Sugar: The New Tobacco

Written by:

Carol Liang, MPH candidate 2017

You’ve heard it. You know it. But you probably don’t want to admit it. The loved substance, sugar, is the new trans fat in society; it is the poison to our meals. We’re all in denial from facing our beloved sweet tooth. In fact, most of America needs to go to sugar rehab for an addiction more dangerous than understood.

When we eat sugar, our body releases dopamine, which is associated to reward-motivated behavior. This is similar to the way drugs work; according to a number of studies on the brain, sugar is as addictive as cocaine. It involves constantly craving more to satisfy the body’s reward system. Excessive dependency on sugar is especially true in America: the American Heart Association recommends no more that 9.5 teaspoons for adults per day, yet the average person consumes 22 teaspoons.

More needs to be done to prevent the children of today from fueling the adult obesity epidemic in the United States, where one-third of adults are now diagnosed as obese. Communal weight gain in children can be attributed to refined sugars in food and drinks, which are all too common in their diets. Today, 25% of children aged 2 to 5 are overweight or obese. Recently, the CDC warned mothers to start reading toddler food labels, as they found that 35% of child food products are above the Institute of Medicine’s sugar guidelines. In 2009, children aged 1 to 3 had an average sugar intake of 12 teaspoons per day, 3 to 4 times higher than the suggested limit for children their age.

Sugar is known to be the classic “bad” treat; however, the magnitude of the risks involved need to be stressed. You probably know what the risks are: obesity, type 2 diabetes, stroke, heart disease and cancer.  But did you know women with the highest blood sugar levels have a 26% higher chance of getting cancer than those with the lowest levels? Or people whose daily diets comprise of 25% sugar are twice as likely to die from heart disease than those whose diets contain less than 10% sugar?

The main source of sugar, sugar-sweetened beverages (SSBs) — soda, juice, sport beverages etc.— are of most concern. A can of coca cola alone contains 39 grams of sugar — 14 grams above the WHO’s recommended daily sugar intake. Every day, half of the American population drinks at least one sugary drink.  SSBs, alone, are responsible for 25,000 deaths per year in America.

So, what can we do to decrease sugar intake and eradicate the obesity epidemic? Education about the risks of sugar is essential, but not sufficient. In February 2015, Michael Bloomberg’s 2012 failed plan to tax sugary drinks in New York was reintroduced by the Dietary Guidelines Advisory committee, who followed in his footsteps and proposed for federal taxes on sodas. This could essentially save the lives of millions.

While some might argue it is an individual’s right to choose what to eat and drink, it is the government’s moral responsibility to protect fellow citizens from the now known health risks. There is also an ongoing debate about the economic downfalls of enforcing taxes on SSBs, especially for large soda corporations. Though, actions such as placing warning labels on products, banning large soda sizes, and implementing taxes would decrease rates of obesity, heart disease, strokes etc., and hence, prevent future economic burdens in healthcare.

Given both high sugar intake and smoking are contributors to cancer and heart disease — the 2 leading causes of deaths in the United States — it is questionable why high sugar products have no state or federal regulations and taxes, unlike cigarettes. Berkeley recently passed a law taxing all sugary drinks; cities should follow to highlight the degree of risks linked to sugar consumption. It is time we stop categorizing sugar as a guilty pleasure, and instead, start treating it as the new tobacco.

While a cold soda on a hot summer day, a slice of pumpkin pie over Thanksgiving, or a sugar cookie at Christmas is always a treat; always remember the potential long-term risks involved are certainly not sweet.


From Chop’t to School Lunchrooms

By Julia Yao

With the love that salad chains like Chop’t and Sweet Greens are receiving in major cities like New York City and Washington D.C., salads are enjoying their status as not just a forgettable side dish, but an enjoyable main course. Check out a location during the weekday lunch hour, and you’ll find a line that spills onto the street. What is making these chains so successful that people are willing to wait up to, kid you not, thirty minutes for a customized bowl of raw vegetables?

Messages telling us to eat a balanced diet with plenty of vegetables, proteins, and whole grains are pervasive throughout our communities. For those of you who can afford it, a meal at Chop’t is a low-stakes way to take part in the world of “healthy eating.” If you don’t like it, don’t go back. More importantly, it gives you the opportunity to choose, among an array of healthy options, the things that you know you actually like. You can choose every component – the grains, the vegetables, the protein, and the dressing – and if you decide that you want to throw in potato chips as a treat, go ahead. Because it is low-stakes, it also offers you the opportunity to try new things. Maybe one day, you decide to try kale to see what all the hype is about. Or that new super grain, quinoa. Or maybe you decide to give broccoli another try, because your taste buds have change.

In a country obsessed with choices, choices, and more choices, salad bars are making people question why they ever bothered with pre-packaged ones that often contained items they didn’t want.

