Sunday, October 22, 2017


My book on a cereal box. I think I was the first dietitian to be on a cereal box:)

“I want to make healthy choices at the grocery store,” you say to yourself. Picking up a box of crackers and looking at the ingredient list, you see many words you don’t understand.

They are not even pronounceable. What are they? Are they necessary? Are they harmful? You want to know!


Which additives are safe? Usually these additives with long names are at the end of the “Ingredient” list, so we know that the amount in the package is very little. But, if so, why are they used?


Additives are regulated according to up-to-date research results. Food additives must be shown to be safe before they can be introduced into the food supply. Chemicals are usually tested on their ability to cause cancer.

BHT (butylated hydroxytoluene), for example, is necessary to retard rancidity in oils so that our product doesn’t spoil. Some cereal boxes even state that, “BHT is added to packaging to help preserve freshness.” Most products don’t tell you anything. Of course, we wouldn’t buy a product that isn’t fresh. Therefore, the small amount of BHT added to a product will ensure freshness. Further research has shown that BHT may block the action of a large group of chemicals that cause cancer. Some scientists think they are partly responsible for the decline in stomach cancer among Americans.

Despite all the news and warnings about contaminated produce, the American food supply is among the safest in the world.


Also colorants, pesticides, antibiotics and hormones - all regulated by the FDA. The amounts, types and uses must conform to strict rules. On the other side, food manufacturers pay for these additives so the less used the better for them financially. Moreover, realizing that consumers are demanding fewer additives, they are continuously working to supply foods that contain less unpronounceable words in the Ingredient List.

Additives are not added to products to confuse us, but to improve taste, shelf life, and texture. We will, after all, only buy a food if it’s yummy and looks attractive. If additives were not in the products, our food would spoil. If the food is spoiled we won’t eat it. If you hear shrill claims such as “Additives will cause cancer when you’re old,” ignore them. Use your common sense. If preservatives were not added to foods, we wouldn’t live long enough to worry about diseases. We would all starve to death when young.


Under the Federal Food, Drug, and Cosmetic Act (the Act), FDA is responsible for evaluating the safety and approving the use of food additives and color additives. In addition, FDA currently reviews petitions to affirm that substances used in food are generally recognized as safe (GRAS).


Fringe groups continuously warn consumers that the food supply is harmful. The members of these groups usually have no academic background in nutrition. They are very often misinformed and have a general distrust of anything governmental. Logically, their claims are flawed. Why would government agencies dupe consumers by condoning a harmful ingredient and then eat the same foods as we do? It would mean they’re poisoning themselves. Or do they have a secret cache of non-preserved foods hidden somewhere?

The link between pesticides and cancer deaths are controversial. The food industry is continuously researching new ways to decrease the use of pesticides, yet you’ll hear that fruits and vegetables should not be eaten because of possible negative effects. Fruits and vegetables have preventive effects on many cancers, which overwhelm any hazard from detectable pesticide residues. However, always wash fruits and vegetables before eating them.


Few foods are given a break by the “alternative” nutritionists. By the way, “nutritionist” is not a protected title. Anyone can call herself or himself a nutritionist. If you are looking for nutrition advice from an expert, check that the individual is a Registered Dietitian (RD). The American Dietetic Association’s website, can find you one in your area. Dietitians are a regulated health profession and have to conform to high standards of education and conduct.


“I choose ‘natural’ foods whenever I can.” This I hear this all the time. What does “natural” mean? Perhaps it means that fewer additives are used with the product, but since there is no regulation to govern this, can we believe it?

If my clients consume “natural” foods, I do mention that these foods may be more expensive and have a shorter shelf life than the regular product, but I don’t discourage them if they prefer the taste.


Organic foods have become increasingly popular with chefs and consumers. “Organic” refers to the process of growing fruits, vegetables and grains without the use of chemicals or pesticides. Organically grown plants have a shorter shelf life and less uniformity than plants that have undergone chemical treatments. As you can imagine, to grow produce without fertilizing or using pesticides is expensive, because disease and pests can ruin crops. If you can afford organic foods, then by all means try them. The taste may be better and you’ll be supporting environment friendly farming practices.


“I only choose foods without MSG.”

What is MSG? MSG (mono-sodium glutamate) is a flavor enhancer, and is used mainly in Chinese soups and sauces. Because a few people have problems such as headaches or tingling sensations (known as the Chinese Restaurant Syndrome) when consuming foods containing MSG, this additive has become most unpopular.

