foods is highly problematic and there’s evidence to suggest that eating sugar makes you crave and consume more sugar starting with our experiences as babies and even in utero (see a recent article on Gilt Taste for more on this).

And according to Robert Lustig, a professor of clinical pediatrics at UC San Francisco, a low carb diet or a low glycemic diet is what helps keep our insulin levels low, he believes that elevated insulin levels are at the root of obesity. “To borrow a phrase from Bill Clinton: It’s the insulin, stupid. The reason any diet will work is because it lowers insulin. And a diet that doesn’t, like the traditional low-fat diet, won’t work,” he said in a recent Los Angeles Times article.

Anecdotally, I’ve noticed that once my clients cut sugar and simple carbohydrates from their diets their cravings for these kinds of foods quickly dissipate. It’s only observational, but I see it repeatedly and so do other nutritionists and doctors I know.

Over online at The New York Times, Mark Bittman wrote about the JAMA study with a conclusive evaluation, “The message is pretty simple: unprocessed foods give you a better chance of idealizing your weight—and your health. Because all calories are not created equal.”

But there’s still no consensus among doctors, nutritionists, researchers, or writers.

The implications for coming to a scientific consensus about whether or not types of calories do matter cannot be understated since it could effect regulation for Big Food as well as the dietary recommendations from the government which translates to (among other things) what children eat in school every day. Right now, MyPlate recommends that Americans eat an average of 6.3 servings of grains a day. Even the American Diabetes Association recommends a high carbohydrate and low fat diet. But if the results from this latest study are accurate, all of these recommendations may ultimately prove harmful. Acknowledging that all calories are not created equal and that ultra processed foods are detrimental to everyone would go a long way in changing our crash course with diet related disease and death.

A version of this post first appeared in The Atlantic

Conventional wisdom says that weight gain or loss is based on the energy balance model of "calories in, calories out," which is often reduced to the simple refrain, "eat less, and exercise more." But new research reveals a far more complex equation that appears to rest on several other important factors affecting weight gain. Researchers in a relatively new field are looking at the role of industrial chemicals and non-caloric aspects of foods -- called obesogens -- in weight gain. Scientists conducting this research believe that these substances that are now prevalent in our food supply may be altering the way our bodies store fat and regulate our metabolism. But not everyone agrees. Many scientists, nutritionists, and doctors are still firm believers in the energy balance model. A debate has ensued, leaving a rather unclear picture as to what's really at work behind our nation's spike in obesity.

Bruce Blumberg, professor of developmental and cell biology and pharmaceutical sciences at the University of California, Irvine, who coined the term "obesogen," studies the effect that organotins -- a class of persistent organic pollutants that are widely used in the manufacture of polyvinylchloride plastics, as fungicides and pesticides on crops, as slimicides in industrial water systems, as wood preservatives, and as marine antifouling agents -- have on the body's metabolism. Organotins, which he considers to be obesogens, "change how your body responds to calories," he says. "So the ones we study, tributyltin and triphenyltin, actually cause exposed animals to have more and bigger fat cells. The animals that we treat with these chemicals don't eat a different diet than the ones who don't get fat. They eat the same diet -- we're not challenging them with a high-fat or a high-carbohydrate diet. They're eating normal food, and they're getting fatter."

A widely reported study that came out in January in The American Journal of Clinical Nutrition (AJCN) would seem to dispute this finding: it confirms the belief in the energy balance model, and has been cited as proof by many researchers working in the field. I asked an author of the study, Dr. George Bray, professor of medicine at Louisiana State University, about the myriad of additives and industrial ingredients in our food that were not accounted for in this study. "It doesn't make any difference," he said in a telephone interview. "Calories count. If you can show me that it doesn't work, I'd love to see it. Or anybody else who says it doesn't -- there ain't no data the other way around."

The participants in the AJCN study were given low, normal, and high amounts of protein and 1,000 more calories than needed. The study does not take into account the content and form of calories, how they were processed, or with what additives or industrial chemicals.

Bray doesn't believe that additives or how foods are processed or produced will ultimately affect the outcome of studies. In fact, he completed research in 2007 that he refers to as his "Big Mac study," which fed participants three meals a day for three days giving one group fast-food items like Big Macs and the other group foods made "from scratch." Bray says the results showed that the type of food made no difference: "At least in an acute study measuring glucose tolerance, insulin, and things -- they don't make any difference. Now, if you fed them over a longer time period, it's clearly going to be the quantity that matters, largely."

One study conducted at Princeton University indicates that types of calories do matter. Researchers found that rats drinking high fructose corn syrup (HFCS) gained significantly more weight than rats drinking sugar water, even though the amount of calories consumed was the same. The rats drinking HFCS also exhibited signs of metabolic syndrome, including abnormal weight gain, especially visceral fat around the belly, and significant increases in circulating triglycerides.