Why do we assume adults know what types of vegetables they like and give them the benefit of choice, but we often assume that if children don’t eat a vegetable, it means that they don’t like to eat any vegetables? Here’s a thought. What if we present school children with the same Chop’t salad bar? Do you think they will walk away saying, “No, thank you” to all the options available to them?

The answer is simple. Children are no different from adults in this regard – they have their likes and dislikes. If they are given a prepackaged meal with things that they dislike, they are most likely not going to enjoy it; but if they are given the vegetables they do like, they are much more likely to like it in its entirety.

When it comes to school lunches, many barriers – among which are budget constraints, lack of human resources, lack of political will – force schools into a lunch menu that lacks variety and choice of healthy, tasty options. The problem with this model is that it assumes that if children don’t like the only vegetables presented to them, then they don’t like vegetables at all.

At the same time school children are lacking choices of healthy options, they are also inundated with unhealthy ones. Private companies, usually large food conglomerates and fast food chains, sign contracts with school to sell “competitive items” on school’s “A La Carte” menu. From this menu, students can purchase cheap fast meals, like pizza and hotdogs, and processed snacks, like chips and candy. Students, therefore, do have options. The problem is that the choice is not between healthy ones, but between healthy and unhealthy items. This has huge implications for students’ health and development of lifetime eating patterns.

This is why Let’s Move Salad Bars to Schools (LMSBS) is taking the Chop’t model of choice to the school lunchroom. In support of First Lady Michelle Obama’s Let’s Move Campaign, the program was founded in 2010 through the collaboration of Chef Ann Foundation, National Fruit and Vegetable Alliance, United Fresh Produce Association Foundation, and Whole Foods. It was founded on the idea that children have their preferences as well as the ability to develop preferences in the lunchroom, so if they have the room to decide for themselves, they will be more likely to take and consume the vegetables of their choosing. The program’s mission is to implement salad bars in every school that wants one.

The main barriers to implementing salad bars in every American school are lack of human and financial resources. Many don’t have the ability to store, prep, and serve fresh food. LMSBS, thereby, engages the whole community in fundraising, advertising, and implementation efforts. Through the organization’s website, both educators and parents can take the first step by applying for a salad bar to be donated to their school. The community can take action by donating to a general fund that goes towards supporting salad bars across the nation or a specific fund directed towards supporting their own school district. Blog posts also engage the community in a larger conversation about healthy eating and how to provide children with food they actually want to eat.

The program has shown to be hugely beneficial through both research studies and from on-the-ground anecdotes. An evidence-based program, studies have shown that that giving students the option to choose from a variety of fresh produce significantly increases their overall consumption of fruits and vegetables; it increases the variety they try; it helps students develop longer lasting habits of eating fruits and vegetables; it reduces school food waste because students can take as much as they would actually like to eat; and it supports local agriculture, since schools can directly partner with local farms and producers to fill their salad bars with fresh produce.

Anecdotally, it has strong support from nearly all stakeholders: students, teachers, parents, farmers, school district officials, and the White House. The program helps jumpstart the conversation about what it means to really provide healthy school meals that are both tasty and nutritious for students; it provides the space and opportunity to encourage students to try new fruits and vegetables; teachers love that they can chat with students about the types of fruits and vegetables they like and then continue the conversation in the lunchroom by encouraging students to choose the foods they like from the salad bar.

School meal programs are sometimes so focused on the nutritional content of food that they forgo children’s diverse taste preferences. Like adults, children are obsessed with choices, choices, and more choices. They like having the opportunity to choose what they prefer and the room to try, or not try, new foods.

In the end, LMSBS is much more than simply feeding children salad. It infuses a culture of loving good food in the school setting, which has the potential to encourage healthy eating habits beyond the lunchroom. It’s a way to help students develop their taste preferences and the room to try new things. It’s a way to help shape lifetime eating habits that will positively impact wellbeing.

Food Security: The start of my advocacy journey

By: Jacqui Cotton

Growing up, I remember feeling particularly sensitive about hunger. I was unsettled and saddened to think about other people going hungry at night, potentially right within my community. I was fortunate to grow up in a comfortable suburb in Monmouth County, New Jersey where most of my friends and neighbors enjoyed middle or upper-middle class lifestyles and where poverty and hunger were relatively invisible to the unknowing eye. Still, I was always sickened by the thought of other people’s hungry stomachs. I felt a duty to donate to each community food drive, and I would volunteer with school clubs that supported the local food bank.

As I progressed through my education, I found the field of public health which combined my dual interests in health and social issues. I started thinking more about the penetrating social issues that were at the core of human experiences such as health and hunger—how could I do more to tackle these social ills that would have more impact than simply donating a can of corn?

