Bonnie Modugno, MS, RD - The Elephant in the Room: Fast Food (Doesn’t) Make You Fat
Probably the most stated and universally accepted nutrition sound bite is this one: Fast Food makes you fat. People believe all the public health hype. If you frequent a fast food establishment, you are inherently eating bad food, food that will have your cholesterol soaring and your waistline expanding. Hog wash.
What makes perfectly intelligent and often well educated people accept and believe such a ridiculous sound bite? How does one sector of the food environment get so much grief about its food when obesity and health issues linked to food are so enormous (pun intended)? The incidence of obesity in America– and child obesity in particular– is a bigger and more complex problem than any one food source.
GOVERNMENT GOVERNING BADLY
I have sat in a few city council as well as Planning and Land Use Meetings (PLUM) in Los Angeles the last few years. I was invited to speak at a high school event in San Francisco with Supervisors Eric Mar and Bevan Duffy. I may be naïve, but I am appalled at the lack of transparency and the hidden agendas.
The government types seem to universally accept that fast food is the culprit. Fast food is making everyone obese. This argument wouldn’t be so specious except lots of thin people eat fast food. Many obese people don’t eat fast food. Even the “average” customer at McDonald’s frequents the restaurant just over 2 times a month. Are those two meals a month really making so many people obese?
My cynical self sees the elephant in the room. Government types have jumped on the fast food bashing bandwagon to further their agendas. They see a universally misunderstood, emotionally charged issue that can be manipulated for their own benefit. They are running fast and loose with the facts. Overwhelmed, underfunded and outgunned by the food industry, desperate public health entities lunge at any opportunity they can to gain a foothold.
PEOPLE WANT TO BELIEVE THE MYTH: SIT DOWN RESTAURANT FOOD IS HEALTHIER
Earnest public health advocates as well as dedicated clinicians continue to pound the point home: Fast food makes you fat. Avoid fast food. Avoid fried food. Avoid sugar. Cut down on salt. Too bad fast food establishments aren’t the only places you can buy “fast food”, food high in sodium, sugar, and fat.
In 2005 I looked at what the so called “healthier” sit down restaurants were feeding the kids. After reviewing 14 kid’s menus from local neighborhood cafes and chain restaurants the evidence was clear. These sit down restaurant served children the same food as their quick service counterparts.
Overwhelmingly the menus offered hamburgers and fries, some form of fried chicken strips and fries, pizza, and the like. Less than 7% of the restaurants offered a fruit or vegetable on the menu. Often milk wasn’t an option for the lower cost meal. Resorts and hotel restaurants fared even worse. Less than 5% of their kid’s menu options offered a fruit or vegetable.
Sit down restaurants often offer all you can drink sodas and free dessert. I did not assess serving size, but at a glance I know that most restaurants do not following USDA guidelines regarding calorie intake suitable for a child. When he was young, my child ordered his share of kid’s meals. My guess is that very few of these establishments put any thought into the amount of energy they serve the kids.
NUTRITION ON THE MENU: WILL IT CHANGE BEHAVIOR?
In January of 2011 we are supposed to see nutrition information available on every menu of every restaurant with at least 20 sites in California. Early evidence shows that this information could be a game changer.
Many popular chain restaurants serve meals or entrees that hover between 1000-2000 calories each. Early in the game, one popular national chain known for generous portions jumped the gun and listed their four digit entrees, noting the calories directly on their menu and website. Entrees offered anywhere from 1000, 2000, even 3000 calories each!
Rumor has it that sales dropped dramatically. Within months new menus without the calorie amounts were printed. Most calorie information was removed from the website. Now a separate reference book is available with the information for those who ask.
Some establishments have devised ingenious and disingenuous ways to deceive the public. I have seen menus list all the items separately—even when they are usually served together. It is common that the 900 calorie sandwich is listed in one location. The 700 calorie French fries are listed someplace else. The beverage calories are listed but ultimately unknown. There is no telling how many free refills you will accept.
