Tagged Eat

Time-Delayed Eating Leads to Better Food Choices

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A study of online grocery orders found that people who order several days before delivery make better food choices than those who seek last-minute deliveries.

A study of online grocery orders found that people who order several days before delivery make better food choices than those who seek last-minute deliveries.Credit Yana Paskova for The New York Times

Want to improve your diet? Try time-delayed eating — ordering (or at least choosing) your food long before you plan to eat it.

A series of experiments at Carnegie Mellon University found that when there was a significant delay between the time a person ordered their food and the time they planned on eating it, they chose lower-calorie meals.

What was interesting, researchers said, was that the participants were not making a conscious choice to order less. Most didn’t even realize they were choosing lower-calorie options.

Being less hungry when they ordered the meal accounted for only a small part of the difference, said Eric M. VanEpps, a post-doctoral student at the University of Pennsylvania Center for Health Incentives and Behavioral Economics who led the research while at Carnegie Mellon. The research was published this summer in the journal American Marketing Association.

Dr. VanEpps believes people have what he calls a “bias toward the present,” that alters the calculations they make about something that is occurring momentarily.

“If a decision is going to be implemented immediately, we just care about the immediate consequences, and we discount the long-term costs and benefits,” Dr. VanEpps said. “In the case of food, we care about what’s happening right now – like how tasty it is – but discount the long-term costs of an unhealthy meal.”

On the other hand, when you order a meal in advance, “you’re more evenly weighing the short-term and the long-term costs and benefits,” he said. “You still care about the taste but you’re more able to exert self control.”

The finding is the latest to suggest that timing matters when it comes to healthful eating. When people order groceries online, they are more likely to choose healthier foods when they schedule a delivery date several days away, one study found..

Another study showed that people choosing a snack a week in advance were more likely to pick an apple or banana over a candy bar. When choosing a snack for immediate consumption, they were more likely to choose a candy bar.

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One study showed that people choosing a snack in advance were more likely to pick an apple or banana over a candy bar.

One study showed that people choosing a snack in advance were more likely to pick an apple or banana over a candy bar.Credit Tony Cenicola/The New York Times

The latest research, which focuses on three eating-delay experiments, offers a number of insights that can help us make better choices for eating out.

In the first experiment, 394 employees of a large health care company were asked to place their lunch orders at least 30 minutes before they wanted to pick up their meal. They had the option to place an order as early as 7 a.m. for lunches that were to be picked up between 11 a.m. and 2 p.m. Some people placed their order five hours in advance while others barely made the deadline, placing an order 31 minutes ahead of pickup.

The more hours people planned ahead, the fewer calories they ordered and ultimately consumed. For every hour in advance the participants ordered their meal, they ordered 38 fewer calories. The biggest effect of the time-delay was seen in women.

In another experiment, the Carnegie Mellon researchers recruited more than 1,100 workers and controlled the time delay between ordering and eating. One group of workers at the same company placed their food order before 10 a.m. and had to wait at least an hour before eating. Another group placed its lunch order after 11 a.m., and waited just 30 minutes before eating it. In one arm of the experiment, calorie labels were put on meals containing fewer than 500 calories.

The same pattern ensued: When people ordered lunch longer in advance, they were more likely to choose the meal with less than 500 calories. What was interesting was that they didn’t seem to think they were doing anything unusual and said they would have chosen the same option, regardless.

Did people order more calories later in the morning because they were hungrier? A third experiment attempted to answer this question. The researchers recruited about 200 university students who took classes that ended around lunchtime, and asked them to answer surveys in exchange for a free lunch.

Some students took the survey before their class, while others took it right before receiving their meal. The surveys asked about unrelated issues in order to mask the true purpose of the trial, and gave the students the opportunity to order their meal and also indicate how hungry they were.

Once again, the pattern held: Students who took the survey before their class (and thus placed their food order earlier) ordered lunches containing about 100 fewer calories. The sandwiches they chose were similar in type to those of the students who ordered later, but they were more likely to order bottled water instead of a soda and chose less caloric combinations of fruit and cookies.

Dr. VanEpps isn’t sure advance ordering will work the same way if you are going out for dinner or a celebratory meal. But if businesses or schools want to encourage employees and students to eat healthfully, he said “let them make decisions further in advance.”

But some researchers were skeptical about people’s ability to plan ahead like this on a regular basis.

“This requires a level of organization and forward planning that would be impossible for someone like me,” said Marion Nestle, a professor of nutrition, food studies and public health at New York University. But, she said, “More power to those who can do this!”

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Are You Ready to Eat Your Natto?

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Ann Yonetani makes natto, a fermented soybean food popular in Japan, in Queens, N.Y.

Ann Yonetani makes natto, a fermented soybean food popular in Japan, in Queens, N.Y.Credit

Does a stinky, fermented soybean condiment belong on your plate? Ann Yonetani, a microbiologist turned food entrepreneur, thinks so.

The preparation, called natto, has a mild, earthy taste and looks like a mishmash of tiny brown jelly beans suspended in white goo. It is popular in many parts of Japan but has yet to catch on in most other places. Dr. Yonetani, who teaches food science at the New School, founded NYrture Food last year to introduce natto to New Yorkers, calling it one of the most potent sources of healthful bacteria there is.

Bacteria have not traditionally been something we wanted in our foods. Increasingly, though, researchers like Dr. Yonetani, a Columbia-trained specialist in cell reproduction, believe that in our quest to avoid germs, we have inadvertently eliminated many of the beneficial bugs that help to comprise a healthy human microbiome, the community of microbes that live in our gut.

“Food used to be fresh and dirty. We lived surrounded by nature,” said Dr. Yonetani. “Nowadays, we are exposed to too little microbial diversity.”

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Spaghetti with parmesan, black pepper and natto, garnished with broccoli rabe greens and flowers.

Spaghetti with parmesan, black pepper and natto, garnished with broccoli rabe greens and flowers.Credit Ann Yonetani

Dr. Yonetani, who calls herself a “microbe farmer,” says that each tablespoon of her finished product contains a billion of the healthful soil bacteria Bacillus subtilis, a count that is “orders of magnitude greater than what you would find in a typical probiotic food.” Because natto contains lots of dormant bacterial cysts, which Dr. Yonetani has observed under the microscope, she speculates that the bacteria can survive the high-acid environment of the stomach and “colonize the intestine, where conditions are more welcoming.”

It is a potent selling point given the growing interest in the microbiome and the booming market for probiotics, products that reputedly help replenish the healthful bacteria in our bodies.

“The microbiome is a hot issue right now, and proponents of probiotics are riding that wave,” said Marion Nestle, a nutrition expert at New York University. Still, she said, our knowledge of probiotics remains “in its infancy.” Most of the studies that demonstrate the efficacy of probiotics, she noted, are sponsored by yogurt companies that may report only positive outcomes.

“Are probiotics good for you? Sure, why not?” Dr. Nestle said. “Are they miracle foods? That would be nice, if true, but the science isn’t there yet.”

Fermented foods rich in living bacteria have long been popular in Japan as a way to promote health, said Dr. Yonetani, who was first introduced to natto as a child during visits to relatives there, where it is commonly consumed with rice for breakfast, and often mixed with chives and raw eggs. Just as children in America are urged to eat their spinach, in Japan they are told to eat their natto.

But for many of us who didn’t grow up on natto, there is a certain yuck factor. Natto’s slimy coating — reminiscent of okra — led one biologist collaborator of Dr. Yonetani’s at Harvard, where she did research, to call it “Klingon food.”

As with most probiotics, the science about natto is at an early stage. Dr. Ralph Holsworth, an emergency room supervisor and biomedical researcher in a rural hospital in Colorado who has coauthored several studies on the enzyme nattokinase, a byproduct of natto fermentation, said that the enzyme “breaks down fibrin in the blood, a protein aggregate involved in blood clotting, decreases the ‘stickiness’ of the red blood cells, and assists in the prevention of arterial plaque formation.” These blood-thinning actions, he said, may lessen the severity of heart attacks and strokes.

Dr. Holsworth uses the enzyme in his medical practice to help prevent blood clots and assist in healing from surgery. Nattokinase is not yet widely used in mainstream medical practice, although it has been gaining popularity as a food supplement with the public.

Natto may also be good for bone health, said Dr. Dennis Goodman, a clinical professor of medicine and director of integrative medicine at New York University. He cited a study that showed that in eastern Japan, where they eat more natto than in western parts of the country but otherwise have similar diets, there are significantly lower levels of osteoporosis. Dr. Goodman attributes this to natto’s high levels of vitamin K2, a form of vitamin K, which he said works like a theater usher by directing calcium to the bones.

“Most people are not getting nearly enough K2 in their diet,” said Dr. Goodman, who has written a book about the vitamin. “The only food that gives you a sufficient amount is natto.” Dr. Yonetani says that a single heaping tablespoon of natto contains approximately 300 micrograms of K2, about seven times the minimum daily requirement.

To make the product, Dr. Yonetani rents a room at the back of the Organic Food Incubator, a cooperative space for artisanal food producers in Long Island City, Queens. Her closet-narrow kitchen is fitted with pressure cookers, boxes full of glass jars and a microscope. A papier-mâché Daruma, a troll-like deity said to bestow good luck on fledgling businesses, oversees the operation.

As she peels back the plastic wrapper from a freshly fermented tray, scores of sticky spider’s web thin strands of biofilm rise up from the batch, and a limburger cheese-like aroma pervades the air. Sampling the two-day-old natto with a plastic spoon, Dr. Yonetani pronounces it finished.

“It’s got some nice coffee notes,” she effuses, with the discernment of a wine connoisseur. She offers me a spoonful. The taste is not at all unpleasant, a cross between chopped liver and cottage cheese. “Every batch comes out a bit different,” Dr. Yonetani said. “That’s not something the food industry likes. But I think it’s beautiful, because that’s biology.”

Sweetgreen Makes Healthful Fast Food — But Can You Afford It?

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Employees work the line at Sweetgreen, a chain restaurant that uses fresh ingredients from local farms to make fast food healthier, in Berkeley, Calif.

Employees work the line at Sweetgreen, a chain restaurant that uses fresh ingredients from local farms to make fast food healthier, in Berkeley, Calif.Credit Jason Henry for The New York Times

Healthful, fast and affordable food is the holy grail of the public health and nutrition community. A popular restaurant chain shows just how much of a challenge that is.

It began when three Georgetown University students were frustrated that they could not find a healthy fast-food restaurant near their campus. With money raised from family and friends, they started their own, renting a small storefront on M Street in Georgetown. The result was Sweetgreen, a restaurant that offered organic salads, wraps and frozen yogurt. Pretty soon, the daily line of lunchtime customers stretched out the door and around the corner.

Ten years later, the line is still there, but Sweetgreen has grown into a nationwide salad chain, with more than 40 locations. Sweetgreen is part of a small but growing breed of farm-to-table fast-food chains – like Chopt Creative Salad Company on the East Coast and Tender Greens in California – that are giving fast-food restaurants a plant-based makeover. Their mission: to fix fast food, which has long been fattening and heavily processed.

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At Sweetgreen, fresh vegetables, cheeses and other ingredients are shipped directly to each restaurant from nearby farms and then chopped or cooked on site.

At Sweetgreen, fresh vegetables, cheeses and other ingredients are shipped directly to each restaurant from nearby farms and then chopped or cooked on site.Credit Jason Henry for The New York Times

Sweetgreen’s owners say their goal is to offer customers foods made with nutritious, sustainable and locally grown ingredients. The company has decentralized its food sourcing and production. Fresh vegetables, cheeses and other ingredients are shipped directly to each restaurant from nearby farms and then chopped or cooked on site. They don’t sell soda or use refined sugar.
Sweetgreen expects to open another 20 stores in major cities around the country this year, and eventually to expand to places where experts say healthy, delicious fast food is needed most — low-income neighborhoods.

But while the chain has proven there is a big appetite for more healthful fast food, the goal of taking this concept to poor areas may be a distant reality. The company and other chains like it operate almost exclusively in affluent communities, far from the low-income food deserts where obesity is rampant and farmers’ markets and healthy food stores are scarce. And with salads that typically cost between $9 and $14, some question whether a healthful fast-food chain like Sweetgreen can ever be affordable for average Americans.

Maegan George, a Columbia University student who lives near a Sweetgreen, calculated that for the price of one Sweetgreen salad, she could buy the same ingredients in bulk at a local market and make several similar salads at home.

“I’m a first-generation student and I’m on full financial aid,” she said. “Sweetgreen is delicious and I enjoy it. But there’s no way I could afford to eat there on a regular basis.”

Jackie Hajdenberg, another Columbia student, wrote about the restaurant for the campus newspaper, The Spectator, earlier this year, lamenting that on a per calorie basis, a salad at Sweetgreen was three times the price of a Big Mac at McDonald’s.

“Sweetgreen has not only made it easier for people to make healthy decisions – it has also illustrated the unequal socioeconomic landscape of the world in which we live,” she wrote.

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Salad options at Sweetgreen change often, depending on what is available at local farms.

Salad options at Sweetgreen change often, depending on what is available at local farms.Credit Jason Henry for The New York Times

Sweetgreen says it prices its food so that it can compensate its suppliers and employees fairly, and that it expects nutritious fast food to become more affordable as the healthy food movement grows. Nicolas Jammet, a co-founder of Sweetgreen, said the company wants to serve lower-income customers, and has long-term plans to expand to low-income communities.

To get there, he said, the company will have to overcome hurdles involving its supply chain, the minimum wage and greater nutrition awareness and education among the public. For the past six years the company has been running a nutrition education program in schools that teaches children about healthier eating and locally grown food.

“It’s a long-term goal for us to be part of this larger systematic change that needs to happen,” he said. “But there are so many parts of this problem that need to be addressed.”

Mr. Jammet notes that the company was among the first to show that fast-food chains don’t need profits from soda and sugary drinks to succeed. He believes chains like Sweetgreen have caused a ripple effect throughout the fast-food industry.

In January, for example, Chick-fil-A unveiled a new kale, broccolini and nut “superfood” salad, responding to customer demands for “new tastes and healthier ways to eat in our restaurants.” McDonald’s is experimenting with kale salads, and Wendy’s is testing a spinach, chicken and quinoa salad.

“Companies like McDonald’s have more power to change the way that people eat than we do,” Mr. Jammet said. “We don’t see these companies as the enemy. We just have to force change on them.”

Public health experts say that such changes cannot come soon enough. A University of Toronto study recently showed that people have a higher risk of developing diabetes if they live in “food swamps” – an area with three or more fast-food restaurants and no healthy dining options.

Another study published in JAMA in June found that the percentage of Americans eating an unhealthy diet — high in sugar, refined grains, soft drinks and processed foods and low in fruits and vegetables — was on the decline, but the improvements in diet were much smaller for lower-income Americans.

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Customers wait in line at Sweetgreen in Berkeley, Calif.

Customers wait in line at Sweetgreen in Berkeley, Calif.Credit Jason Henry for The New York Times

Overall about twice as many people from poor households have poor diets compared to those at higher income levels.
Why is traditional fast food so cheap? One reason is the underlying infrastructure of the industry. Many of the ingredients, like the soy that’s turned into oil for deep fryers, or the the corn that’s fed to animals and used to make high-fructose corn syrup, begin with crops that are heavily subsidized by the government. To make their food economical, many traditional fast-food chains mass-produce their food in large factories, often stripping it of fiber and other nutrients that decrease its shelf life, while adding salt, sugar and other flavorings and preservatives.

Then they freeze and ship the processed components, like burger patties, bread, pickles and sauce, to their restaurants. There they are reheated and assembled, often with minimal effort, ensuring that a Big Mac in Seattle looks and tastes the same as a Big Mac in Charlotte, N.C.

By comparison, every Sweetgreen location has a chalkboard that lists the farms where its organic arugula, peaches, yogurt or blueberries are produced. As a result, the menus vary by location and by season. In Boston, Sweetgreen stores use New England Hubbard squash. In Los Angeles, the menu features a different variety of squash grown locally in California.

Those differences mean fresher, more nutritious ingredients, but ultimately costlier food for customers — one of the obstacles that Sweetgreen and other chains like it will have to overcome if they hope to make their food more accessible to all income brackets.
Marion Nestle, a professor of nutrition, food studies and public health at New York University and the author of “Food Politics,’’ says restaurants like Sweetgreen offer an encouraging, but imperfect, model for making fast food more healthful.

“What’s not to like?” she asks. “The cost, maybe, but for people who can afford it the quality is worth it. Next step: Moving the concept into low-income areas.”

Related:

How the Government Supports Your Junk Food Habit

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Credit Fred R. Conrad for The New York Times

At a time when almost three-quarters of the country is overweight or obese, it comes as no surprise that junk foods are the largest source of calories in the American diet. Topping the list are grain-based desserts like cookies, doughnuts and granola bars. (Yes, granola bars are dessert.)

That’s according to data from the federal government, which says that breads, sugary drinks, pizza, pasta dishes and “dairy desserts” like ice cream are also among Americans’ top 10 sources of calories.

What do these foods have in common? They are largely the products of seven crops and farm foods — corn, soybeans, wheat, rice, sorghum, milk and meat — that are heavily subsidized by the federal government, ensuring that junk foods are cheap and plentiful, experts say.

Between 1995 and 2010, the government doled out $170 billion in agricultural subsidies to finance the production of these foods, the latter two in part through subsidies on feed grains. While many of these foods are not inherently unhealthy, only a small percentage of them are eaten as is. Most are used as feed for livestock, turned into biofuels or converted to cheap products and additives like corn sweeteners, industrial oils, processed meats and refined carbohydrates.

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Health advocates have long pointed out this seeming contradiction. While the federal government recommends that people fill half their plates with fruits and vegetables to help prevent obesity, only a small fraction of its subsidies actually support the production of fresh produce. The vast majority of agricultural subsidies go instead to commodity crops that are processed into many of the foods that are linked to the obesity crisis.

“The subsidies damage our country’s health and increase the medical costs that will ultimately need to be paid to treat the effects of the obesity epidemic,” a 2012 report from the U.S. Public Interest Research Group, a nonprofit consumer advocacy organization, concluded. “Taxpayers are paying for the privilege of making our country sick.”

Now federal health researchers have examined the relationship between metabolic disease and the consumption of federally subsidized foods.

The study, led by a team at the Centers for Disease Control and Prevention and published this month in JAMA Internal Medicine, looked at over 10,000 adults and the foods they reported eating in a typical day. Then the researchers split the subjects into groups according to the proportion of foods they ate that were derived from the seven major subsidized commodities.

After adjusting for age, sex, socioeconomic factors and other variables, the researchers found that those who had the highest consumption of federally subsidized foods had a 37 percent greater risk of being obese. They were also significantly more likely to have belly fat, abnormal cholesterol, and high levels of blood sugar and CRP, a marker of inflammation.

While the study does not prove cause and effect, its authors say that this strong association is consistent with other research showing that diets that are higher in subsidized foods tend to be poorer quality and more harmful to health.

“This tells us that the factors that influence the prices of our foods are an additional factor,” said Ed Gregg, chief of the epidemiology and statistics branch in the C.D.C.’s Division of Diabetes Translation. “We’re hoping that this information reaches policy makers and the people who influence how subsidies work.”

The subsidies program was started decades ago in part to support struggling farmers and to secure America’s food supply. Since 1995, the government has provided farmers with close to $300 billion in agricultural subsidies overall, which are included in the federal farm bill, along with money for nutrition initiatives like the federal food stamps program, known as SNAP. The farm bill is renewed by Congress every five years and is projected to cost $956 billion between 2014 and 2023.

But critics say the subsidies program no longer serves its original purpose. Instead of supporting small farmers who grow fruits, nuts and vegetables – which the government calls “specialty crops” — the program now primarily subsidizes large producers that churn out a handful of “commodity” crops that include grains, corn, sorghum and oilseeds like soybeans.

According to the Government Accountability Office, small “specialty” farms represent three-quarters of the country’s cropland but receive just 14 percent of government subsidies. Large agribusinesses that specialize in growing the major commodity crops represent 7 percent of the cropland and receive about half of all subsidies.

Previous versions of the farm bill even stipulated that farmers who took subsidies for commodity crops could not grow fruits and vegetables. If they did, they were penalized, said Caroline Franck, the co-author of a 2012 report in the Archives of Internal Medicine that explored the role of agricultural subsidies in obesity.

Ms. Franck, a research assistant at the Lady Davis Institute for Medical Research of the Jewish General Hospital, McGill University, said many factors influence what people choose to eat. While it’s difficult to argue that subsidies are a direct cause of obesity, they clearly play a role.

“I think it’s safe to say that what happens at the top of the food chain has an impact on what happens at the bottom,” she said. “Agricultural policies are just not aligned with public health goals.”

In part because of public pressure, the last farm bill, which was passed in 2014, allowed farmers who grow commodity crops to use 15 percent of their acreage to grow fruits, vegetables and other specialty crops. It provided support to organic farmers, including $100 million for research to improve organic production. And it funded a “healthy incentives” program that encourages food stamp recipients to consume more fruits and vegetables by increasing the value of food stamps that are used to buy fresh produce at retail stores or farmers’ markets.

Ms. Franck said that early results suggest that the program is increasing the amount of fresh produce people consume. But others are not so sanguine. Raj Patel, a research professor at the Lyndon B. Johnson School of Public Affairs at the University of Texas at Austin, said that the funding for fruits and vegetables in the most recent farm bill was “crumbs” compared to the billions in subsidies for commodity crops.

Dr. Patel said it was time for the federal government to adopt a “national food policy” like one that has been proposed by the Union of Concerned Scientists, a nonprofit advocacy group. Among other things, a national food policy would ensure that farm workers receive fair wages, that all Americans have access to healthy foods, and that the government’s nutrition recommendations and agricultural policies are aligned, he said.

“It would transition us away from the unhealthy consequences of the current industrial food policy,” he said. “I think there’s something very broken about the subsidy system.”

Cutting Sugar Rapidly Improves Heart Health Markers

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Obese children who cut sugar from their diets saw improvements in markers of heart disease after just nine days, a study in Atherosclerosis found.

For the study, researchers evaluated 37 children ages 9 to 18 who were obese and at high risk for heart disease and Type 2 diabetes. The children were given food and drinks totaling the same number of calories, fat, protein and carbohydrates as their typical diets.

The only change was their sugar intake: The researchers swapped foods high in added sugars, like pastries and sweetened yogurts, for options like bagels and pizza. This lowered dietary sugar from 28 percent to 10 percent, and fructose from 12 percent to 4 percent of total calories.

After nine days, the researchers found a 33 percent drop in triglycerides, a type of fat tied to heart disease; a 49 percent reduction in a protein called apoC-III that is tied to high triglyceride levels; and dramatic reductions in small, dense LDL cholesterol, a risk factor for heart disease.

Though this study is small and short-term, it builds on this group’s previous research implicating added sugars as a contributor to metabolic disorders and heart disease.

“Sugar calories are not like other carbohydrate calories,” said Dr. Robert Lustig, a co-author of the study and professor of pediatrics at Benioff Children’s Hospital at the University of California, San Francisco. “Without changing total carbohydrate, or fat, or protein, we were able to accomplish this enormous improvement in their cardiovascular risk factors,” unrelated to weight loss, he said.

An App to Deconstruct Your Food

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A screenshot of the Sage app.

A screenshot of the Sage app.Credit

Ever wondered how long you’d have to swim to burn off the calories in an organic peanut butter cup? Or how far the strawberries or burger on your plate traveled to get there?

For answers, ask the Sage Project, one of the latest of the food technology companies helping consumers navigate nutrition. While a number of food apps count calories and track eating habits, Sage goes beyond the food label to give customers additional information about additives and preservatives, how much sugar has been adding during processing or how far a food has traveled.

“Food labels are a data visualization that we see every day, but we don’t get a lot from them,” said Sam Slover, the co-founder and chief executive of Sage. “There are a lot of things about those labels that make assumptions about what you know and what you want to know.”

Do we really need another food app? Apple’s app store already lists more than three dozen apps offering users information and advice about calories, nutrition data and weight loss, but research shows that many consumers have a failed relationship with their food apps. For instance, in January, about 16 percent of the people who downloaded the Lose It app were using it once a day. By June, only 10 percent were using it that often, according to research firm 7Park Data.

“These apps have trouble keeping customers loyal — if you use them successfully, you don’t need them any more, and if you don’t use them successfully, you may not think it’s worth it to try more,” said Byrne Hobart, the lead analyst at 7Park Data. “They’re kind of like the dating apps that way.”

The Sage app hopes to inspire more loyalty by providing a trove of useful and quirky information about the food you eat. It contains data on about 20,000 products, though you still may not find your favorite junk foods. Most of the products in the database are described as “natural” and “organic.” But if you shop at Whole Foods, you’re in luck. Sage has partnered with Whole Foods Market, deconstructing all of the roughly 7,000 items sold in the grocer’s new “365” store chains in Los Angeles and Lake Oswego, Ore.

To begin using Sage, which is available online or as a web-based app, a user signs up and enters any food restrictions and personal preferences. Only want to see products without additives and preservatives? No problem. Interested in digestive health? Sage will comb through its database and show you products with probiotics, high fiber and whole grains.

The app displays a wide variety of information using colorful graphics and animated food characters, and it’s surprisingly fun and entertaining to use. The app told me that Surf Sweet gummy bears, for instance, do have a fair amount of added sugar but also have “good nutrient density,” meaning that, among other things, they supply a high amount of vitamin C (much to my delight). A jump-roping chocolate bar informs me that I’d need to jump rope for 19 minutes — or a snorkeling olive recommends 23 minutes of swimming — to burn off a serving of Justin’s Organic milk chocolate peanut butter cups.

“Customers want a better understanding of how a product is sourced, the quality standards behind it, whether the labor that made it was paid a fair wage, its impact on the environment,” said Jason Buechel, the chief information officer at Whole Foods. “This is a way to give them all that information that isn’t captured on the nutrition label.”

Take the Beast Burger, for instance, a meatless burger sold at Whole Foods. Type the name of the burger into Sage or flip through a list, and you’ll find its basic nutritional profile and calorie content, with highlights of its nutritional strengths.

Using animated food characters — a pear doing yoga, a watermelon riding a bike — the app shows how much exercise would be required to work off the burger. In my case, it’s 20 minutes of running, 22 minutes of jumping rope, 28 minutes of swimming or biking, 44 minutes of dance or 89 minutes of yoga.

Sage also identifies any allergens — corn and seeds in the case of the Beast Burger — and offers detailed explanations of all the burger’s ingredients, and why they’re used should you be interested. For instance: “Calcium chloride, a salt, is used in canned goods to improve stability and quality and as a firming agent in tofu production.”

The system awards “badges” to the burger for things like an abundance of healthy fats and protein and having recyclable packaging, and it explains what diets — dairy free, gluten free, vegan, vegetarian and ketogenic — it does not violate. To make nutrition recommendations like “fiber friendly” or “heart healthy,” Sage uses nutritional standards set by the Food and Drug Administration and the American Heart Association. An in-house team of dietitians and nutritionists have created standards for badges like “healthy fats” or “contains probiotics” — areas where the F.D.A. doesn’t set guidelines.

Finally, the app tells you where the product is made or sourced. The Beast Burger is American made. If you decided to check out Driscoll strawberries, you might learn your batch came from Mexico.

It also can tailor daily nutritional requirements to a user’s specific weight, height and lifestyle. For instance, Sage came up with a recommended daily caloric intake of about 3,300 calories that is rich in protein for Mr. Slover, given his height, weight and exercise routine — he’s a triathlete. It recommended a 1,600-calorie diet with a lower portion of protein for his mother.

“All those things on a label telling you that a product gives you, say, 10 percent of the daily requirement of protein is based on a default, 2,000-calorie-day diet, a kind of one-size-fits-all approach that doesn’t work,” Mr. Slover said.

One thing the Sage app won’t tell you is what you should or shouldn’t eat. You will have to figure that out for yourself. “I’m not a big fan of red, yellow and green scoring mechanisms for food,” Mr. Slover said. “I don’t think they’re well received by consumers or used very much.”

For Coffee Drinkers, the Buzz May Be in Your Genes

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Credit Andrew Scrivani for The New York Times

Like most of my work, this article would not have been possible without coffee.

I’m never fully awake until I have had my morning cup of espresso. It makes me productive, energized and what I can only describe as mildly euphoric. But as one of the millions of caffeine-loving Americans who can measure out my life with coffee spoons, (to paraphrase T.S. Eliot), I have often wondered: How does my coffee habit impact my health?

The health community can’t quite agree on whether coffee is more potion or poison. The American Heart Association says the research on whether coffee causes heart disease is conflicting. The World Health Organization, which for years classified coffee as “possibly” carcinogenic, recently reversed itself, saying the evidence for a coffee-cancer link is “inadequate.” National dietary guidelines say that moderate coffee consumption may actually be good for you – even reducing chronic disease.

Why is there so much conflicting evidence about coffee? The answer may be in our genes.

About a decade ago, Ahmed El-Sohemy, a professor in the department of nutritional sciences at the University of Toronto, noticed the conflicting research on coffee and the widespread variation in how people respond to it. Some people avoid it because just one cup makes them jittery and anxious. Others can drink four cups of coffee and barely keep their eyes open. Some people thrive on it.

Dr. El-Sohemy suspected that the relationship between coffee and heart disease might also vary from one individual to the next. And he zeroed in on one gene in particular, CYP1A2, which controls an enzyme – also called CYP1A2 – that determines how quickly our bodies break down caffeine.

One variant of the gene causes the liver to metabolize caffeine very quickly. People who inherit two copies of the “fast” variant – one from each parent – are generally referred to as fast metabolizers. Their bodies metabolize caffeine about four times more quickly than people who inherit one or more copies of the slow variant of the gene. These people are called slow metabolizers.

