America is Eating Healthy (According to one App)

I'm a big fan of mobile eating apps.  I think they have the potential to change eating habits and change our food environment.  However, I think many of them are purely driven by tech and gaming experts.  This is not a bad thing.  But without involving people who understand medicine and nutrition, the apps are unlikely to actually help people become healthier.

One of the hot new apps is The Eatery, as discussed in this article:
App Shows Promise for Hacking Eating Behavior - Technology Review

Users take a picture of their food.  Other users rate how healthy it is.  10 (green) means super health and 0 (red) means very unhealthy.  Here's a map of the ratings of healthy meals:

Now anyone who understands nutrition will be puzzled by the fact that most of the United States is green, meaning most of the meals people take pictures of are healthy.  Thus, we are all eating healthy and there isn't really a problem with poor eating in this country.

So there are two possibilities:
     1. The people who use the app are mostly healthy eaters.  (Then what purpose does the app have?)
     2. Most of the user ratings are false.  (Most people don't know what a healthy meal looks like.)

I think either possibility is true.  Option 1 will be fixed when there is an expansion of mobile technologies.  Also, if research shows these apps work, then professionals might recommend them to "unhealthy" eaters, expanding the reach of the apps.

To fix option 2, tech companies need to align with nutrition and medical professionals.  This is difficult, as the two types of industries often have different goals.  But it is possible, and together we could change the way we all eat.

Salt: Bad, Good, or We Don't Know?

The following article was the most emailed of last Sunday's New York Times, and is worth a read:

We Only Think We Know the Truth About Salt - NYTimes.com

The questions on the "clear" relationship between high salt intake and mortality are not new.  The article speaks about some of them, but even I remember these questions being raised.  When I was a freshman studying nutrition at Cornell, my introductory nutrition professor, David Levitsky, raised doubts about salt's connection to poor health.

In my favorite class at Cornell, "Mineral Nutrition and Chronic Disease," taught by Charles McCormick, we spent weeks delving into the literature on sodium, blood pressure, and heart disease.  As I left the class, I had serious doubts about the link.  There were clearly some salt-sensitive people with high blood pressure, for which salt reduction reduced their numbers.  But should we reduce the whole population's salt intake?

Still, I thought that even if the benefit of reducing salt was small on an individual level, the population benefits were likely large.  Even a small reduction in everyone's blood pressure could probably prevent deaths.  So in medical school I worked on a petition to the FDA, filed by CSPI, to limit salt in foods.

Now, even if salt itself is not a cause of increased mortality, it may be a marker of something else: poor eating habits.  Maybe the people who eat salt just eat a long of junk food.  Maybe limiting salt would still be a good thing, as people will drink less sugary beverages to quench their thirst.  But it may be prudent to have more research on this public health policy before we cause harm.

We do not want salt to go the way fat went: It was bad, and then it was good.  One thing I know is good: make sure 1/2 of every plate is vegetables and you are walking daily.

We are Winning the Soda War

This week New York Mayor Bloomberg proposed limiting the size of sugary beverages.  This is his latest tactic in reducing consumption of these beverages.  Earlier, he proposed a soda tax.  He also proposed prohibiting SNAP (food stamp) participants from purchasing sodas with government money.  Both of these measures failed because he needed outside approval (i.e. the Stata or Federal government).

His legal team indicates that no outside approvals are needed for this measure.  They have authority under the restaurant laws in New York.  I still think it is likely that the soda and restaurant industries will sue the city.  (McDonald's makes most of their money from soda.)

It would be great if this measure went through.  This intervention is just changing the default size of the drinks, a clear behavioral economic intervention.  People can still buy 2 or 3 or 5 drinks if they want.  It might even be the same price.  The freedom of choice is still there.

The best news from all of this is that we are winning the war on soda.  The industry is becoming defensive.  All of the publicity is giving soda a bad rap.  That's the purpose.  The soda industry spends billions of dollars a year marketing beverages to kids.  All of this negative media around soda gives us a chance to fight against that marketing.

Thank you Mayor for leading us in this war.