Typical portions today are enormous. We have a distorted sense of value. We want to believe more is better. It is not unusual to be served food on a platter. The platter for my meal at one local bistro looks suspiciously similar to the platters my mom would use to serve a family of eight.
One restaurant chain had the nerve to try to identify their 1000+ calorie meals as “2 servings”.
EATING OUT MAY NOT BE THE ONLY PROBLEM
The National Restaurant Association reports that 50% of every food dollar is spent away from home. Research says people eat more calories at restaurants than at home, but I wonder.
Does the research consider just the meals eaten at home? What about the snacks? We are no longer a country that eats at a table. Snacking accounts for 40% of food intake for children and many adults. I suspect that most people probably eat a modest meal at home. I think most people don’t cook much. They are probably assembling a quick or simple meal because they don’t have the time, energy or desire to put together a full dining experience.
Breakfast is a bowl of cereal, a yogurt, a muffin or a piece of toast. Lunch may be a sandwich or a salad, possibly with a piece of fruit. At their first session most of my clients report that eat very little food before “the witching hour”, about 3 or 4 o’clock in the afternoon.
When you eat very little throughout the day, the body provides additional energy from stored carbohydrate (glycogen) in the liver. Every time you feel hungry during the day and put off eating your body ends up tapping into this reserve. By the witching hour, the calorie cheaters have tapped out the stored energy and hunger hits and sticks with a vengeance.
Sometimes the feeding frenzy begins before anyone even thinks of dinner. Snacks come out of hiding in a desk drawer or purse. The office kitchen is scanned for leftover bagels or donuts. Somebody’s desk has a jar of candy available for the taking. There is an organized run for “coffee”, a euphemism for the highly caloric beverages that are served at coffee houses everywhere.
I know many clients who come home from work and start eating the minute they enter the doorway. There are snacks before dinner. Anyone who cooks and assembles food can be found munching on the ingredients while they prepare their plate. All too often dinner extends into the living room after dinner with a serial intake of snacks in front of the television. I wonder if the researchers are counting all the calories consumed at home or just those consumed at the dinner table. For these folks “dinner” lasts from 5 until 10 PM.
ABUNDANT, HIGHLY ADULTERATED FOOD IS EVERYWHERE
Every supermarket, convenience store, liquor store, pharmacy, hospital cafeteria, entertainment venue, and vending machine sells food that is highly refined and adulterated.
Increasing rates of obesity, diabetes, heart disease and cancers are true public health crises. Children born today will likely not live as long or with the same health as their parents. We cannot afford children with type II diabetes. We cannot afford young adults on dialysis. Medical care is not cheap. We cannot afford the excessive amount of cheap, tasty food that we are offered everywhere, all the time.
FOOD IS (relatively) CHEAP
Our food supply has radically changed during the last half century. In 1947 the average household spent 27% of their after tax dollars on food. Today families spend between 9-12% of their net income on food. Food is relatively cheap. But not all food is cheap in the same way.
Fresh fruits and vegetables cost more. Between 1985 and 2000, USDA data tells us that the cost of fresh fruits and vegetables increased 118%. During that same time period the cost of sodas increased 20%.
USDA farm policy continues to subsidize wheat, corn and soy. The exact ingredients used to make highly refined and adulterated foods. It is government policy that makes bread, cookies, candy and soda so cheap. How ironic that these refined carbohydrates are now considered to be the problem, driving the obesity epidemic even more than fat intake.
Even beef and milk are relatively cheap to buy. Subsidized corn and soy are used as animal feed in order to maximize profits at the feed lot. These animals are not allowed their natural diet in order to allow us a cheaper, fattier, less healthy product at the market. For years I have had a hard time trying to rationalize a national farm policy that flies in the face of national health policy.
BUYING FOOD AT THE SUPERMARKET DOESN’T MAKE IT HEALTHY
Supermarkets are no refuge. Average supermarkets offer 48,000 items. One study assessed the nutritional quality of supermarket food. Foods earned one star for good food choices, two stars for better choices and three stars for the best choices. The two nutritionists who designed the program did not assess candy, gum or alcohol. Still, less than 25% of the products offered earned even one star.
Supermarkets cater to our fast paced, busy lives. Convenient and pre-prepared food is the fastest growing sector in the marketplace. Over ten years ago I started asking my clients if they cook or “assemble”.
Less floor space is dedicated to basic whole foods. Raw produce, dairy and meats fill up a miniscule percentage of a market’s footprint. Even markets that cultivate a healthier image make most of their profit on the value added items, not to mention all the supplements and so call “health foods” that are highly refined and processed themselves.
CONFUSING THE ISSUES
The truth is that the obesity and health challenges we face as a nation are daunting. It is seductive to latch onto absolute sound bites declaring “fast food is fat food” like a tenacious bull dog. But there is trouble ahead. In the face of mounting evidence that dispels the myths, public health and government bull dogs are not letting go.
When undue resources are directed towards demonizing fast food, little attention is paid to the dismal state of our food supply everywhere. I have clients wanting to lose weight, diagnosed with any number of metabolic diseases, who don’t understand why they are struggling. Sometimes they boast, sometimes they lament: “But I don’t eat fast food.”
Fast food doesn’t inherently make anyone fat. Fast food is not inherently more caloric, higher in fat or more refined sugar than food served anywhere else. It is not even served in the largest portions.
When fast food restaurants serve vegetable and fruit salads, grilled chicken sandwiches, one percent milk and other “healthy” fare, how can people continue to believe that fast food inherently serves food that is less healthy than every other food venue?
EMBRACING EDUCATION, CELEBRATING CHOICE
People with influence continue to misinform the public at their own peril. They will soon be exposed as the opportunistic and short sited “man behind the curtain that they are. We can only hope the shrill pundits attacking fast food are as gracious in their exposure as The Wizard of Oz.
Current research is already questioning the high carbohydrate, low fat mantra. Renown nutrition epidemiologist Walter Willet has stated that the research shows refined sugars and starches are likely much more of the problem. There is even rumbling that saturated fats are not as problematic as once thought, especially the saturated fats derived from animals that consume their natural diet. These fats are rich sources of omega 3 fatty acids, conjugated linoleic acids and other healthful nutrients.
FOOD QUALITY STARTS ON THE FARM, FINISHES IN THE KITCHEN
We are learning that the quality of food, how animals are fed and how crops are grown impact the nutrient density of that food. When soil is nurtured will the full spectrum of nutrients from composted foods and waste products, the entire soil ecology improves. The activity of worms and other insects enhances the viability of the soil. Grass grows better, animals feed better, crops grow better, and we feed better.
I appreciate that eating food in its most natural state reduces intake of problematic ingredients like high fructose corn syrup and partially hydrogenated oils (trans fats). I have learned that telling people to avoid salt during cooking is futile. Salting foods appropriately when cooking is not the problem.
Seventy percent of all sodium consumed comes from highly processed and refined items. Some the most significant sources of sodium don’t even taste salty. Bread, pastries and cereal contribute surprising amounts of sodium in the diet because people eat these foods frequently.
In sum, every fast food establishment has the opportunity to prepare and serve excellent food. There is nothing inherently unhealthy about fast. While the slow food movement has its merits, my guess is that most proponents of eating “close to the earth” have been stuck eating on the run. There is no reason to shun fast food done well.
THE NUTRITION MESSAGE NEEDS TO CHANGE
Convenience and taste are the two top factors driving people’s food choices. Quick service restaurants are here to stay. The message needs to change. We need to encourage fast food patrons to make judicious food choices at fast food restaurants. We need to encourage everyone to make judicious food choices everywhere. We need to help people avoid a polarized relationship with food.
It serves no one to make people feel guilty about eating anything other than “healthy” food. Guilty people end up pretending. They become opportunistic eaters, taking advantage of every treat and extra serving offered. They become closet eaters, even their best friends don’t know. They lie to their doctors, they lie to their dietitians, they lie to their families, and to themselves.
It’s time to be far more honest about food. It’s not where you eat. It’s what you eat when you get there.