With funding from the National Institutes of Health, Dr. El-Sohemy and his colleagues recruited 4,000 adults, including about 2,000 who had previously had a heart attack. Then they analyzed their genes and their coffee consumption. When they looked at the entire study population, they found that consuming four or more cups of coffee per day was associated with a 36 percent increased risk of a heart attack.

But when they split the subjects into two groups – fast and slow caffeine metabolizers – they found something striking: Heavy coffee consumption only seemed to be linked to a higher likelihood of heart attacks in the slow metabolizers.

“The increased risk that we saw among the entire population was driven entirely by the people that were slow metabolizers,” said Dr. El-Sohemy, who is also on the science advisory board at Nutrigenomix, a personalized nutrition company. “When you look at the fast metabolizers, there was absolutely no increased risk.”

The trend among fast metabolizers was quite the opposite. Those who drank one to three cups of coffee daily had a significantly reduced risk of heart attacks – suggesting that for them coffee was protective.

Dr. El-Sohemy suspects that because caffeine hangs around longer in a slow metabolizer, it has more time to act as a trigger of heart attacks. But fast metabolizers clear caffeine from their systems rapidly, allowing the antioxidants, polyphenols and coffee’s other healthful compounds to kick in without the side effects of caffeine, he said.

Other more recent research seems to point in the same direction. In Italy, a team of scientists looked at hypertension in 553 fast and slow caffeine metabolizers. Once again, the subjects’ genetic profiles predicted whether coffee was potentially harmful or healthful. Heavy and even moderate coffee drinkers were significantly more likely to have hypertension if they were slow metabolizers. But fast metabolizers saw their risk of hypertension fall as their coffee intake rose.

That is not to say that every coffee drinker should run out and have their CYP1A2 genes analyzed by one of the many direct-to-consumer genetic testing companies. Dr. Marilyn Cornelis, an assistant professor at the Northwestern University Feinberg School of Medicine, said her research had identified many genes involved in caffeine metabolism, and that relying on only one or two genetic factors could provide people with a false sense of reassurance.

“There are clearly other genetic and environmental factors contributing to differences in caffeine metabolism,” she said. “And these are not captured by existing tests.”

Nonetheless, this greater understanding of the link between coffee and genetics has opened up a wide new area of research. Scientists are now studying whether the CYP1A2 gene and others might mediate coffee’s influence on breast and ovarian cancer, Type 2 diabetes and even Parkinson’s disease.

It has also prompted a closer look at the effects of caffeine on exercise. Though it has long been accepted that caffeine enhances sports performance, research by Christopher J. Womack, a professor of kinesiology at James Madison University, suggests that endurance athletes who are fast caffeine metabolizers may benefit more than others.

In one study in 2012, Dr. Womack and his colleagues studied the effect of caffeine pills and placebos on the performance of male cyclists. Dr. Womack found that the slow metabolizers completed a 40-kilometer race on a stationary bike one minute faster on caffeine. But the fast metabolizers improved their time by four minutes.

Dr. Womack suspects that the fast metabolizers saw greater benefits because the rapid metabolism of caffeine further heightened their sympathetic nervous systems — which control the so-called fight or flight response.

“In the broad sense, the average person is going to perform better with caffeine,” he said. “Some people have a huge effect. Not surprisingly, it has something to do with our genetics.”

As an avid coffee consumer, I was curious about my own genes. Through a company called FitnessGenes, which analyzes 41 different genes related to diet and exercise – including CYP1A2 – I learned that I was a so-called fast caffeine metabolizer. The company says that 40 percent of people are fast metabolizers. About 45 percent have both a slow and a fast copy, and 15 percent carry two copies of the slow allele.

Dan Reardon, a medical doctor who founded FitnessGenes, said that, anecdotally, slow metabolizers who drink coffee tend to report a very gradual wakefulness, sometimes lasting hours. But fast metabolizers often experience something very different with coffee: an immediate spike in alertness followed at times by a relatively quick dip in energy.

While my DNA results suggested that my twice-daily espresso habit might be for the best, researchers have only just begun to understand how our genes and coffee habits interact. In a 2015 study, Dr. Cornelis and a team of international scientists identified eight genetic variants that appear to make people more likely to seek out coffee, including at least two variants that are involved in the psychologically rewarding effects of caffeine.

The research could help to explain why some people see little or no appeal in a freshly brewed cup of coffee – while others, like me, can hardly fathom a morning without it.

Eat Well is a new weekly column on the science and culture of eating.

No Health Benefit to Replacing Fat With Carbs

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Low-fat diets that are high in carbohydrates are unlikely to improve your health, a new study shows.

Researchers came to the conclusion after studying the eating habits and health behaviors of 126,233 men and women who completed health questionnaires every two to four years for up to 32 years. Then they calculated the effect of replacing just 5 percent of saturated fat calories with another type of fat or carbohydrates.

The study, in JAMA Internal Medicine, found that replacing 5 percent of daily calories from saturated fats (mainly animal fat) with foods high in monounsaturated fat, such as olive oil and avocados, was associated with a 27 percent reduction in total mortality and reduced death from cardiovascular disease, cancer and neurodegenerative disease.

A similar switch from saturated fat to polyunsaturated fats, such as the omega-3 and omega-6 fatty acids in fish and walnuts, was associated with a 13 percent reduction in total mortality and a 29 percent reduction in death from neurodegenerative diseases.

But replacing saturated fats with carbohydrates, such as sugars and refined grains, did not confer any health benefits.

“Not all fats are created equal,” said the senior author, Dr. Frank B. Hu, a professor of nutrition at the Harvard T.H. Chan School of Public Health. “We should eat more good ones from fish and avocados, instead of animal fats. And second, the low-fat, high-carbohydrate diet is not beneficial for improving health and longevity.”

The Urgency in Fighting Childhood Obesity

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Credit Paul Rogers

Life-threatening ailments like heart disease, cancer, stroke and Type 2 diabetes most often afflict adults. But they are often consequences of childhood obesity.

Two new studies, conducted among more than half a million children in Denmark who were followed for many years, linked a high body mass index in children to an increased risk of developing colon cancer and suffering an early stroke as adults. The studies, presented at the European Obesity Summit in Gothenburg, Sweden, this spring, underscore the importance of preventing and reversing undue weight gain in young children and teenagers.

One study, of more than 257,623 people, by Dr. Britt Wang Jensen and colleagues at the Institute of Preventive Medicine, in Bispebjerg, Denmark, and Frederiksberg Hospital in Copenhagen, grouped children according to standard deviations from a mean B.M.I., adjusted for a child’s age and sex.

They found that each unit of increase in being overweight at age 13, generally corresponding to a two- to three-point increase in B.M.I., increased the risk of developing colon cancer by 9 percent and rectal cancer by 11 percent.

The second study, involving 307,677 Danish people born from 1930 to 1987, used a similar grouping of B.M.I. The risk of developing a clot-related stroke in early adult life increased by 26 percent in women and 21 percent in men for each unit of increase in being overweight at all stages of childhood, but especially at age 13.

Although neither study proves that excess weight in childhood itself, as opposed to being overweight as an adult, is responsible for the higher rates of cancer and stroke, overweight children are much more likely to become overweight adults — unless they adopt and maintain healthier patterns of eating and exercise.

According to the American Academy of Child and Adolescent Psychiatry, obesity most often develops from ages 5 to 6 or during the teen years, and “studies have shown that a child who is obese between the ages of 10 and 13 has an 80 percent chance of becoming an obese adult.”

In a study published in 2014 in The New England Journal of Medicine, Solveig A. Cunningham and colleagues at Emory University found that “overweight 5-year-olds were four times as likely as normal-weight children to become obese by age 14.” The study, which involved a representative sample of 7,738 kindergartners, found that the risk of becoming obese did not differ by socioeconomic status, race or ethnic group, or birth weight. Rather, it showed that excess weight gain early in life is a risk factor for obesity later in childhood across the entire population.

Children are generally considered obese when their B.M.I. is at or above the 95th percentile for others of the same age and sex. Currently, about one-third of American children are overweight or obese. By 2012, the Centers for Disease Control and Prevention reports, 18 percent of children and 21 percent of adolescents were obese.

The adverse effects of excess weight in childhood and adolescence don’t necessarily wait to show up later in life. In a review of complications resulting from youthful obesity, Dr. Stephen R. Daniels, a pediatrician at the University of Colorado School of Medicine and the Children’s Hospital in Denver, found that problems in many organ systems were often apparent long before adulthood. They include high blood pressure; insulin resistance and Type 2 diabetes; high blood levels of heart-damaging triglycerides and low levels of protective high-density lipoprotein (HDL) cholesterol; nonalcoholic fatty liver disease; obstructive sleep apnea; asthma; and excess stress on the musculoskeletal system resulting in abnormal bone development, knee and hip pain, and difficulty walking.

Problems of youthful obesity go beyond physical ones. Obese adolescents have higher rates of depression, which in itself may foster poor eating and exercise patterns that add to their weight problem and result in a poor quality of life that persists into adulthood.

In a study conducted in Singapore, researchers reported that “individuals who were obese in childhood are more likely to have poor body image and low self-esteem and confidence, even more so than those with adult onset obesity.”

Another study by Dr. Jeffrey B. Schwimmer of the University of California, San Diego, and colleagues found that obese children and adolescents reported a diminished quality of life that was comparable to that of children with cancer.

Taken together, the data speak to the critical importance of preventing undue weight gain in young children, a task that depends largely on parents, who are responsible for what and how much children eat and how much physical activity they engage in. As researchers from the University Medical Center Groningen in the Netherlands put it, “Early recognition of overweight or obesity in children by their parents is of utmost importance, allowing interventions to start at a young age.” Yet, they found in a study of the parents of 2,203 5-year-olds, “parents underestimated their overweight child in 85 percent of the cases.”

Though it seems logical that parents who think their children are overweight would make a special effort to assure they would “grow into” their weight as they get older, research has shown the opposite. Such children tend to get even fatter, according to findings from the Longitudinal Study of Australian Children reported in April in the journal Pediatrics by Eric Robinson of the University of Liverpool and Angelina R. Sutin of Florida State University College of Medicine.

Even being labeled overweight can itself be damaging and make it harder for children to avoid bad habits, the authors suggested. A 2014 study of girls aged 10 to 19 found that “regardless of actual weight, adolescents who reported having been labeled ‘too fat’ by a family member or peer were more likely to become obese nearly a decade later.”

“I encourage parents to change the environment at home,” Dr. Daniels of the University of Colorado said in an interview. “Without being authoritarian, they should limit high-calorie-dense foods, keep sugar-sweetened beverages out of the house and assure that kids eat the right amount of fruits and vegetables and fewer calorie-dense snacks. Parents also need to be tuned into opportunities for physical activity and set hard-and-fast rules about television and time spent on electronics.”

Following the “5210” daily program endorsed by the American Academy of Pediatrics can help: Aim for five fruits and vegetables a day; keep recreational screen time to two hours or less; include at least one hour of active play: and skip sugar-sweetened beverages and drink water.

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How to Sell Kids on Vegetables

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Credit Damon Winter/The New York Times

The same marketing techniques used to convince children to eat junk food are highly effective in promoting fruits and vegetables, a new study has found.

Researchers assigned 10 elementary schools to one of four groups. In the first, they posted vinyl banners around the salad bar depicting cartoon vegetable characters with “super powers.” In the second, they showed television cartoons of the characters. The third got both cartoons and banners, and a control group got no intervention. The study, in Pediatrics, went on for six weeks in 2013.

Compared to control schools, TV segments alone produced a statistically insignificant increase in vegetable consumption. But in schools decorated with the banners alone, 90.5 percent more students took vegetables. And where both the banners and the TV advertisements were used, the number of students taking vegetables increased by 239.2 percent.

“A lot of people have pushed back on this, saying marketing is evil,” said one of the authors, David R. Just, a professor of applied economics at Cornell. “But I have to disagree. It’s possible to use marketing techniques to do some good things.”

Putting such programs into practice, Dr. Just said, presents problems. “Schools are left to do their own marketing, and that’s not cost effective. These need to be national programs. McDonald’s is effective because you see their marketing everywhere.”

Ask Well: Is Watermelon Good for You?

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Credit Karsten Moran for The New York Times

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Milk and Other Surprising Ways to Stay Hydrated

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Credit Tony Cenicola/The New York Times

Most Americans have heard that they should drink eight glasses of water a day to stay hydrated, but there is surprisingly little data to support this advice.

But now, a new “beverage hydration index” provides evidence-based suggestions for how to most efficiently hydrate. The index was developed from a British study published in December that tracked how long 13 common beverages remain in the body after being consumed.

“In the last 25 years, we’ve done many studies on rehydration after exercise,” said Ronald J. Maughan, a hydration expert from Loughborough University, and lead author of the study. “We thought it was time to look at hydration in typical consumers who aren’t exercising.”

The hydration index is modeled after the well-known glycemic index, which measures how the body responds to the carbohydrate content of different foods. (The glycemic index is used to help individuals keep their glucose-insulin response under control.) The guiding principle behind the new hydration index is that some fluids last longer in your body than others, providing more hydration. After all, if you drink a cup of water and then immediately excrete half that amount in your urine, you haven’t added eight ounces to your water supply, but only four.

The British study determined the hydration index of 13 common beverages by having the participants, 72 males in their mid-20s, drink a liter of water as the standard beverage. The amount of water still remaining in subjects’ bodies two hours later — that is, not voided in urine — was assigned a score of 1.0. All other beverages were evaluated in a similar manner, and then scored in comparison to water. A score higher than 1.0 indicated that more of the beverage remained in the body as compared to water, while a score lower than 1.0 indicated a higher excretion rate than water.

The results showed that four beverages — oral rehydration solution, like Pedialyte; fat-free milk; whole milk and orange juice — had a significantly higher hydration index than water. The first three had hydration index scores around 1.5, with orange juice doing slightly better than water at 1.1. Oral rehydration solutions are specifically formulated to combat serious dehydration such as that resulting from chronic diarrhea.

“It’s a very clever, even brilliant study,” said Lawrence Armstrong, a hydration expert at the University of Connecticut and immediate past president of the American College of Sports Medicine. “It assumes that water is the optimal rehydration fluid, which is biologically correct, and then compares other fluids to water.”

Why is milk so efficient at rehydration? “Normally when you drink, it signals the kidneys to get rid of the extra water by producing more urine,” Dr. Maughan said. “However, when beverages contain nutrients and electrolytes like sodium and potassium, as milk does, the stomach empties more slowly with a less dramatic effect on the kidneys.”

Perhaps surprisingly, drinks containing moderate amounts of caffeine and alcohol or high levels of sugar had hydration indexes no different from water. In other words, coffee and beer are not dehydrating, despite common beliefs to the contrary, and regular soda can hydrate you just as well as water.

“It’s true that caffeine is a diuretic, but not at the concentration found in most coffee drinks,” Dr. Maughan said. “When we are thirsty, drinking normal tea, coffee or cola helps to rehydrate us. The exceptions are very strong coffee drinks or strong alcoholic drinks like distilled spirits.”

The hydration index could prove useful when making decisions about what beverages to consume and when. For example, if you’re going on a long drive and won’t have access to fluids (or to bathrooms), you’d be smarter to drink milk with its high hydration index rather than water or iced coffee. But don’t forget that milk has many more calories than water, so don’t overdo it, either.

While severe dehydration is rare except in heavy exercise, extreme environments and disease, studies have shown that heat and dehydration can contribute to increased mortality rates during hot weather. “Mortality increases sharply during heat waves, mostly because people don’t drink enough to compensate for their increased fluid losses,” Dr. Maughan said.

Dr. Armstrong noted that in hot weather, it’s important to monitor your hydration status throughout the day. He suggested paying attention to your thirst, and drinking when necessary. Also, if your urine color is a dark yellow, it’s time for a refreshing drink.

Don’t Eat Raw Dough, F.D.A. Cautions

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Credit iStock

Maybe you’ve swiped a bite of raw cookie dough while preparing a batch to bake. Or perhaps you’ve let your children lick the batter from the cake bowl, or use homemade “play dough” to make crafts. But even if the dough is free of raw eggs, which you think might give you a pass, don’t eat it.

Yesterday, the Food and Drug Administration issued a message warning people not to eat raw dough because of a recent outbreak of E. coli linked to contaminated flour.

So far, a reported 38 people in 20 states have been infected by a strain of bacteria called Shiga toxin-producing E. coli O121 found in flour. The infections began last December, and 10 of those infected have been hospitalized.

Symptoms of the bacterial infection include severe stomach cramps, diarrhea (often bloody), and vomiting. Most people get better within a week, but in some cases, infections can lead to a type of kidney failure called hemolytic uremic syndrome. Those who are most vulnerable to severe illness include children under 5, older adults and people with weakened immune systems.

Investigations by the Centers for Disease Control and Prevention and the F.D.A. traced the source of the outbreak to flour that was produced in November 2015 at the General Mills facility in Kansas City, Mo. General Mills has issued a voluntary recall of 10 million pounds of flour produced between Nov. 14 and Dec. 4, sold under three brand names: Gold Medal, Signature Kitchens and Gold Medal Wondra. Flour that is part of the recall should be thrown away.

Unlike other raw foods, like eggs or meat — which many people recognize as contamination risks — “flour is not the type of thing that we commonly associate with pathogens,” said Jenny Scott, a senior adviser in the F.D.A.’s Center for Food Safety and Applied Nutrition.

In this case, investigators believe that the grain became contaminated in the field, where it is exposed to manure, cattle, birds and other bacteria. “E. coli is a gut bug that can spread from a cow doing its business in the field, or it could live in the soil for a period of time; and if you think about it, flour comes from the ground, so it could be a risk,” said Adam Karcz, an infection preventionist at Indiana University Health in Indianapolis.

Normally, flour is cooked before it is consumed, destroying any pathogens. “For the most part, the risk from flour is pretty low, and most use of flour involves a ‘kill step’ — people bake with it,” Ms. Scott said. In commercial uses like “raw” cookie-dough ice cream, companies generally heat-treat it to eliminate bacteria, she said.

Consumers, then, need to be aware that they should follow food safety guidelines for flour. That means washing your hands thoroughly before and after handling raw flour. And Ms. Scott warned against letting children play with homemade play dough. “Kids are going to handle it and touch their faces, and they’re going to lick their fingers; it’s hard to supervise that,” she said.

At home, Mr. Karcz suggests sealing your flour container and storing it in a cool, dry place to prevent contamination. And after using flour, be sure to clean up your countertops, cutting boards and utensils to prevent the spread of any bacteria.

If you do develop symptoms of infection, contact your health care practitioner for treatment and to report the illness, particularly if you suspect it’s connected to an outbreak.

“We want to encourage consumers to report their illnesses, even though it’s an imperfect system,” Ms. Scott said. “We’d like to have the tests done and get everything reported and identify these outbreaks so we can follow up, discover root causes and make changes in the system so that people don’t get sick in the future.”

Fat Dad: The Coffee and Cigarette Diet

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Credit Andrew Scrivani for The New York Times

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The author’s parents, summer-ready.

The author’s parents, summer-ready.Credit

My dad’s face lit up as he placed the engraved linen envelope on the table. We were to be guests at the annual pool party at his boss’s home in East Hampton, N.Y. Not only were we invited for dinner, we were invited to stay for the whole glorious weekend.

Our host was my dad’s boss at the McCann Erickson ad agency, where he was a new creative director. Getting an invitation to his house was more than a polite formality; it was an honor. His family lived on Park Avenue, summered in the Hamptons, and lived by the Emily Post school of etiquette. My family never summered anywhere. We didn’t dress for dinner, we didn’t play golf or tennis, and no one in my family had ever studied Latin or carried a monogrammed bag.

While my dad was flattered, the pressure that accompanied the invitation was huge. His weight had ballooned to almost 400 pounds since landing the job, thanks in part to the decadent three-course client lunches and late-night strategy dinners. In the office, people were focused on my dad’s marketing ideas, but in the Hamptons, my dad said appearances were everything, and there was no hiding behind his creative storyboards and well-thought-out campaigns. He would be presenting my mom, my little sister, April, and me, and showing himself in a more vulnerable setting.

The month leading up to the Hamptons trip was filled with anxiety. My mom and I rushed around shopping for the perfect outfits, and my dad, determined to fit into a bathing suit, starved himself, declaring he was on the “Super Model Diet,” which consisted of hot coffee, cold coffee, coffee shakes, coffee bread, unlimited cigarettes and water.

Even at 10 years old, I knew this was not healthy. I had read the many nutrition and diet books that filled every bookshelf in our house. Each week a new diet, a new promise for miracle results.

“All the actresses and dancers in my commercials swear by this one,” my dad said. “They say substituting a zero-calorie cigarette for lunch helps them stay camera-ready,” he added.

Seeing how worried I was, my dad declared he had never had so much energy, begging my sister and me to try to tag him while he ran up and down the halls of our apartment — not even tempted to take a peek at the diet bread I had just baked for him — adding the required three-quarters of a cup of coffee to my ingredient list.

After successfully losing over 20 pounds on the coffee and cigarette diet in a couple of weeks, my dad headed to Mr. Big & Tall on Eighth Avenue for a couple of items before picking up the Hertz Rent-a-Car. My dad was proud of his new lime-green Bermuda shorts with pictures of palm trees. As we drove to the Hamptons in our beach clothes, my parents argued because my mom, who was in charge of directions, kept navigating us the wrong way. When we finally made it off the highway, my parents became calmer, admiring the quaint churches, old houses and windmills planted on village greens.

Arriving hot and disheveled after our long drive, we were greeted by my father’s boss’s wife, who was wearing a neatly pressed blue Pucci cocktail dress, adorned with a single strand of pearls. Tucking her coiffed blond hair behind her ears, she offered us iced tea with orange slices and led us to the back yard. It was like no pool party I had ever been to, and I wondered if anyone was actually planning to swim.

The tables had crystal candlesticks, and waiters were passing around trays of delicious appetizers that I couldn’t pronounce. Among them were rumaki  — chicken livers wrapped with chestnuts — and soufflés — puffy omelets loaded with cream. There were plates stacked on top of plates and more silverware than I had ever seen. For dinner, we each had our own one-and-a-half-pound lobster with a side of mussels and white sweet corn from the local farm stand. The kids and the grown-ups were served the same food, but we were not seated at the same table. Parents and kids sitting together was a no-no, according to our host’s son, whom I was placed next to.

The boy, who was wearing a jacket and a tie, was only a year older than I was but had the demeanor of a grown man. When I asked, “Aren’t you hot in that stuffy outfit?” he said that the men in their family “always wear a tie and a blazer at dinner each and every night.” He motioned to me to unfold my napkin and place it over my bare legs, dangling above the ground.

I tried to follow his lead as I saw my dad covered in melted butter and lobster juice. He seemed to be enjoying himself immensely, not shy about asking for seconds and thirds of potatoes au gratin as he forfeited the salad and green beans. “I need to leave room for the good stuff,” he exclaimed, loosening his belt buckle, as the table howled in laughter, watching my dad joyfully dash to the dessert table.

“Go for the gusto, Lerman!” my dad’s boss bellowed, pleased that all the guests started chanting my dad’s award-winning slogan for Schlitz beer.

“You Only Go Around Once in Life, So Grab the Gusto,” they yelled out, encouraging my father to load and re-load his plate.

While I knew that the next day my dad would have regrets, and his vicious cycle of yo-yo dieting would begin again, that night I relaxed, savoring every bite of the succulent meat — hoping my first lobster dinner would not be my last.

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Swimsuit-Ready Iced Coffee Shake


Dawn Lerman is a Manhattan-based nutrition expert and the author of “My Fat Dad: A Memoir of Food, Love and Family, With Recipes,” from which this essay is adapted. Her series on growing up with a fat father appears occasionally on Well. Follow her @DawnLerman.

A Few More Vegetables and a Little Less Meat May Reduce Diabetes Risk

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Credit Justin Mott for The New York Times

You don’t have to be a vegetarian to reap the benefits of a plant-based diet.

New research shows that eating a few extra servings of healthy plant-based foods each day and slightly reducing animal-based foods like meat and dairy products can significantly lower your risk of Type 2 diabetes.

The findings are based on an analysis of the eating patterns of 200,000 men and women from three long-term studies who reported on their diets repeatedly over the course of two decades, and were published this week in PLOS Medicine.

The studies — the Nurses’ Health Study, the Nurses’ Health Study 2 and the Health Professionals Follow-Up Study — asked participants to fill out more than 100 detailed questions about their eating habits. They provided information not just about the foods they ate but about how the food was prepared and even what cooking oils were used.

While self-reported dietary information can be flawed, extra steps were taken to confirm the data. Participants completed questionnaires every two to four years, and the nutrient intake information was compared to tests of blood biomarkers to make sure they matched up. The results were also adjusted, or modified, to account for other characteristics that contribute to Type 2 diabetes, like being overweight.

The research was also unusual in that it distinguished between healthful and unhealthful plant-based foods. Healthful plant-based foods include whole grains, fruits, vegetables nuts, seed and legumes, while an unhealthful plant-based diet could include refined carbohydrates like bagels and muffins, starchy vegetables like potatoes and French fries and sugary foods like cake and cola. Animal-based foods include meat of all kinds, fish and seafood as well as eggs, dairy products and animal fats like butter.

On average, adults who ate a plant-based diet with few animal products cut their risk of Type 2 diabetes by 20 percent. But when researchers distinguished between healthful and unhealthful plant-based foods, they found that diabetes risk dropped by 34 percent among the healthful plant-based eaters. Notably, there wasn’t a benefit to plant-based eating when a person consumed a lot of refined carbohydrates and starchy vegetables. In that case, a person’s risk of developing Type 2 diabetes increased slightly.

While most American adults are omnivores, eating from many different food sources, and few are vegetarian, the research suggests that simply reducing the amount of animal-based food you eat from five or six servings a day to about four servings a day can lower the incidence of Type 2 diabetes. When people make these changes in diet, they usually cut back on red meat and processed meats and substitute healthier plant-based foods, including protein-rich ones like nuts, seeds and legumes, said Frank Hu, the study’s senior author and a professor at Harvard’s T.H. Chan School of Public Health.

“What we’re talking about is a moderate shift – replacing one or two servings of animal food a day with one or two plant-based foods,” said Dr. Hu. “We’re not talking about a dramatic change from being a carnivore to being vegan or even vegetarian – we’re talking about a small shift, that’s doable for most people. You can still include some meat, but not have it in the center of the plate.”

Good plant-based foods are known to be rich in fiber, antioxidants, good fats and a wide array of micronutrients, and have been shown to improve glucose metabolism and lower inflammatory markers. But scientists say they also help promote the good-for-you bacteria that live in your gut.

“When we ingest food, we’re feeding ourselves, but we’re also feeding the bacteria in our gut,” said Dr. Hu. “If you switch from an animal-based dietary pattern to a plant-based pattern, after a while – I don’t know how long it would take, a few weeks or months – the type of bacteria will also change.”

The bacteria in the gut use components of plant-based foods like fiber for their own survival and growth. These components are metabolized by the intestinal bacteria, and the end products are short-chain fatty acids, which have been shown to have beneficial effects on inflammation, insulin resistance and overall metabolism. They also may send a satiety signal to the brain, so people feel fuller.

When you eat refined carbohydrates and have less fiber in the diet, the healthy bacteria that metabolize fiber will be reduced, “so you won’t have the short-chain fatty acids that would have beneficial effects in your body,” Dr. Hu said.

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Parents Should Avoid Comments on a Child’s Weight

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Credit Stuart Bradford

Should parents talk to an overweight child about weight? Or should they just keep their mouths shut?

Parents in this situation are understandably torn. Say something, and they risk shaming a child or worse, triggering an eating disorder. Say nothing, and they worry they’re missing an opportunity to help their child with what could become a serious long-term health problem.

Now a new study offers some guidance: Don’t make comments about a child’s weight.

The study, published in the journal Eating & Weight Disorders, is one of many finding that parents’ careless — though usually well-meaning — comments about a child’s weight are often predictors of unhealthy dieting behaviors, binge eating and other eating disorders, and may inadvertently reinforce negative stereotypes about weight that children internalize. A parent’s comments on a daughter’s weight can have repercussions for years afterward, contributing to a young woman’s chronic dissatisfaction with her body – even if she is not overweight.

“Parents who have a child who’s identified as having obesity may be worried, but the way those concerns are discussed and communicated can be really damaging,” said Rebecca Puhl, deputy director of the Rudd Center for Food Policy and Obesity at the University of Connecticut. “The longitudinal research shows it can have a lasting impact.”

The impact on girls may be especially destructive, she said, because “girls are exposed to so many messages about thinness and body weight, and oftentimes women’s value is closely linked to their appearance. If parents don’t challenge those messages, they can be internalized.”

The new study included over 500 women in their 20s and early 30s who were asked questions about their body image and also asked to recall how often their parents commented about their weight. Whether the young women were overweight or not, those who recalled parents’ comments were much more likely to think they needed to lose 10 or 20 pounds, even when they weren’t overweight.

The study’s lead author, Dr. Brian Wansink, a professor and the director of Cornell University’s Food and Brand Lab, characterized the parents’ critical comments as having a “scarring influence.”

“We asked the women to recall how frequently parents commented, but the telling thing was that if they recalled it happening at all, it had as bad an influence as if it happened all the time,” said Dr. Wansink, author of the book “Slim by Design.” “A few comments were the same as commenting all the time. It seems to make a profound impression.”

Some studies have actually linked parents’ critical comments to an increased risk of obesity. One large government-funded study that followed thousands of 10-year-old girls found that, at the start of the study, nearly 60 percent of the girls said someone — a parent, sibling, teacher or peer – had told them they were “too fat.” By age 19, those who had been labeled “too fat” were more likely to be obese, regardless of whether they were heavy at age 10 or not.

Comments made by family members had even stronger effects than comments made by unrelated people.

Several studies have found that when parents encourage overweight teenagers to diet, the teenagers are at higher risk of lower self-esteem and depression and of being overweight five years later.

Research by Dianne Neumark-Sztainer, a professor at the University of Minnesota, found that when parents talked to their teens about losing weight, teenagers were more likely to diet, use unhealthy weight-control behaviors and binge eat. Those behaviors are less likely to develop when conversations with parents focused on healthy eating behaviors, rather than weight per se.

Harsh comments about weight can send the message that parents are “tying weight to some kind of perception about how the child is valued,” Dr. Puhl said, and that can trigger negative feelings. “The children are internalizing that, and thinking they’re not O.K. as a person. And that is what’s leading to other outcomes, like disordered eating.”

So what’s a parent to do? Do they just stand by while their child gains weight?

Dr. Neumark-Sztainer was besieged by parents asking her this question, and wondering, “How do I prevent them from getting overweight and still feel good about themselves?”

In her book, called “I’m, Like, SO Fat: Helping Your Teen Make Health Choices About Eating and Exercise in a Weight-Obsessed World,” she notes that parents can influence a child’s eating habits without talking about them. “I try to promote the idea of talking less and doing more — doing more to make your home a place where it’s easy to make healthy eating and physical activity choices, and talking less about weight.”

For parents, that means keeping healthy food in the house and not buying soda. It means sitting down to enjoy family dinners together, and also setting an example by being physically active and rallying the family to go for walks or bike rides together. Modeling also means not carping about your own weight. “Those actions speak louder than words,” Dr. Puhl said.

While your children are young, “there doesn’t need to be a conversation at all – it really is just about what’s being done at home,” Dr. Neumark-Sztainer said.

If an older child is overweight, “wait for your child to bring it up, and be there to support them when they do,” she said. “Say, ‘Look, I love you no matter what size you are, but if you would like, I will support you. I suggest we focus not so much on your weight but on your eating patterns and behaviors. What would be helpful for you?’”

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Coffee May Protect Against Cancer, W.H.O. Concludes

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Credit Fred R. Conrad for The New York Times

An influential panel of experts convened by the World Health Organization concluded on Wednesday that regularly drinking coffee could help protect against some types of cancer, a decision that followed decades of research pointing to the beverage’s many health benefits.

The announcement marked a rare reversal for the panel, which had previously described coffee as “possibly carcinogenic” in 1991 and linked it to bladder cancer. But since then a large body of research has portrayed coffee as a surprising elixir, finding lower rates of heart disease, Type 2 diabetes, neurological disorders and several cancers in those who drink it regularly.

Much of the evidence for coffee’s health benefits stems from observational studies, which cannot prove cause and effect. But the favorable findings on coffee consumption have been so consistent across so many studies that numerous health authorities have endorsed it as part of a healthy diet.

Last year, the panel of scientists that shaped the federal government’s 2015 dietary guidelines said there was “strong evidence” that 3 to 5 cups of coffee daily was not harmful, and that “moderate” consumption might reduce chronic disease. The World Cancer Research Fund International reported in recent years that coffee protects against multiple cancers. And the authors of one systematic review said that coffee consumption should be encouraged in people with chronic liver disease because it seems to lower their mortality.

The World Health Organization is the latest group to suggest a daily cuppa Joe might be good for health. The organization’s International Agency for Research on Cancer, also known as IARC, said it assembled a team of 23 scientists who reviewed more than 1,000 studies which showed no conclusive proof that coffee causes cancer. But the studies did suggest it was protective against some types of cancer, such as liver and uterine.

It is not entirely clear why. But scientists say coffee contains many antioxidants and other compounds that are being studied for their anti-cancer properties. Studies have linked decaffeinated coffee consumption to lower rates of chronic disease too, suggesting coffee’s benefits are not simply due to caffeine.

Whatever the mechanism, the news is sure to be welcomed by many Americans – about half of whom drink coffee every day. Around the world, more than 1.6 billion cups of coffee are consumed daily, making it one of the world’s most popular drinks behind tea.

In their report issued Wednesday, the IARC scientists did identify one surprising risk for coffee and tea drinkers. They said that drinking “very hot” beverages was “probably carcinogenic” because the practice was linked to esophageal cancer in some studies. But researchers say that may be caused by excessively hot beverages inflaming the lining of the throat – something that people could easily avoid by letting their hot tea or coffee cool off for a few minutes before drinking them.

Eat Whole Grains, Live Longer?

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Credit Karsten Moran for The New York Times

Two large review studies have reached the same conclusion: Eating whole grains is associated with significant reductions in the risk for premature death.

One report, in BMJ, found that whole grain consumption was associated with a reduction in the risk for death from cancer, coronary heart disease, respiratory disease, infectious disease and diabetes. Using data from 45 studies, researchers calculated that compared with eating none, eating 90 grams of whole grains a day reduced the risk for all-cause mortality by 17 percent.

The other analysis, in Circulation, used data from 14 prospective studies with 786,076 participants and found that compared with those who ate the least whole grain foods, those who ate the most had a 16 percent reduced risk for all-cause mortality and an 18 percent reduced risk for cardiovascular mortality. Each 16-gram increase in whole grain intake reduced mortality risk by 7 percent.

A slice of 100 percent whole grain bread contains about 16 grams of whole grains, and current dietary guidelines recommend 48 grams or more of whole grains daily.

The senior author of the Circulation study, Dr. Qi Sun, an assistant professor of nutrition at Harvard, cautions that eating whole grains is not a panacea.

“You shouldn’t hope that you will cure diseases with whole grain foods,” he said. “You still have to pay attention to other good dietary and behavioral practices.”

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Is Sugar Really Bad for You? It Depends

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The federal government’s decision to update food labels last month marked a sea change for consumers: For the first time, beginning in 2018, nutrition labels will be required to list a breakdown of both the total sugars and the added sugars in packaged foods. But is sugar really that bad for you? And is the sugar added to foods really more harmful than the sugars found naturally in foods?

We spoke with some top scientists who study sugar and its effects on metabolic health to help answer some common questions about sugar. Here’s what they had to say.

Why are food labels being revised?

The shift came after years of urging by many nutrition experts, who say that excess sugar is a primary cause of obesity and heart disease, the leading killer of Americans. Many in the food industry opposed the emphasis on added sugars, arguing that the focus should be on calories rather than sugar. They say that highlighting added sugar on labels is unscientific, and that the sugar that occurs naturally in foods like fruits and vegetables is essentially no different than the sugar commonly added to packaged foods. But scientists say it is not that simple.

So, is added sugar different from the naturally occurring sugar in food?

It depends. Most sugars are essentially combinations of two molecules, glucose and fructose, in different ratios. The sugar in a fresh apple, for instance, is generally the same as the table sugar that might be added to homemade apple pie. Both are known technically as sucrose, and they are broken down in the intestine into glucose and fructose. Glucose can be metabolized by any cell in the body. But fructose is handled almost exclusively by the liver.

“Once you get to that point, the liver doesn’t know whether it came from fruit or not,” said Kimber Stanhope, a researcher at the University of California, Davis, who studies the effects of sugar on health.

The type of sugar that is often added to processed foods is high-fructose corn syrup, which is the food industry’s favored sweetener for everything from soft drinks to breads, sauces, snacks and salad dressings. Made commercially from cornstarch, high-fructose corn syrup is generally much cheaper than regular sugar. It contains the same components as table sugar – glucose and fructose – but in slightly different proportions.

What about “natural” sweeteners?

Food companies like to market agave nectar, beet sugar, evaporated cane juice and many other “natural” sweeteners as healthier alternatives to high-fructose corn syrup. But whatever their source, they are all very similar. To suggest one is healthier than another is a stretch, experts say. In fact, last month, the F.D.A. urged food companies to stop using the term evaporated cane juice because it is “false or misleading” and “does not reveal that the ingredient’s basic nature and characterizing properties are those of a sugar.”

Is high-fructose corn syrup worse than regular sugar? How is it different?

High-fructose corn syrup and regular sugar are so similar that most experts say their effects on the body are essentially the same.

The main difference is that the variety of high-fructose corn syrup used in soft drinks tends to have more fructose. In one 2014 study, researchers analyzed more than a dozen popular soft drinks and found that many sweetened with high-fructose corn syrup – including Pepsi, Sprite, Mountain Dew, Coca-Cola and Arizona Iced Tea – contained roughly 40 percent glucose and 60 percent fructose. Regular sugar contains equal parts glucose and fructose.

Why doesn’t the F.D.A. require that added sugars be listed in teaspoons rather than grams?

When the new food labels go into effect, the daily recommended limit for added sugars will be 50 grams, or roughly 12 teaspoons, daily. (One teaspoon of sugar is 4.2 grams.) But the new food labels will list the amount of added sugars solely in grams.

Many nutrition advocates have urged the F.D.A. to require that food labels list added sugars in both teaspoons and grams on food labels, arguing that Americans often underestimate the actual amount of sugar in a product when it’s expressed in grams alone.

But the F.D.A. ultimately sided with the food industry, which opposed the teaspoon proposal.

“It would be difficult, if not impossible, for a manufacturer to determine the volume contribution that each ingredient provides toward the added sugars declaration,” the agency said. “For example, a cookie made with white chocolate chips and dried fruit would have added sugars in the form of sugar in the batter as well as in the white chocolate chips and the dried fruit.” The F.D.A. also said that requiring both grams and teaspoons would “cause clutter and make the labels more difficult to read.”

But Michael Jacobson, the president of the Center for Science in the Public Interest, an advocacy group that had petitioned the F.D.A. to require the teaspoon measurement, said the agency was under enormous pressure from the food industry, “which knows that consumers would be far more concerned about a product labeled 10 teaspoons than 42 grams.”

So what’s the issue with added sugars?

It mainly comes down to the way they’re packaged.

Naturally occurring sugar is almost always found in foods that contain fiber, which slows the rate at which the sugar is digested and absorbed. (One exception to that rule is honey, which has no fiber.) Fiber also limits the amount of sugar you can consume in one sitting.