Miriam Bocarsly, the lead author of the Princeton study and a Ph.D. candidate there, said in a phone interview: "The question of calories in, calories out is a very good one and is highly debated in the field. You have traditional nutritionists who say 'energy in energy out,' but we have this result and at this point all we can really say is that this is what is happening in the rat model. Something is obviously different between HFCS and table sugar, and the next question is, What is that difference?"

Blumberg says that fructose itself is an obesogen. "Crystalline fructose doesn't exist in nature, we're making that," he says. "Fructose is not a food. People think fructose comes from fruit but it doesn't. The fructose that we eat is synthesized. Yes, it's derived from food. But cyanide is derived from food, too. Would you call it a food?"

Robert H. Lustig, a pediatric neuroendocrinologist and a professor of pediatrics at the University of California, San Francisco, also believes that fructose is an obesogen. "I personally do lump fructose in with [obesogens]," he told me in an email. "There are those who don't, because fructose is a nutrient, and they want to think of an obesogen as a foreign chemical. But because fructose tricks the brain into eating more in a free-range situation, it has some properties consistent with an obesogen."

Lustig is another researcher and doctor who finds fault in the calories in, calories out model. "I don't believe in the energy balance model, which is calorie-centric," he says. "I believe in the fat deposition model, which is insulin-centric. The reason is that by altering insulin dynamics, you can alter both caloric consumption and physical activity behavior. This has been my research for the past 16 years." What Lustig means is that by increasing circulating insulin -- often as a result of consuming too much fructose -- people become hungrier and more fatigued, which results in overeating and little motivation to exercise.

Another possible obesogen that has made headlines recently is bisphenol-A (BPA), which is found in an overwhelming number of food items and packaging material. Frederick S. vom Saal, curators' professor at the University of Missouri-Columbia, receives funding the National Institute of Environmental Health Sciences for his research on BPA. "We do animal experiments with chemicals like BPA, and we dramatically alter the way fat is regulated in those animals," vom Saal said in a phone interview. "And they're not changing their food intake."

The Centers for Disease Control and Prevention (CDC) reports that "nearly all" Americans tested have BPA in their urine, "which indicates widespread exposure to BPA in the U.S. population." The American Chemistry Council has called for a ban on BPA in baby bottles and sippy cups (which California and several other states have already done), and some food manufacturers are already moving away from using BPA in their packaging. On Monday, Campbell's Soup announced it will stop using BPA in the lining of its cans. The Food and Drug Administration (FDA) is scheduled to decide by the end of March whether to ban the chemical's use in all food and beverage packaging.

Vom Saal believes that BPA is only the most prominent example of many substances in our food supply and environment that functions as an obesogen. "If people really want to solve the obesity, diabetes, and cardiovascular disease epidemics," he says, "it isn't a wise thing to be ignoring any contributor to this. And we're not obese just because of HFCS, or because of BPA. I also know that nicotine and PCBs and other chemicals are implicated in diabetes and metabolic disease as well."

The energy balance model diverts responsibility back to the consumer because conventional wisdom says the spike in obesity is the result of people consuming more foods than ever before.

Lustig echoes vom Saal's belief that a wide range of substances in our food supply and our environment are likely leading to obesity and metabolic disease based on hosts of studies of various substances. These include soy-based infant formula, phthalates (used in many plastics), PCBs (found in coolant and electrical equipment), DDE (a type of pesticide), fungicides, and atrazine (a common pesticide).

If the obesogen theory comes to be accepted and casts doubt on the energy balance model, the food industry will be in trouble. It would be harder to keep promoting diet and "health" foods that may be low in calories but that also contain an array of substances that may actually prove to contribute to weight gain.

The emphasis that industry places on personal choice puts the onus back on the individual and leaves the consumer with tough decisions to make about industrial food products and additives. The food industry does not disclose what kinds of potential obesogens, like certain organotins or BPA, are in its products, because these substances are not required to be listed on labels and are difficult for the FDA to regulate. With an emerging debate in the scientific community and an absence of information on labels, consumers are left making their best guess on the safety and health of foods.

"People say to me all the time, 'What do I do?'" vom Saal says. "And the answer is, there's not much we can do, because industry has no legal mandate to tell you, and so they refuse to tell you the way they're using these chemicals. How do you avoid something you are blind to?"

The energy balance model also diverts responsibility back to the consumer because conventional wisdom says that the spike in obesity and diet-related disease is the result of people consuming more foods than ever before. But a review of the literature in The Obesity Epidemic: Science, Morality, and Ideology by Michael Gard and Jan Wright asserts that there is no evidence that food intake levels have increased in industrialized countries, or that activity levels have declined. According to Gard and Wright, some studies even suggest a reduction in energy intake over the past several decades.