In one research project, people were given foods with MSG for a certain time period and then foods without MSG for the same amount of time. They weren’t told that the foods in the second period did not contain MSG. The number of people who developed headaches was the same for both, with or without MSG. Once again, the placebo effect, showing that perhaps if you believe MSG is in the dish, you’ll develop the headache whether the substance is present in the food or not.

The World Health Organization (WHO) researchers have concluded that the consumption of MSG, even in large amounts, is not harmful. Yet we see advertised regularly that certain foods do not contain MSG, as if it does create a problem when in food. This is group-fear and belief. I have seen quoted in numerous nutrition articles that from one to 25 percent of people are sensitive to MSG. Although the claims may sound logical, they are classic examples of off-balance conclusions and selectivity of research. The result is mass hysteria and “NO MSG” signs wherever you go. My suggestion is, don’t worry about MSG unless you show definite symptoms of a bad reaction to the substance.


Do you think you consume too many non-nutritive (artificial or non-caloric) sweeteners? They are found in many products such as soda, gum, sweets and tabletop sachets. Through my years in practice, I have not yet found anyone who comes near to the maximum amount allowable, so your consumption is probably okay. To me, obesity is a really big problem. If the use of sweeteners help people satisfy their sweet tooth and keep them away from high calorie foods, that is good.

Before a sweetener is approved, it goes through several levels of intense scrutiny. Research work is submitted to a panel of health experts who decided what is healthy after they finish their analysis of the research. Ultimately, their goal is to protect consumers and keep them healthy.

Aspartame, better know as NutraSweet, can be used for the whole family. You will find the characteristic twirly logo on many foods and beverages. However, individuals with a rare genetic disease called phenylketonuria must avoid aspartame.

Sucralose was approved for use and can be found in many foods and beverages, as well as in tabletop sachets. It’s called Splenda. It took more than 15 years and over 140 safety and environmental studies to confirm that sucralose is safe.

Will you lose weight if you use sweetener instead of sugar? Not really, because people tend to think they can eat more of other foods when they use sweetener. How many times have you seen a friend order a chocolate mousse cake and then use a sweetener in his coffee to compensate? He may consume less calories in your coffee - maybe 20 calories less - but the dessert will contain 450 calories. You can’t really compare the two, can you?

Using a sweetener does inhibit my desire for sweet foods. I put sweeteners in my coffee and tea. I use diet soda, “diet” hot chocolate and low calorie jellies. Psychologically I haven’t lost control, and yet have satisfied my sweet tooth. Sweeteners play an important role in my diet and that of my clients.


“I put honey in my tea. I don’t touch sugar,” boasted a friend. He was surprised to hear that honey has no benefits over sugar, neither in nutritive nor in caloric value. Use it if you like it, but don’t look for special health advantages in it. This is not the only misconception. The two most common questions I am asked about sugar are:

Should I avoid sugar?

No, sugar adds flavor and variety to the diet. It is not harmful per se. Sugar does not cause obesity, diabetes or heart disease. However, it does supply calories, so it needs to be limited to small quantities, together with other foods, if you want to lose weight. Many people avoid high-fiber cereals that contain sugar. If the cereal tastes terrible, you won’t eat it, so it has to be sweetened slightly.

Where sugar can be harmful is in the consumption of “sticky” products such as toffees, dried fruit and sweet baked goods. Foods that lodge on or between the teeth provide more time for bacteria in the mouth to produce tooth-decaying acid. Follow meals with foods that will not promote tooth decay, such as sugarless gum, sugarless beverages, peanuts or cheese.

I love sweet things and would find it hard to deprive anyone of this delicious sensation. My advice is that you simply limit the amount to times when you really feel like something sweet.

How do I know if sugar is added to a product?

As with additives, sugar claims are regulated. If a product says no sugar added, it means precisely that - no sugar is added to the product. However, the product itself may contain sugar, so it does not mean sugar-free. Moreover, the product does not necessarily have to contain sucrose (table sugar); it may contain other sugars such as honey, glucose, fructose, which supply the same amount of calories as sugar.

Sugar alcohols may be listed such as maltitol, zylitol or sorbitol, which are not absorbed well by the body so supply slightly less calories per gram than table sugar. Sugar alcohols have a laxative effect in large amounts. My clients have been surprised when they discover the reason for their loose stools. Any substance with “-ose” or “-ol,” at the end of it is a type of sugar. So no sugar added does not mean calorie free.