When I arrived at Mailman, I was still unsure about my direction in public health. During the Core we touched upon a milieu of public health issues and needs, each tugging at my heart-strings and making my question my personal mission and career path. I found myself living in a new environment, where hunger and homelessness is tragically rampant on our streets and subways, and where the inequities of our society are glaringly obvious. While our coursework did not touch upon hunger, food access, and its impact on health as much as I would have welcomed, I found myself motivated by the environment around me and by my FPOP colleagues with similar interests in the far reaching effects of food on population health. I had solidified my passion and field of interest—the intersection between health and food (in)security.

During the spring semester, determined to learn more about anti-hunger advocacy and the way health issues are navigated through our leaders and policymakers, I worked at the Food Bank for New York City as the Government Relations intern. The Food Bank for New York City is the largest Feeding America organization in the country, working with 1,000 charities and schools across the five boroughs. One in five New Yorkers depends on the Food Bank for food and other resources such as benefits access, tax assistance, nutrition education, and financial empowerment. In addition to serving 1.4 million New Yorkers each year, the organization does extensive advocacy work in the anti-hunger and anti-poverty sector—this is where I wanted to get my feet wet.

Through my day-to-day work and interactions with other members of the Research and External Affairs team, I learned about the intersection of legislation, advocacy, and the anti-hunger agenda. I researched relevant policies on nutrition and food assistance programs, such Child Nutrition Reauthorization and the Supplemental Nutrition Assistance Program (SNAP, formerly known as Food Stamps). I prepared relevant and timely policy-related documents such as legislative testimony, policy briefs, research backgrounds, and letters to elected officials. I had several opportunities to attend events such as press conferences, city council hearings, and lobbying days, where I saw firsthand how pressure can be applied strategically to advance agendas through policy and legislation. I attended Albany Advocacy Day at the state capital, and advocated alongside community members and other stakeholders in small meetings with state senators and assembly members. These experiences also helped me become more familiar with emergency food program funding and operations at the city, state, and federal level.

After a successful and interesting semester, I was excited to be offered an extension and a position change for the summer. I began serving as the “Hunger Cliff Fellow,” working between several departments including Research & External Relations and Communication & Marketing. My major project has been working on the re-launch of an online advocacy and information platform to be shared with other anti-hunger partners and policymakers across the country. The goal of the site is to raise awareness and stimulate conversation around SNAP in order to strengthen and protect the program from future cuts. As I dove deeper into research and advocacy around SNAP, I learned about the intricacies and challenges of navigating politically fraught topics like food stamps, or hunger and poverty relief and reform more generally.

During my summer work, I also became more involved in another citywide coalition led by the Community Food Advocates—the Lunch 4 Learning campaign, which focuses on universalizing free school meals in NYC schools. It was exciting and rewarding to work with other leaders from different policy circles including the anti-hunger community, school food, and children’s health and education. I learned a lot about their grassroots advocacy work, campaign strategies, and communications and outreach, particularly at the city level, by attending these meetings.

While I don’t consider myself an advocacy expert by any means, I have learned a great deal while working at the Food Bank and among fellow anti-hunger advocates. I’ve had to think critically about how to best package certain health and social messages to push forward our policy priorities. I was able to work with a lot of big data that had been collected by the Food Bank and partners such as the USDA and Food Research and Action Center, as well as experiment with storytelling in order to create more compelling messages for our advocacy campaigns. I was introduced to many national and local social policies and learned a lot through independent research and discussions with my senior team members. I saw the intersection of food policies and food programs and also witnessed many of the Food Bank’s innovation programs to combat hunger and poverty at a more systemic level (e.g. financial empowerment and tax services). This work involves a lot of systems thinking, not just related to the food distribution cycle, but also to the deeper social issues and policies from which hunger stems.

The part that drives me the most within this field is the fact that hunger is a solvable problem. It is large and daunting, yes—but ultimately it is a condition that can be eliminated through sweeping social reform and innovation. My passion is not merely hunger relief through emergency food programs—I dream of a sustainable, long-term solution for a well-nourished society that doesn’t have to worry where their next meal is coming from, but this cannot be achieved without persistent advocacy. I view food security as preventative healthcare, and with poverty being a leading social determinant of health, I think anti-hunger work is inextricably tied to public health. As I continue to advance the Hunger Cliff project, I look forward to learning more about health advocacy this semester to enhance and inform my work at the intersection of health and hunger.

OCTOBER Foodie Inspired Events Happening in NYC!