Julie Guthman, a professor of community studies at the University of California, Santa Cruz, points out in her new book, Weighing In, that the amount of calories consumed across racial lines and income levels varies little, according to a study by the United States Department of Agriculture (USDA). This is despite the fact that obesity and overweight do vary across racial lines and income levels: Poorer people tend to be more obese, and African Americans and Latinos have higher rates of obesity than do whites. This means there must be some other mechanism, Guthman says, besides excess calories, in the varying levels of obesity. In her book, she refers to the possible role of environmental factors like exposure to obesogens and other toxins, stress, and non-nutritional aspects of food.

Guthman would like to see stronger regulation on the part of the government, and a discussion that focuses more on how food is produced and not just on how much is eaten. "I think people would like to say that weight loss is simple and that it's all about changing personal behavior," Guthman says. "So there's an emphasis on trying to make people have better lifestyles or on changing the built environment."

This seems to fit with Marion Nestle's approach to educating people on weight loss. Nestle is the co-author of a new book on the subject, Why Calories Count. "BPA, PCBs, and other such contaminating chemicals can't possibly be good for health," she said in an email. "But it's really hard to prove that they cause demonstrable harm. They might have something to do with obesity -- I suppose it's not impossible -- but why invoke complicated explanations when the evidence for calories is so strong? Let's say obesogens affect a body weight regulatory factor, which they very well might do. But so what? Weight is regulated by more than a hundred biological factors, and these are redundant, which means that if something goes wrong with one of them the others fill in the deficit."

The "so what," Guthman says, is that "We really don't understand the science enough, and there's new evidence in the science that completely re-shifts how we think about these things."

According to Blumberg, the food industry would like to discredit emerging research on obesogens. "What industry typically does is fund studies that produce the opposite conclusions, thereby shedding doubt on the science," he says. "If you take BPA as an example, the vast majority of studies performed by independent government and academic scientists show that it has numerous deleterious effects on health. In contrast, not a single industry-funded or -conducted study has found any hazard associated with BPA."

Can we afford to continue to frame the discussion simply in terms of calories in and calories out? Or by looking only at conventional categories like fat, protein, and carbohydrates and diary, meat, grains, and vegetables? Given the proliferation of industrial pollutants and the ultra-processing of foods in our current food systems, it seems that we can't.

“What new scientific paradigms like this do is shake up the existing science,” Guthman says. “People are resistant to it because so much is embedded in the old paradigm — once you open that up, the science is open to all sorts of other claims.”

Food corporations enjoy carte blanche on what they can say about their foods, how and to whom they advertise, and even (to a large degree) the ingredients they choose to put in their foods. But when the Obama administration recently proposed voluntary guidelines [PDF] for the types of food advertised to children, industry giants decided to preempt these guidelines and create their own. Since the government released its new guidelines, two powerful industry groups have reared up. One is the Sensible Food Policy Coalition, headed by former Obama Press Secretary Anita Dunn, and led by PepsiCo, Viacom, Kellogg's, General Mills, Time Warner, the American Association of Advertising Agencies, and the Association of National Advertisers. This group was quickly created in response to the government's new guidelines, and its sole purpose is to prevent them from going into effect.

The second industry group making noise is the Children's Food and Beverage Advertising Initiative (CFBAI), led by ConAgra, Coca-Cola, PepsiCo, General Mills, and Kellogg's. The members of CFBAI sell thousands of food and beverage products around the world and thus share joint interests when it comes to advertising policies.

The government's guidelines evolved as part of Michelle Obama's Let's Move! campaign, and are intended to protect children from the onslaught of advertising for highly processed, nutritionally void foods. The guidelines propose that by 2016, all food products most heavily marketed to children and adolescents ages 2 to 17 must meet the following two nutrition principles: They must "provide a meaningful contribution to a healthful diet," and "should minimize the content of nutrients that could have a negative impact on health or weight."

This translates as quite modest caps on added fat, sugar, and sodium: one gram or less of saturated fat, zero grams trans fat, no more than 13 grams of added sugars, and no more than 210 grams of sodium per serving. The trouble is, many processed foods already meet this criteria: Trix cereal, which is heavily marketed to children across various social media platforms, as well on TV and in print, contains 10 grams of sugar per serving, zero grams saturated fat and trans fat, and 180 mg of sodium, which puts it right up there with some of the worst foods our nation's children are eating. Trix is chock full of sugar, additives, food dyes, and preservatives that have been to shown to have myriad ill effects.

The food industry members of the CFBAI called the voluntary guidelines "unworkable and unrealistic" and then proposed their own guidelines -- guidelines that would require no modifications to two-thirds of their food products. Meanwhile, the CFBAI is trying to paint this as a groundbreaking progress, and even the chairman of the Federal Trade Commission (FTC) agrees. "The industry's uniform standards are a significant advance and exactly the type of initiative the commission had in mind when we started pushing for self-regulation more than five years ago," Jon Leibowitz, chairman of the FTC, said in a statement about the advertising initiative.

It's unclear how creating regulations that allow for two-thirds of the processed food products to remain unchanged is "significant progress." What is clear is that the industrial food giants want no part in creating healthier foods for children. They claim the modest guidelines will cause job loss in an already troubled economy, appealing to the conservative base that scoffs at any government regulation and cries "nanny state" when the government attempts to intervene in our health crisis.

And while the right wing makes claims of socialism and ridicules Michelle Obama for trying to regulate food corporations on the grounds that the few should not control the many, the truth is, the few are indeed controlling the many. Large food conglomerates like General Mills, Kellogg's, Con-Agra, PepsiCo, and Coca-Cola are the epitome of this scenario. These corporations effectively control what most middle- and low-income people eat in this country. If you are born into a poor family, with relative food insecurity, then it makes economic sense to eat the most calorically rich (usually nutrient-void) foods for the least amount of money. Not coincidentally, this is what the large food corporations excel at producing.

It comes as no surprise, then, that the most recent research examining obesity found that poor, African American women make up the largest population of obese Americans, with Latino women following close behind. In fact, poor women of all races were the most likely to be obese, and the research shows troubling links between poverty, government assistance, and health problems in the United States.

Findings from a Yale Rudd Center for Food Policy and Obesity study released last November indicate a similar trend. The study found that the industry specifically targets teens and minority youth more often and with less healthy items. African American youth saw at least 50 percent more fast food ads on TV in 2009 than their white peers.

Kelly Brownell, director of the Rudd Center, said this is particularly alarming since these are the populations most at-risk for obesity and diabetes. According to the Centers for Disease Control and Prevention, the rate of obesity for African Americans is 51 percent higher than for white Americans, and the prevalence of obesity among the nation's Hispanic population is 21 percent higher than it is for their white peers.

The Obama administration is on the right track by creating guidelines to regulate a food system that functions completely unchecked, but it shouldn't cave to industry pressure by allowing food corporations to regulate themselves -- isn't that exactly what they've been doing for the past 60 years?

The USDA finally did away with the much-maligned Food Pyramid and replaced it with MyPlate. Many in the food world are calling it progress. It's certainly a clearer and more concise image and deserves some credit for the fact that half of the plate is comprised of fruit and vegetables. "This is a step in the right direction," Marion Nestle wrote in an email. "It's the best they could come up with and some education needs to go with it, as always."

In my view though, when you look a little deeper, you see that beyond the clearer image not much has really changed.

The five food categories indicated in the image are: Fruits, Vegetables, Protein, Grains, and Dairy. At first glance the MyPlate image appears to eliminate many problematic sugary, processed foods, but when you actually click on the categories a host of unhealthy foods are revealed.

For example, the fruit category includes fruit juice which should be considered a "sugary drink" something the recommendations say to drink less of. There are 15 grams of sugar in one small four-ounce juice box of Mott's 100 percent apple juice and an eight-ounce glass of Tropicana Orange juice has 22 grams of sugar--depending on how many ounces consumed, these fruit juices approach or even exceed the amount of sugar found in sodas.

There's no doubt that fruit juice is a step up from soda, but in a country where 26 million people have diabetes and many other people exhibit signs of insulin resistance (the precursor to diabetes) liquid sugar in any form is detrimental. This is why the fruit category should be strictly whole fruit -- whole fruit contains fiber to help balance out the sugar content and thus has a lower glycemic load. Whole, fresh fruits also contain many vital vitamins, nutrients, and minerals not found in the processed juice version.

But many Americans don't have enough access to fresh fruit -- and the emphasis on drinking fruit juice appeals to food corporations who profit on fruit juices and other processed fruit products. Indeed, on the Web sites for Mott's and Tropicana, you find out that your apple and orange juice provide the required fruit recommendations by the USDA.

When you click on the dairy category you find that chocolate and strawberry flavored milks are included -- more examples of "sugary drinks" inexplicably deemed acceptable by the USDA. Flavored milks, regularly served in school lunch cafeterias across the country and subject to much debate, contain loads of sugar. A serving of strawberry milk contains 27 grams of sugar, equal to the amount of sugar in eight ounces of Coca-Cola. (Flavored milks were just banned by the Los Angeles Unified School District).

Meanwhile, the grains group remains amorphous. The guidelines do say to keep half of the grains you consume whole, but that's not indicated in the graphic. Again, this group is far too inclusive and leads the consumer to believe that many highly refined ready-to-eat breakfast cereals, white buns, breads, and rolls are part of a healthy diet. Given these vague guidelines one could eat Lucky Charms for breakfast, a Subway sandwich on a white bread roll for lunch, and a few slices of Domino's pizza for dinner and consider these processed grain-filled options as part of the healthy MyPlate meal.

Much on the MyPlate Web site is based on outdated science. The low-fat and fat-free dairy recommendations are based on the premise that saturated fats are harmful (see my article on fats for more on this) and that Americans should cut down on these calories -- but the truth is Americans are not getting heavier due to the fat in dairy products but rather due to the overconsumption of sugars and refined carbohydrates.

As is illustrated in this infographic, while obesity rates have soared since the 1970s the amount of calories consumed in the form of dairy, meat, and nuts has remained mostly stable. On the other hand, the amount of calories consumed in added sugars, added fats (the type of fats are not indicated in this graphic but I would bet they are in the form of highly processed vegetable oils and trans-fats) and grains has also soared. This suggests that the fats found in real foods like dairy are not the cause of our nation's massive weight gain.

The underlying issue is quality of food not just quantity. But this won't be addressed as long as industrial food corporations hold sway over the dietary guidelines. Discussing quality gets to the root problem of access to healthy, whole foods in this country. Quite simply, the USDA cannot insist that people eat only high quality foods while many don't have access to them. Herein lies a conflict of interest for the USDA since it has the dual role of promoting the business of industrial food production and simultaneously advising Americans on healthy eating.

Indeed, the MyPlate recommendation to, "Enjoy your food but eat less" is hardly helpful when the goal of the industrial food industry is to encourage Americans to eat more. Industrial food corporations are great at filling bellies with highly caloric yet nutritionally void food -- and sugar and refined carbohydrates are the main culprits. If the USDA truly wanted to endorse healthier eating, it would focus on promoting nutrient-dense foods. Switching to a nutrient-dense diet goes a long way in addressing portion control -- it's difficult to overeat a real food diet.

The ideal image would be more exclusive-that is to say, many foods now endorsed by the USDA as part of MyPlate would be eliminated. The fruit group would be strictly fruit, the vegetable group strictly vegetables. The protein group would include dairy (the fact that dairy is a separate category highlights the influence of the powerful dairy lobby) and would eliminate the many processed foods now listed as part of these groups: Flavored milks, processed cheeses, processed deli meats, and processed soy products. The grains group would eliminate refined and processed grains and reserve these to be used minimally in the form of treats. The same applies to all sugary foods and sugary drinks.

As Michele Simon rightly points out in her recent post, what's really needed to affect change are policy changes. She writes, "It's going to take way more than a measly $2 million educational campaign to get Americans to fill up half their plate with fruits and vegetables. It's going to take a massive overhaul of our agricultural policies."

And this is why we'll never see a real food MyPlate. As long as our current agricultural policies and farm subsidies remain the same, the government can't offer much else in the way of recommendations. What they've recommended is what's available to most of the American population--processed and packaged foods subsidized by government policies.

MyPlate is simply a cleaner graphic image with mostly the same old information. I can think of a much better way to spend that $2 million dollar budget: Fund urban farming projects so more Americans can actually fill those plates with fruits and vegetables. Now that would be real progress.

For something that's so often mixed with anti-caking agents, salt takes a lot of lumps in the American imagination. Like fat, people tend to think of it as an unnecessary additive -- something to be avoided by seeking out processed foods that are "free" of it. But also like fat, salt is an essential component of the human diet -- one that has been transformed into unhealthy forms by the food industry. Historically, though, salt was prized. Its reputation can be found in phrases like, "Worth one's salt," meaning, "Worth one's pay," since people were often paid in salt and the word itself is derived from the Latin salarium, or salary.

Those days are long over. Doctors and dietitians, along with the USDA dietary guidelines, recommend eating a diet low in sodium to prevent high blood pressure, risk of cardiovascular disease, and stroke; and doctors have been putting their patients on low-salt diets since the 1970s. But a new study, published in the May 4 issue of The Journal of the American Medical Association (JAMA), found that low-salt diets actually increase the risk of death from heart attack and stroke -- and in fact don't prevent high blood pressure.