A medium apple contains about 19 grams of sugar and four grams of fiber, or roughly 20 percent of a day’s worth of fiber. Not many people would eat three apples at one time. But plenty of children and adults can drink a 16-ounce bottle of Pepsi, which has 55 grams of added sugar – roughly the amount in three medium apples – and no fiber. Fiber not only limits how much you can eat, but how quickly sugar leaves the intestine and reaches the liver, Dr. Stanhope said.

“You can’t easily eat that much sugar from fruit,” she said. “But nobody has any problem consuming a very high level of sugar from a beverage or from brownies and cookies.”

Why is it a problem to have too much sugar?

Many nutrition experts say that sugar in moderation is fine for most people. But in excess it can lead to metabolic problems beyond its effects on weight gain. The reason, studies suggest, is fructose. Any fructose you eat is sent straight to your liver, which specializes in turning it into droplets of fat called triglycerides.

“When you ingest fructose, almost all of it is metabolized by the liver, and the liver is very good at taking that fructose and converting it to fat,” said Dr. Mark Herman, an assistant professor of medicine at Harvard. Studies show a predictable response when people are asked to drink a sugary beverage: A rapid spike in the amount of triglycerides circulating in their bloodstreams. This also leads to a reduction in HDL cholesterol, the so-called good kind.

Over time, this combination – higher triglycerides and lower HDL – is one major reason sugar promotes heart disease, said Dr. Aseem Malhotra, a cardiologist and adviser to the United Kingdom’s national obesity forum. This sequence of events may even overshadow the effects of LDL cholesterol, the so-called bad kind.

“What many people don’t realize is that it’s triglycerides and HDL that are more predictive of cardiovascular disease than LDL cholesterol,” Dr. Malhotra said. “I’m not saying LDL isn’t important. But if there is a hierarchy, triglycerides and HDL are more important than LDL.”

Dr. Malhotra said that when people reduce their sugar intake, “their overall cholesterol profile improves.”

“I see this in so many of my patients,” he added. “The effects are rapid.”

How much sugar is too much?

One of the largest studies of added sugar consumption, which was led by the Centers for Disease Control and Prevention, found that adults who got more than 15 percent of their daily calories from added sugar had a higher risk of cardiovascular disease. For the average adult, that translates to about 300 calories, or 18 teaspoons of added sugar, daily. That may not sound like a lot. But considering that a single 12-ounce can of Coca-Cola has almost 10 teaspoons of sugar, it can add up quickly

The study found that most adults got more than 10 percent of their daily calories from added sugar, and that for 10 percent of people, more than 25 percent of their calories came from added sugar. The biggest sources for adults were soft drinks, fruit juices, desserts and candy.

While those might seem like obvious junk foods, Dr. Malhotra said, about half of the sugar Americans consume is “hidden” in less obvious places like salad dressings, bread, low-fat yogurt and ketchup. In fact, of the 600,000 food items for sale in America, about 80 percent contain added sugar.

Everyone’s tolerance for sugar is different. Studies show, for example, that people who are already obese may be more susceptible to metabolic harm from sugar than others. But Dr. Malhotra said that he generally advises people to follow the World Health Organization’s guidelines, which recommend that adults and children consume no more than about six teaspoons daily of added sugar.

“Could I tell you the exact limit where sugar starts to definitely impact cardiovascular health?” he said. “That’s difficult. But I think if people stick within the W.H.O. limits, then their risk is reduced.”

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Should You Take a Vitamin? Do You Know What a Vitamin Is?

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Credit Catherine Price

Many people can rattle off the names of the most popular vitamins and the foods that contain them in abundance. But understanding exactly what vitamins are and what roles they play in the body is far more complicated. In fact, though scientists recognize that there are 13 vitamins that are essential for good health, there is no real consensus on what they actually do and exactly how much of them we truly need.

Catherine Price, a science journalist, explores these questions and more in a book that was recently released in paperback, called “Vitamania: Our Obsessive Quest for Nutritional Perfection.” Ms. Price traces the history of vitamins from their discovery as lifesaving organic compounds that prevented strange diseases to their ubiquity today in foods, beverages and dietary supplements. Ms. Price sheds surprising light on the mythology surrounding vitamins and explains why even basic advice promoted by experts – like the nutrient requirements for healthy adults known as the recommended dietary allowance, or RDA – may be misguided.

Recently, we sat down with Ms. Price to discuss some of the most common misconceptions about vitamins, the reasons vitamin D testing can be misleading, and which questions you should ask yourself before deciding whether to take a multivitamin. Here are edited excerpts from our conversation.

Q.

Why did you write this book?

A.

I have Type 1 diabetes, which forces me to think about how food interacts with our bodies every time I eat. And yet when my husband turned to me out of the blue one day and asked, “What is a vitamin?” I realized I didn’t know the answer. Vitamins turned out to be a perfect subject for me. I love investigating things that seem so familiar to us that we never think to ask questions about them. They were a mystery hiding in plain sight, and I was intrigued.

Q.

How have vitamins changed the way we think about food?

A.

Vitamins were the first “superfoods”— they introduced the idea that there are particular foods, ingredients and dietary chemicals that have health benefits that go beyond mere nutrition. It turns out that there’s a direct line between the discovery and early marketing of vitamins and our current beliefs in the magical powers of kale. Learning about the history of vitamins made me much better at recognizing nutritional hype, which helps me make much better — and calmer — decisions about what to eat.

Q.

What are some of the most common misperceptions about vitamins?

A.

My biggest pet peeve is that when we hear the word “vitamin,” we automatically think of pills instead of food — and then use “vitamin” to refer to all dietary supplements. This is incorrect. There are only 13 vitamins, which are essential for health, compared to over 85,000 dietary supplements for sale in America. Also, we assume that scientists know exactly what vitamins do in our bodies and how much of each we need, but they don’t. We assume that all vitamins and dietary supplements are required to be tested for safety and effectiveness before they’re sold. But they’re not.

Q.

Should the average person take a multivitamin?

A.

Ask yourself what you eat. Does your plate look like the cover of a Michael Pollan book? Then you’re already getting plenty of vitamins and other nutrients from your food. Do you eat a lot of fortified foods like breakfast cereal and sports drinks? Then you probably don’t need to take a multivitamin either, because you’re essentially eating one. The people who benefit the most from multivitamins are those with restricted diets or health issues that make it hard to absorb nutrients from food, or who get most of their calories from foods that are so junky that they haven’t even been enriched with synthetic vitamins. Man cannot live on potato chips alone.

Q.

In your book you say it’s a bad idea to get tested for blood levels of vitamin D and other nutrients. Why?

A.

I wouldn’t say it’s necessarily bad — it’s more that it’s not particularly helpful. We know that vitamin D is essential for healthy bones, but the jury’s still out on what else it might do. This makes it impossible to determine what our requirements actually are, which in turn makes it impossible to figure out what an optimal level should be. And despite an ongoing standardization effort, results for the same blood sample can differ depending on which lab they’re sent to. It’s like taking an exam that doesn’t have an answer key — and that’s scored differently depending on who grades it.

Q.

Why is taking large doses of some vitamins a bad idea?

A.

It’s a bad idea to assume that just because something is essential in small doses, bigger doses must be better. Some vitamins are known to be toxic in high doses. Vitamin A is the most notorious. In some cases, high doses of vitamins that we thought would be helpful have been shown to cause more harm than good. In the 1990s, high doses of beta-carotene, which is a precursor to vitamin A, were tested as a possible prevention for cancer, but were eventually linked to an increased risk for lung cancer, especially among smokers. Remember: Even water can kill you if you drink too much of it.

Q.

In your book you argue that the “Percent Daily Value” figures on food and supplement labels are close to meaningless. Why?

A.

First of all, we each have different vitamin requirements, which means that 100 percent for me is not 100 percent for you. Second, the recommended dietary allowances aren’t meant as personalized recommendations to begin with. And third, most of the percentages in the “percent daily value” column on current food and supplement labels are calculated off of the RDAs from 1968. Yes, 1968. The FDA plans to use more updated recommendations in the next version of the nutrition and supplement facts panels, but for now, most of those numbers are still based on recommendations that are nearly a half a century old.

Q.

What are some of the most peculiar things you learned about vitamins while writing this book?

A.

That synthetic vitamin D is made by irradiating grease from sheep’s wool. That American politicians became convinced that thiamin deficiencies would make us lose World War II. That the guy who discovered vitamin B12 did so by eating raw meat, regurgitating it, and then tube-feeding it to his unknowing patients. And that before being affiliated with vitamins, Fred Flintstone and Barney Rubble used to advertise Winston cigarettes. It turns out that the story of vitamins is much bigger, weirder, more interesting and more useful than I ever could have anticipated.

A Low-Salt Diet May Be Bad for the Heart

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Credit Tony Cenicola/The New York Times

People with high blood pressure are often told to eat a low-sodium diet. But a diet that’s too low in sodium may actually increase the risk for cardiovascular disease, a review of studies has found.

Current guidelines recommend a daily maximum of 2.3 grams of sodium a day — the amount found in a teaspoon of salt — for most people, and less for the elderly or people with hypertension.

Researchers reviewed four observational studies that included 133,118 people who were followed for an average of four years. The scientists took blood pressure readings, and estimated sodium consumption by urinalysis. The review is in Lancet.

Among 69,559 people without hypertension, consuming more than seven grams of sodium daily did not increase the risk for disease or death, but those who ate less than three grams had a 26 percent increased risk for death or for cardiovascular events like heart disease and stroke, compared with those who consumed four to five grams a day.

In people with high blood pressure, consuming more than seven grams a day increased the risk by 23 percent, but consuming less than three grams increased the risk by 34 percent, compared with those who ate four to five grams a day.

The lead author, Andrew Mente, an epidemiologist at McMaster University in Toronto, said that eating less salt does indeed lower blood pressure.

“But low sodium intake may be harmful,” he added. “It’s important not to rely on blood pressure alone, but rather to look at actual clinical events — heart attack, stroke, mortality.”