For a ½-cup serving of canned sliced peaches (in juice - no sugar added), the sugar content is 12 g. For canned sliced peaches in light syrup, the sugar content is 16 g, a slight increase. The difference in calorie content is 16 calories (sugar supplies 4 calories per gram, 4 x 4 = 16). As you can consume 1500 to 2500 calories per day, depending on your sex, size and activity, 20 calories is not going to make a big difference. Choose the one you like the most, but keep to the serving size of half a cup!


The FDA sets sodium guidelines. Healthy American adults should reduce their sodium intake to no more than 2300 milligrams per day. This is about 1 teaspoon of sodium chloride.

For lower-salt living:
• Choose fresh, frozen or canned food items without added salts.
• Select unsalted nuts or seeds, dried beans, peas and lentils.
• Avoid adding salt and canned vegetables to homemade dishes.
• Select unsalted, fat-free broths, bouillons or soups.
• Select fat-free (skim) or low-fat milk; low-sodium, low-fat cheese, low-fat yogurt.
• When dining out, be specific about what you want and how you want it prepared. Ask for your dish to be prepared without salt.
• Learn to use spices and herbs to enhance the taste of your food.
• Don’t throw salt on your food before you taste it. Always taste your food first, and if you really need more salt, add it sparingly - that’s the rule.

However, it’s not the salt you sprinkle on your food that’s the biggest problem. Far more salt is used when cooking and in chips, pretzels, popcorn, cheese, crackers, canned/dehydrated soups and ready-made dinners.

Salt labeling:
• Sodium-free -- less than 5 milligrams of sodium per serving
• Very low-sodium -- 35 milligrams or less per serving
• Low-sodium -- 140 milligrams or less per serving
• Reduced sodium -- usual sodium level is reduced by 25%
• Unsalted, no salt added or without added salt -- made without the salt that's normally used, but still contains the sodium that's a natural part of the food itself
The FDA and USDA state that a food that has the claim "healthy" must not exceed 360 mg sodium per reference amount. "Meal type" products must not exceed 480 mg sodium per reference amount.

Salt claims and content can be found on products such as cracker packets, margarine tubs, canned soups and cereal boxes. The salt content of fresh meat, poultry, eggs and fish does not have to be labeled, as they are quite low in salt. But beware of processed meats, which also don’t need labeling, but can be very high in salt.

Why do I need to lower my salt intake?

A high salt intake is linked to high blood pressure, certain cancers, kidney stones and osteoporosis. So we should aim for moderation in everything, which means lower intake of salt and salty foods. We eat far too much of it - approximately 6,000 mg sodium per day. Replace high-salt foods with fresh fruits and vegetables, and grains.

“I avoid soda because I heard it’s high in salt”

Soda contains approximately 20 mg sodium per can, which is certainly not high. Rather decrease your sodium intake from some of the following foods you consume every day:

French fries, 1 regular : 120 mg sodium
Potato chips, 15: 160 mg sodium
Ketchup, 1 Tbs: 205 mg sodium
Cheese, cheddar, 1-½ oz: 265 mg sodium
Bread, 2 slices: 300 mg sodium
Vegetable juice cocktail, canned, ½ cup: 450 mg sodium
Nuts, salted, ½ cup: 460 mg sodium
Pretzels, 1 oz: 540 mg sodium
Tomato sauce, ½ cup: 620 mg sodium
Rice: white, long grain, 1 cup, cooked with salt: 780 mg sodium
Rice: white, long grain, 1 cup, cooked without salt: 4 mg sodium
Pickle, dill, 1 large: 830 mg sodium
Pizza, 1 slice with meat, cheese, vegetables: 900 mg sodium
Cheeseburger, 1 regular with the works: 975 mg sodium
Soup: canned chicken noodle, 1 cup : 1100 mg sodium
TV chicken dinner, 1 regular: 1030 mg sodium
Salt, 1 tsp: 2300 mg sodium

With the recommended maximum daily intake of 2,300 mg sodium per day, it easily adds up. Calculate your total sodium intake for a typical day. Make a plan to lower it if necessary.

For lower salt cooking, replace salt with herbs, spices, lemon juice, vinegar, salt substitutes, garlic powder, fresh garlic, onion powder and fresh onion.