The study's findings inspired much criticism and controversy -- as research that challenges conventional dietary wisdom often does. When The New York Times briefly reported on it, even the title conveyed the controversy: "Low-Sat Diet Ineffective, Study Finds. Disagreement Abounds." The Times reports that the Centers for Disease Control and Prevention "felt so strongly that the study was flawed that they criticized it in an interview, something they normally do not do." According to the Times, Peter Briss, a medical director at the Centers, said that the study was small, that its subjects were young, and that they had few cardiovascular events -- making it hard to draw conclusions.

But most of all, Briss and others criticized the study because it challenges dietary dogma on sodium intake. These experts claim that a body of evidence establishes sodium consumption as a serious driver of cardiovascular disease. But if you take a careful look at the evidence, you'll see that the case against sodium crumbles under the weight of its contradictions. Gary Taubes wrote about the controversy on the benefits of salt reduction more than 10 years ago in a piece for Science called "The (Political) Science of Salt." He portrayed a clash between the desire for immediate and simple answers and the requirements of good science. "This is the conflict that fuels many of today's public health controversies," Taubes asserted.

The JAMA study published early this month is not the first to find that a low-salt diet may be detrimental. In 2006, data from the NHANES II study showed that death from heart disease and all causes rose with lower salt consumption. Published in the American Journal of Medicine, the report found that:

Lower sodium has been associated with stimulation of the sympathetic nervous system, that, in turn, has been associated with adverse [cardiovascular disease] and mortality outcomes. Sodium restriction may also influence insulin resistance.

The insulin resistance association is compelling since so many Americans are exhibiting signs of insulin resistance, the precursor to diabetes. Michael Alderman, a blood pressure researcher at Albert Einstein College of Medicine and editor of the American Journal of Hypertension, said in an email, "The problem with reducing sodium enough to change blood pressure [is that it] has other effects -- including increasing insulin resistance, increasing sympathetic nerve activity, and activating the renin-angiotensin system and increasing aldosterone secretion. All bad things for the cardiovascular system."

There are those who will argue that any study claiming that sodium is not as harmful as previously believed are connected to the salt lobby, but this is untrue. The most recent JAMA study has no such connection and many real-food advocates, myself included, believe that salt is an essential part of a healthy diet. Alderman was once an unpaid consultant for the Salt Institute but no longer is, according to the Times article.

There is also a strange psychological component to this debate as is often seen in the nutrition world: When a message has been hammered in and repeated millions of times over the course of decades, whether or not that message is actually true becomes irrelevant -- and the people invested in presenting that message, whether for monetary gain or not, are especially resistant to any evidence that might be contrary. When asked about this phenomenon and the standard recommendations on salt, Alderman said, "They are based upon the hope that the blood pressure effect of lowering sodium would translate into a benefit in health. Opposition to these findings -- which only adds to a substantial body of similar information -- is that these folks have long held the faith that lowering sodium was a good idea. They have opposed randomized trials with the bogus argument that a randomized controlled trial would be too tough and expensive. Not so. They choose faith over science, but it's not a theological issue."

Witness the low-fat campaign that has raged on for decades despite research that now shows the low-fat campaign was actually based on little scientific evidence. When it comes to the fat debate, the crucial issue is determining which fats are healthy and which fats are not: Real, whole-food sources of fats, like butter and eggs, are healthy while industrially produced sources of fats, like partially hydrogenated oils or trans-fats, are not. Real fats and industrial fats cannot be lumped into the same category, and when they are, as is often the case in scientific research, the results are muddled. This was the case with studies on coconut oil, which used partially hydrogenated versions to determine that coconut oil was unhealthy, tarnishing its reputation as one of the worst fats. Meanwhile, recent research using unprocessed coconut oil shows that it is actually a healthy fat with a host of health benefits.

As for salt, the same logic can be applied. There are no studies based on a diet that draws its sodium from unrefined salt and from foods containing naturally occurring salt (like zucchini, celery, seaweed, oysters, shrimp, beets, spinach, fish, olives, eggs, red meat, and garbanzo beans). Clearer answers would surely emerge with a study like this.

The differences between refined and unrefined salt are significant. (Make sure you use unrefined sea salt, as other sea salts can be just as processed as ordinary table salt.) Unrefined sea salt contains about 82 percent sodium chloride and the rest is comprised of essential minerals including magnesium and calcium; and trace elements, like iodine, potassium, and selenium. Not coincidentally, they help with maintaining fluid balance and replenishing electrolytes.

Refined, processed salt is actually an industrial leftover, according to Nina Planck's book Real Food. Planck describes how the chemical industry removes the valuable trace elements found in salt and heats it 1,200 degrees F. What's left is 100 percent sodium chloride, plus industrial additives including aluminum, anticaking agents, and dextrose, which stains the salt purple. To gain its pure-white sheen, the salt is then bleached. Thus refined salt is hardly a whole food; and consuming a jolt of sodium chloride upsets fluid balance and dehydrates cells, to say nothing of the harm the various additives and bleach residues may cause.

But what's fascinating about this most recent study is that even in monitoring those on a largely industrial foods diet, consuming what's considered high levels of salt, the results indicate that even this is better than a low-sodium diet.

Why might this be? Sodium is one of the two major electrolytes our bodies need to function properly, and like any other element, nutrient, vitamin, or mineral we put into our bodies, it does not exist or function in isolation. Sodium is important for maintaining blood volume, it works in concert with potassium, which is needed for vasodilatation or constriction, and it also interacts with calcium, which is needed for vascular smooth muscle tone. Sodium exists in all of the fluids in our body and is essential to water balance regulation, nerve stimulation, and proper function of the adrenal glands. It is also crucial to maintaining mental acuity -- sodium is required to activate glial cells in the brain -- these cells make up 90 percent of the brain and are what makes us think faster and make connections. This is part of the reason sodium deficiency (sunstroke, heat exhaustion) leads to confusion and lethargy as the human brain is extremely sensitive to changing sodium levels in the body.

Like fat, salt was prized by traditional cultures. Those groups that were landlocked often burned sodium-rich marsh grasses and added the ash to their foods to acquire healthy amounts of salt and they traded with peoples living near the ocean for fish and salt. The tendency of scientific studies to isolate parts of our foods and determine whether or not they are good or bad obfuscates a clear picture of the larger processes involved in eating and metabolizing in the human body. It also complicates something that shouldn't be complicated: eating real, whole foods as they exist in nature. Isolating and demonizing certain aspects of real, whole foods -- like fat and salt -- only confuses the public.

Every five years, the U.S. Department of Agriculture (USDA) publishes dietary guidelines for Americans. The 2010 dietary guidelines are in and to spare you the trouble of reading the 95-page report, here are the key points: Enjoy your food, but eat less; avoid oversized portions; make half of your plate fruits and vegetables; switch to fat-free or low-fat (one percent) milk; compare sodium in foods like soup, bread and frozen meals and choose the food with lower numbers; drink water instead of sugary drinks. These are decent and reasonable guidelines for the most part, and in general, the response from experts has been subdued—no one is jumping for joy, but no one is up in arms either. Marion Nestle is excited that the guidelines direct Americans to eat less; Michael Pollan is happy that the guidelines contain some common sense.

Some are critical of where the guidelines fall short. Dr. David Katz told the Boston Globe that, “Most Americans don’t have the skill-set to build nutritious meals,” and wonders why the guidelines haven’t addressed this underlying problem even as it’s telling Americans to cook at home more often. Still others are critical that while the health of Americans is steadily deteriorating, the cornerstones of the USDA’s guidelines haven’t changed all that much.

I’m a bit underwhelmed myself, but there are several things the USDA should be applauded for. The advice to drink water instead of sugary drinks, cut down on processed foods with high amounts of salt, sugar, and fat, and to eat less. Sound advice, though nothing groundbreaking.

I thought they might take into account some of the latest research on saturated fats, which have increasingly been show to be a critical part of a healthy diet. I was also hoping they would stress the importance of completely eliminating sodas and processed foods more aggressively. Instead, what we’ve gotten is the usual party line on how bad saturated fats are and a somewhat muddled message on processed foods.

One of the biggest flaws in the report is the recommendation to use fat-free or low-fat dairy products. This recommendation comes on the heels of recent research reported in the Los Angeles Times this past December that excess carbohydrates and sugar, not fat, are what’s responsible for America’s obesity and diabetes epidemics. In addition, the USDA needs to take a firmer stance on the elimination of highly processed and refined foods.

Good nutrition includes a balance of good, healthy fat. It does not include a steady stream of highly processed carbohydrates in the form of refined grains and sugars. As I see it, there’s a serious contradiction in the USDA’s recommendations: Telling American’s to limit their intake of refined grains and sugars does not work with also telling them to limit their intake of saturated fats.

Quite often in my practice, I see that people crave poor-quality fatty foods like French fries or chips because they’re deficient in high-quality fats, like omega-3s found in fish, nuts and seeds, or grass-fed meat, eggs, and dairy products. When I recommend they switch to good, clean sources of protein and fat, their unhealthy cravings go away.

There is one important caveat to all of this worth mentioning, which of course is nowhere to be found in the USDA’s guidelines. Buying the cleanest dairy, poultry, eggs, and meat — pasture-based, no hormones, no pesticides, no antibiotics—is important because pesticides, hormones, and other toxins are stored in fat. This means if you’re drinking a glass of full-fat milk or eating a pat of butter from cattle raised on an industrial dairy farm, you’re taking in concentrated amounts of these toxins.

As Mark Bittman points out in his debut opinion column for the New York Times this week, “Food Manifesto for the Future,” concentrated feed lot operations must be a thing of past. He writes, “The concentrated system degrades the environment, directly and indirectly, while torturing animals and producing tainted meat, poultry, eggs, and, more recently, fish.”

Of course, too many people in this country don’t have access to clean food and this is where structural and institutional changes must come in, another aspect of our food system that the USDA’s guidelines don’t delve into enough.

In the meantime, here’s what I wish the USDA guidelines would have said: Eat a primarily plant-based diet that includes plenty of fresh, clean vegetables, beans and legumes; eat fresh fruit in season; eat moderate amounts of pasture-based animal and dairy products in their unadulterated form; eat moderate amounts of whole grains; use fats like butter, olive oil, coconut oil, nuts, and seeds; minimize refined carbohydrates and added, refined sugars; drink plenty of fresh, filtered water; eliminate all sugary beverages.

If the good food movement can gain enough steam over the next five years perhaps this will become a reality.

This post also appeared on Civil Eats

Since Wal-Mart’s announcement on Thursday that it will “reduce sodium by 25 percent, eliminate industrially added trans fats, and reduce added sugars by ten percent by 2015,” some experts on food policy and health are claiming this is a step in the right direction, an encouraging sign of progress. Still others think the jury’s out and it remains to be seen if the initiative will prove beneficial. From a nutrition perspective, I find both of these claims faulty. If we intend to take the obesity and diabetes epidemics seriously, and if we truly care about the abysmal state of health of the American people, we cannot put our faith in an empty Wal-Mart promise that barely scratches the surface of our country’s food and health crisis. Wal-Mart is well aware that in order to stay ahead of the curve with effective marketing they’d better jump on the bandwagon of promoting “healthier” food options. And just as we have seen green washing in large corporations, now we are seeing health washing — it abounds these days: The new McDonald's commercial for a healthy oatmeal breakfast, Wendy’s French fries with real sea salt, and now Wal-Mart’s claim that it will cut the amount of sugar and sodium in their processed foods and remove 300 trillion calories in their foods overall. This makes for good press coverage, but the truth is these goals are miniscule in the face of a toxic processed food supply.

These token changes are actually irrelevant when considering that many of these foods already contain nearly twice the amount of sodium the CDC recommends we consume in an entire day. As for sugar, the AHA says that women should consume no more than six teaspoons of added sugar a day, and men no more than nine. Meanwhile, one, 12-ounce Coke contains 8 teaspoons of added sugar; a 25 percent reduction would still amount to six teaspoons — the upper limit of how much sugar a woman should consume in an entire day.

Clearly the “changes” are intended for PR and marketing advantages only. These kinds of so-called improvements to industrial foods are not helpful and have actually been shown to be counterproductive and harmful.

Remember the Snackwell effect? When presented with low-fat cookies, consumers ate more than they would of normal cookies, thus increasing their overall caloric intake and sabotaging their efforts to lose weight. I worry that the new labels Wal-Mart intends to put on packages of food with reduced amounts of sodium and sugar will have the same effect as customers load up on “healthy” foods that are free of trans-fats and lower in sodium or sugar. Why not eat two cans of soup? Why not drink two sodas?

Blurring the lines between what’s healthy and what’s not only hurts consumers more as it makes the job of finding healthy foods harder and more confusing. This muddying of the waters is precisely the goal of these corporations. If it were clear to the American people what they were actually being sold, I imagine there’d be a lot less buyers. Putting their hard-earned money towards food and drink that’s ultimately harming them seems strange indeed. This is yet another example of the American Fast Food Syndrome at its best, but with a slightly different twist. This time, the corporation at hand is trying to make its processed foods appear healthier and thus appeal to Americans on two fronts: they can eat processed food, participating in what’s considered the normal American diet, while also feeling better about eating these new “healthier” foods.

Expecting Wal-Mart to make processed foods healthier is like asking Phillip Morris to make their cigarettes healthier. Healthy compared to what?

Wal-Mart claims it will reduce the price of fresh fruits and vegetables as part of its initiative as well and this is really the key to improving the health of Americans. But why can’t the government step in and subsidize fruits and vegetables like they do the corn, soy, and wheat that go into nearly every processed food item? Why are we relying on a private corporation to police itself? This is truly a case of the fox guarding the henhouse.

Michelle Obama is well intentioned in bringing attention to our country’s diet-related health problems, but it seems she’d be better off asking her husband to address the deeper, underlying issues at hand rather than asking a corporation like Wal-Mart to make superficial and meaningless changes.

A version of this post was published on Civil Eats