10/1/15-10/18/15 – Food Truck Rally

10/5/15 – Let Us Eat Local

10/6/15 – Book Talk — “Soda Politics” by Dr. Marion Nestle

10/12/15 – Book & Film: “After Winter, Spring” – New York Special Screening

10/16/15- FOODi: Food, Business & Technology

10/17/15 – Eating Through Time Festival

10/19/15 -10/20/15 – James Beard Foundation Conference: Rethinking the Future of Food

10/24/15 – Rodale’s Organic Life Farm2Fork Festival: Slow Down Dinner

10/26/15 – The Manhattan Slur – Dig Inn

Every Saturday of October – Hester Street Fair

General Body Meeting

General Body Meeting_Oct 2015

Join FPOP for the first general body meeting of fall 2015! We will be sharing all the great events we have planned this fall, introducing the e-board to the incoming class and sharing a great lunch! If you are interested in joining the e-board or signing up for a working group this will be a great time to learn more about these positions and ask any questions! Hope to see you there on October 1st!

An Epidemic of Bad Research and Reporting

An Epidemic of Bad Research and Reporting

By: Sarah Kunkle

Original Publication found here:

Earlier this summer, the popular science and technology blog io9 ran a story that caught the eyes of many: “I Fooled Millions into Thinking Chocolate Helps Weight Loss.” Over the course of the article, John Bohannan, a science journalist, describes his elaborate hoax and laments the state of both nutrition research and science reporting. Unfortunately, this is all too common.

Although the study was real, it was intentionally plagued by methodological and analytical flaws, including an extremely small sample size and large number of measurements that gave the study a greater than 60 percent chance of finding at least one statistically significant result. To address these issues, some journals are considering getting rid of p-values (a measure indicating how likely it is that study results are due to chance) and many do not accept studies with fewer than 30 subjects. Nevertheless, many low quality studies still end up published in peer-reviewed journals.

Nutrition research is particularly vulnerable to biased results because of its dependence on self-reporting. A recent Mayo Clinic Proceedings article argued that memory-based dietary assessment methods were “fundamentally and fatally flawed” and should not be used to inform dietary guidelines. Organizations like the Nutrition Science Initiative are trying to combat these issues by funding more rigorous (and expensive) studies. While the evidence is inconclusive for some nutrition research questions, the 2015 Dietary Guidelines Advisory Committee seems to be a step in the right direction with its emphasis on minimally processed wholesome foods rather than specific nutrients.

In addition to poor quality research, bad reporting further complicates the issue. As Bohannon notes, reporters covering topics such as nutrition or broader scientific research should not merely echo what they read in press releases: “you have to know how to read a scientific paper – and actually bother to do it.” Readers should be especially weary of articles that do not mention sample size and effect size.

Bohannan is not alone in his views. Lancet editor Richard Horton recently published a commentary on bad scientific practices, claiming, “much of the scientific literature, perhaps half, may simply be untrue.” Increased public awareness and transparency are likely to ameliorate the problem. In the meantime, both reporters and readers should be cautious as they digest health headlines – if it sounds too good to be true, it likely is.

How to avoid getting duped by overblown health claims (via Quartz)

1. Are humans involved? If the claims are based on a study done in mice, the results are not necessarily applicable to humans.
2. What is the sample size? Be skeptical of results that involve less than 100 people and fairly skeptical of those that involve less than 1,000 people.
3. What type of study? Study design matters. Systematic reviews, meta-analyses, and randomized controlled trials are generally the most reliable for testing hypotheses.
4. Is it correlation or causation? Relevant to the point above on study design, most health studies draw mere correlations rather than direct causes.
5. What are the study’s limitations? A good health story will not only explain the results, but also discuss the study’s limitations and why you shouldn’t trust the claim fully.

July Event!

Happy summer FPOP fans!

For the last few years, the Mailman School has hosted the World Economic Forum’s (WEF) young global leaders. This group is comprised of a cohort of future leaders under 40 years old from around the world who serve in the program for 6 years. The goal of the program is to give them the knowledge base and connections to look for and implement innovative solutions for problems solving. By being part of this program, the school introduces these young leaders to public health while usually honing in on one particular public health issue each year.

This year, the public health component will focus on obesity and physical activity. Over the course of the 2-week program, a few of our faculty – including Claire Wang, Andrew Rundle and Heather Greenlee – will lead sessions on these topics, looking at the environmental, social and other risk factors to this issue. The fellows, in turn, will develop proposals for how to address this epidemic. On Friday, July 17th, they will present their proposals to a panel for larger discussion. Included on the panel will be Dean Fried, Steven Newmark, Senior Policy Advisor and Counsel to New York City Mayor Bill de Blasio, Sara Vernon Sterman, VP, Strategic Investments, the Reinvestment Fund, and Radha Agrawal, Founder and CEO, Super Sprowtz – a story-driven nutrition program, which uses entertainment and puppetry to educate kids about healthy eating habits.

WEF would very much like to invite members from our community, especially students, to listen to this discussion. The details for the event are below.

DATE // LOCATION // Friday, July 17 // Faculty House, 64 Morningside Drive

10:45-12:15 // Pitches and presentations

RSVP here!
Maria O’Brien: Senior Director of Special Projects with the Dean’s Office // Email: