Want to lose weight? Drink (Good) Beer

I just could not resist writing about this when I stumbled upon the interesting factoid about beer and obesity:  States with the highest number of craft beers per 100,000 people also have lower obesity rates (for those of you statistically inclined, the correlation rate is -0.54).  This observation comes from The Atlantic Cities website, which did a report on the increase of craft beer breweries in the United States (there are more craft breweries now than any time since 1887).  What is even more interesting was the quick set of correlations they performed, including the one I just mentioned above.

Let’s work through this relationship. Below are the maps showing US Obesity rates in 2010 (from my previous post) and the map put together by The Atlantic Cities showing the number of craft breweries per 100,000 people, for each state.

First thing to note here, is that many of the the red states on the left (indicating states with adult obesity rates greater than 30%) overlap with the light purple states on the right (indicating that there is, on average, less than 1 craft brewery in the state for every 100,000 people).  I said mostly overlap, as there a few red states (like Michigan) that are a medium-purple too, which tells us that some heavily obese states  average between 2-3 craft breweries per 100,000 people.  Second, notice that dark purple states on the right (indicating, on average 3 or more craft breweries per 100,000 people) are also yellow states on the left (indicating adult obesity rates between 20-25%): Vermont, Montana, and Oregon.  So now I can add drinking my loveable “Old Chub” Scottish Ale as a good substitute for running home from work once a week!

Of course, I’m having fun – because obviously, drinking beer (even yummy craft brews) does not make you thin.  As we all know (and the The Atlantic Cities website is quick to point out) correlation only shows how well two things are related – not that one causes the other.   The question now is, are there any obvious characteristics that make Vermont, Montana, and Oregon polar opposites of places like Texas, Louisiana, Kentucky, and West Virginia, and could possibly be related to both obesity and craft breweries? 

I had two, and neither seem all that probable:  The first is mostly related to Montana, Oregon, and Vermont.  All three are what we could call ‘outdoorsy’ states, and are known for adventure tourism (like skiing, hiking, camping, etc).  So that might explain the low obesity rates – high exercise and activity. How does this relate to craft breweries?  My best guess is, with vacationing and adventure goes drinking and eating good food, and craft breweries would fair well in these states.  As far as I know, few people plan adventure-related vacations to places like Mississippi, West Virginia, or Texas (does anyone really plan a vacation to Texas?).

The second is better education, particularly in agriculture and sciences.  There is already a fairly decent correlation with overall education and decreases in obesity, and The Atlantic Cities website also showed a weak, positive correlation with craft brewery and adults with college degrees (0.32).  Ask any brewer, and he or she will tell you that making beer (or wine for that matter) is highly scientific, and requires lots of chemistry and math.  You need a population that is willing and able to use science everyday as part of its job.  The central US states do not fair well in reports on science and engineering education studies (Mississippi ranked last in all the states on the Science and Engineering Readiness Index of high school students).  So perhaps the underlying cause between craft brewery and obesity is better educational attainment.

As I said, neither are that great at explaining the correlation; if anyone has better ideas, fire away!

Finally, here are two more interesting correlations with craft breweries: Craft brewing is less likely in conservative states, with a modest negative correlation (-0.30) to 2008 John McCain votes (there was no statistically-significant association to Barack Obama votes); And craft brewing is more closely associated with higher levels of happiness and well-being (0.47).

Hurray Beer!

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Our Friends Make us Fat. Maybe.

Do our friends make us fat?  Technology can definitely influence how much we eat, and therefore our weight.  So does the time it takes for us to make healthy food.  There is lots of evidence to suggest that yes, our friends, can lead to increases in food consumption and our weight.

Imagine you go out to grab a meal at your favorite restaurant.  To make this easy, let’s assume you eat 100 calories worth of food if you are by yourself (in all actually, meals are more along the lines of 1200 calories, but I hate math, so let’s stick with 100 calories).  Studies of how people eat in the real world (compared to those done in labs) show that if you go to the restaurant with one other person, you’ll increase your calorie consumption by 33%.   In other words, you will eat 133 calories.  Bring two friends, you consume 147 calories.  Research has shown that by the time you include 7 friends, you will almost double the number of calories you eat. Here is how our 100 calorie dinner has grown:

So what does the mean in ‘real’ numbers?  In 2010 the US Dept of Commerce collected how many calories the average customer at Starbucks ordered:  232.  If we apply the above figure to the average customer ordering food at Starbucks, but this time bringing friends, below is a chart showing the caloric increases.

Our friends, though, are the least of our worries.  Eating with your spouse or a family member almost doubles the calories consumed than if you ate with just your friend.  And of course, there are gender differences.  If you are male, it doesn’t matter if your friend is male or female, you’ll increase your calories about the same.  If you are female, however, you eat more with a male friend then if you are eating with a female friend (personally, I thought it would be the other way around).

So what is happening here?  Why do I eat more with my friends than if I eat alone?  Personal experience gives me one clue:  When I go out to eat with friends, we often start with drinks (which many people forget, do have calories) and a shared appetizer, or two.  (Hell, let’s be honest, we often order three).   Then we each order a meal, and most likely another drink.  Who knows, we might even share our meals.  Whereas alone I or my friend might just order a nice, low-cal Caesar Salad, when there are two, I am more inclined to suggest you order the Caesar Salad, and I’ll order the Chicken Cordon Bleu, and we can split them!  And of course, we might just split dessert. We also know that when we eat with others, we linger.  Eating is a social event, so we take our time.  On average eating with one other person increase the time spent eating by 44%, which means we sit and nibble longer too.

So why the maybe in the title?  Because for large eaters, the effect is the opposite.  If I am someone that usually eats significantly more than the average person, then when I eat with the average person, I drop my calorie consumption.  In other words, eating with others is a normative phenomenon.  Light eaters increase their calories per meal when eating with others, while heavy eaters decrease their calories when eating with others, approaching a middle ground.

So maybe eating with others makes you heavier, but maybe not.  The jury is out on this one.

Endless Days (or Bowls) of Soup

While I was flying home to a family reunion last summer, I sat next to a Marine Drill Sergeant on the plane.  When he found out that I was professor, and that I taught a class on obesity, he laughed. “There is no reason for a whole class on why we are fat,” he chuckled.  “I tell all my new recruits loosing weight is easy.  CICAS:  Calories In, Calories Out, Stupid.  You can eat all you want, as long as you make sure you burn all you eat.”  Admittedly, his statement is true. But it kept me thinking, then why are people still heavy, and only getting heavier?  If it really did boil down to burning all the calories we ate, then there is convincing evidence that Americans should be fit, if not loosing weight.  Considering that the health and gym memberships are a $25 billion industry, and during economic downturns gym memberships experience growth (albeit small), it appears that Americans are working hard at the ‘calories out’ aspect.  So what is happening with the “calories in’ part?

If we look closely at calorie consumption in the United States, we find that most people eat more calories on a given day then they really need.  In 2000 the US Department of Agriculture found that the average daily caloric intake was 2,900.  That is almost 700 calories more than what is recommended for males 18 – 30 years of age.   And looking back at old editions of the Joy of Cooking, recipes have increased their calorie content by 37%, mostly because the portion sizes have increased.  And it does not take that many extra calories each day for you to gain weight.  A study by the University of California Wellness Center found consuming an extra 19 calories per day more than you burn results in gaining 2 pounds over a single year.

But what has only 19 calories?  It is hard for us to picture something that is only 19 calories – and that is because we really are not good at judging calories.  To be fair, it is hard.  Equal amounts of two foods do not mean have equal calories.  Take, for example, cucumbers and M&Ms. A medium sized cucumber has 19 calories, while a single, Fun Size bag of M&Ms has 103 calories.  You would have to eat five medium sized cucumbers to get about the same number of calories as the bag of M&Ms. Put another way, you only get to eat about 3-5 M&Ms to get 19 calories.  So if you eat an extra 3-5 M&Ms each day, for a year, you would gain 2 pounds.

In order to consume fewer calories we need to do something very simple, but admittedly very hard:  Stop eating.  Or maybe, stop eating when we are full.  Americans, however, ignore when our bodies tell us it is time to stop eating.  Psychologist Brian Wansink asked Americans diners (from Chicago) and French diners (from Paris) how they know when to stop eating a meal.  The French said they stopped eating when the food no longer tasted good, or they were no longer hungry.   The Americans, however, said they knew it was time to stop eating when there was no more food left on the plate, or (worse yet) when the television show they were watching while eating was over.  In other words, American’s rely upon external cues to help us determine when we have had enough calories.

Probably the best example of this is another study done by Wansink and colleagues, called the Bottomless Bowl of Soup.  In this study, 54 males at a university were invited to participate in a ‘soup-only’ lunch, and then answer some questions about the soup. Each diner sat at a table with three other people, and was told to enjoy as much soup from his bowl as he wanted.  The participants talked and ate, as one would during a normal lunch.

What the participants did not know was half of the subjects had a ‘self-refilling’ bowl.  That is, the bowls were connected to a pot of soup by a large tube that ran under the table, and was hidden from view.   This allowed Wansink and his colleagues to slowly refill the soup bowls, so that the diner would never reach the bottom of the bowl.  Wansink gave each table 20 minutes before interrupting the meal and asked a series of questions.  One was how each participant knew to stop eating the soup, and more than half of the participants stated, “When the bowl was empty.”  Since half of the bowls were refilling, they would never get empty – and indeed only one person stopped eating and realized the trick.   This was because he attempted to pick the bowl up from the table to drink his soup (It turns out, compared to the French, Americans also have poor dining manners)!

Those participants with a bottomless bowl of soup ate more than those at the table with normal bowls.  And not just a little more – but almost twice as much (14.7 ounces of soup for the bottomless bowl group, compared to 8.5 ounces for the normal).  Wansink also asked each diner how many calories he thought he had consumed.  Here the two groups were similar, each thinking they had consumed about 125 calories of soup. In reality, the group with the normal bowls consumed about 155 calories, while those with the bottomless bowls consumed nearly 270 calories!

But who really eats from a bottomless bowl of soup?  Or drinks from the bottomless bottle of soda?  The answer, of course, is no one.  Not normally. But the average American does eat more calories each day than really needed.  We do not pay attention when our bodies tell us to stop eating – but instead we pay attention to much food we have available.  And this is bad.  As technology and science increase our ability to grow and produce more food, Americans will most likely continue to eat more.  In fact, we know this is true already.  A pair of Australian economists downloaded from the US Department of Agriculture the amount of raw grains American farmers had grown for a 10-year period.  As expected, they found that America increased food production over time, most likely due to better technology for growing and harvesting grains.  The Australians then compared this increase in food production with the average increase in weight for the same 10-year period.  And surprisingly (or not, considering what we have just discussed in the previous paragraphs) the increase in food production matched perfectly the increase in weight.  Meaning, gives us more food, and we’ll eat more food.  We just cannot seem to stop those calories from coming in!

Eating: In Celebration of my new Food Course

Starting this summer, my colleague (and friend) Brian Bouldrey and I will be teaching a new course called The Culture and Politics of Food.  In honor, I hunted through my journal to find an essay I wrote over 12 years ago, procrastinating from doing lab work.  So here it is.  Enjoy!

                                                   Eating Out in the Field

EATING

I’ve always considered eating more than just a basic life sustaining behavior.  Sure, you can argue that at the root of it, as biological organisms we must eat to stay alive.  But as humans, we have evolved into something more than just life sustaining creatures.  We do more than eat.

We feast.  We indulge.  We experience.

Some of my most cherished memories are of meals – or revolve around meals.  As sophomores in college, my two best friends and I went to Chicago for our spring break.  There we found a small Mexican restaurant that was nestled tightly beneath the tracks of the El in Evanston.  The menu itself was not extraordinary – chips & salsa, burritos, margarita and fried ice cream.  But something about the mere sharing of the food made the evening unforgettable.  Whenever the three of us get together, we still reminisce about that night.

Years ago I was in New Orleans for the Society for Neuroscience conference.  New Orleans is the city of Sin – and gluttony is well represented there.  You don’t just eat – you feast upon dishes that tantalize your taste buds.  And over red beans and rice, gumbo, shellfish, beer pints and Etoufee, a fairly eclectic group of people became friends. We were a hodge-podge of scientists, each brining to the table a little of whom we were.  There was Mark who bluntly told everyone he met that he was gay, Cat and her deep rooted spirituality that fought against all the science she learned and loved, Deanna who searched for meaning to what she was going through, Scott and Jun who just wanted to make sure that everyone that evening was having fun.  And me – me just content to sit and watch it all, to be part of it all.  To know that I belonged somewhere, to some group.  There was something about the free flowing of food that allowed us all to open up and share.  As we ate more (we fired through three dozen oysters and more pitchers of beer than I care to count) we shared more of ourselves – maybe it was because as we ate there was literally more of ourselves to share.

How is it we bond emotionally to those we share food with?  How could something so simple – just putting food in our mouths – become the focus point of celebrations and anniversaries?  Perhaps it is because we somehow expose our vulnerabilities; that by eating with someone we implicitly acknowledge how we are all equal?  We are all dependent upon food.

Why is it we feel compelled to eat with those we desire?  Why do we have romantic dinner dates?  Why is it that we find it so rewarding to fix meals for those we love?

Why food?

Because, I think, it is what we are.  We eat.  And for whatever reason, I personally love to eat.  I love to eat simple foods – barbeque chicken and corn on the cob for the 4^th of July, to fondue of shrimp, venison, and wild caught turkey on Christmas Eve.  I think it is because it gives us something to remember.  When we are left with nothing, when our friends are in other places, when your lover is gone and with another, we still have something that makes us complete.  We still exist.

We still have food.

Pie Today. And Every Day.

Americans are getting bigger, and one of the first places to look when hunting for the reason is how we eat.  As biological creatures, we need to eat.  But across all cultures, all languages, eating is more than just a basic need we fulfill everyday – like breathing.  Meals are celebrations and events.  When I come home each year to visit my parents, my mother fixes salmon because she knows it is one of my favorite foods.  It is just one of her ways of showing affection, and gratitude that I made the long trip.

We do more than just eat to stay alive.

And how Americans eat has changed drastically over the past fifty years.  When my mother got married, my grandmother bought her two books: The Betty Crooker Cookbook, and a current edition of the classic cookbook, The Joy of Cooking.  The Joy of Cooking was first published in the 1931, and perusing the recipes is a history lesson in how American households shopped and ate.  The very first chapter is dedicated to the food we eat: Calories, fats, and carbohydrates.  Then we get to entertaining and planning meals, from the types of glasses you should use for serving orange juice each morning to the cocktail glass you should have chilled and filled at 5 PM each day when your husband comes home. There are pictures of cows and pigs showing the names and location of the cuts of meat, so you knew the difference between a shank and a brisket.  There are entire chapters dedicated to the ‘basics’ of cooking, such as the art of double-frying, making a roux, and the difference between blanching and paraboiling.  But more importantly, the recipes read as if you are going to go out back and slaughter the cow yourself if you want steak tonight.   Cooking at home required not only understanding how to create a balanced menu of meals, but was a time consuming process.

French Fried Goodness

After World War II, Americans enjoyed what is called the Golden Age of Food Processing.  Advances in technology took much of the work out of making food.  In the Joy of Cooking, making Never Fail French Fries is no easy task.  First you need to slowly heat a stockpot of oil to 330 degrees.  After slicing your large potatoes, you first blanch them in 90-degree water for 15 minutes and dry them on cloth.  Once the oil is hot enough, you fry them a small handful of slices at a time.  After about 3 minutes fish them out and let them cool  – while you crank the oil up to 375-degree.  Fry a second time, then take the out and season.  Serve immediately (or after letting them cool for just a minute or two).  From start-to-finish takes 40 minutes, including preparation and cooking time.  Today you can buy a bag of pre-cut, pre-seasoned French Fries at the grocery store.  From freezer to table is 14 minutes – If you bake them in the oven.  Microwaving them is even faster.

So we get food faster?  Why does that make us fat?  It is not the speed that contributes to our growing girth:  It is the convenience.  For my mother, getting French Fries for dinner was a special treat – and a fatty one.  Potatoes have long been a staple of the American diet (in the 1960s American ate about 20 pounds of potatoes a year).  But the easiest cooking method (and the healthiest) was baked.  You threw it in the oven for an hour, and then finished cutting, dicing, and mixing the rest of the meal.  And a large (12 oz), plain baked potato is fairly healthy:  220 calories, almost no cholesterol or fat, and 10% of your daily protein needs.  A serving of Ore Ida Classic French Fries (about 1 oz after cooking) contains 110 calories, and 1.5 grams of saturated fat.  So if you ate 12 servings (the equivalent of that one large potato) you would have 1,320 calories.  And with French fries available everywhere now, they have become the standard American side dish (60 pounds of potatoes per person, in 2009).

Americans do not cook like we use too, and this French Fry Effect, so to speak, is everywhere.  When I was in graduate school, I lost a bet to a friend of mine, and my payment was making her a homemade strawberry-rhubarb pie.  I pulled out my Joy of Cooking, and started reading it, and realized I was going to need flour, water, eggs, butter, sugar, strawberries, and rhubarb to get the job done.  Simple enough – but as a single-male, the only items I actually had in my kitchen were the water, butter, and the eggs.  Had I not promised to make the pie from scratch, I would have bought a pre-made pie crust, and a can of pie filling (assuming Libby’s made strawberry-rhubarb filling).  Instead I bought all the ingredients, and spent about 90 minutes from start to finish, fulfilling my obligation.  Don’t get me wrong – the pie was delicious (if I do not say so myself).  But not something I wanted to do every night, in addition to making myself dinner.  That strawberry-rhubarb pie was a treat.  Pies took time, and were served on special occasions.  But today, you can buy one frozen at the grocery store, pop it into the even (next to the tray of French Fries, no doubt) and have it every night.

The New Defintion of a Red State

Let’s go back to 1985.  Not because of the awesome music (although, has anyone else noticed that Lady Gaga sounds so much like Madonna?  But I digress).  We’re going back to 1985 for that cutting-edge technology.

Computerized phone banks.

You see, in the days when The Cosby Show and Miami Vice ruled the airwaves, the high techno geeks were in the laboratory playing with the genetics of computer databases and fiber optics.  And what was born was the ability to have a computer automatically dial random numbers from a database.  Never again would a family make it through Sunday night dinner without a telemarketer calling to sell them long-distance packages.  But something really useful did come from this – the CDC’s Behavioral Risk Factor Surveillance System, or the BRFSS.

Despite the James Bond sounding name, the BRFSS was simply a system to call random phone numbers in the US, and then ask adults to answer question about their behavior and health.  Created by the CDC, the BRFSS collected data not just on how healthy we were (“Have you been diagnosed with diabetes?) but also about your behaviors (“How often do you wear your seatbelt?”).  The idea was, in order to be a healthy person you actually had to behave like a healthy person.  All the wishing in the world would not keep you from getting heart disease: Eating a healthy diet and not smoking would, though.

The BRFSS also collected gender, height, weight, age, and of course, where you lived (according to area code, which in the early 1980s was tied to your actual location, not the address of where you bought your cell phone).  And with this information epidemiologists at the CDC started tracking BMI, or Body Mass Index.  I know what you are going say – everyone hates the BMI, and that it is a poor tool for determining if someone is too fat.  But the BMI does do something really well:  It gives the relationship between height and weight as a single number.  And given that the BRFSS surveys all 50 states, and US territories, it is powerful.  More than 150,000 adults are surveyed each month, and from it we can track BMI in the United States, going as far back as 1985.

So, how many people in the United States had a BMI of greater than 30 (which qualifies as obese) in 1985?

Only a handful of states did the BRFSS in 1985, but from the data we have, all looks pretty good.  Most states had obesity rates of less than 10%, and only eight had rates between 10-15%.  Awesome, as they would have said back then.

So what happened between then and now?

Times were still lean, so to speak, in 1990.  By then almost all the states are collecting data, and obesity rates in all states are less than 15%.  Lots of pretty, light blue.

But something really dramatic happened by 2000.  Now we have all 50 states collecting data, and there is a huge pocket in the central and southern US where 1 out of every 4 US adult is obese.   Line up all your friends, start counting them, and it would go like this:  “One.  Two.  Three.  OBESE.  Five.  Six.  Seven.  OBESE.”  Way to go Ohio, Texas, Indiana, Illinois, West Virginia, Tennessee, Georgia…….  And aside from Colorado (the only light blue state left), the rest of the states have obesity rates of 15 – 20%.

And today (well, 2010 – the most recent data set we have)?  Hides your eyes, it is not pretty.

According to the CDC, over 30% of US adults are obese.  That is 1 in 3, people.  “One. Two. Obese.  Four.  Five.  Obese.  Seven.  Eight.  Obese.”  And notice there is no more blue.  The last ‘blue’ state was Colorado, and up until 2009, it was the only US state or territory that had an obesity rate of less than 20%.  Stop your bragging, Colorado.  You’re one of us now.

So what is the take home here?  Remember, the BMI has both height and weight in it.  So we could argue that only height is changing, and that is why the BMI is changing over time.  But since the BMI is your weight divided by your height-squared, that means the average height of all US adult has to shrink.  And we know that is not happening.

In my obesity class, I tell my students that BMI is not a perfect tool for determining if a single individual (you, or me, or your best friend) is too fat.  But it is the perfect tool for tracking what is happening, on average, in a population – like the United States.  And quite frankly, the United States is fat.  And getting fatter.

Here – we are all BIG family

Can't Stop Till We Get Enough

Last summer, three friends and I decided to do the Big Foot triathlon, located in beautiful Geneva Lake, Wisconsin.  After checking into our hotel, we decided we would ‘carbo-load,’ a triathlon (and marathon) race tradition, of eating pasta and other carbohydrate laden meals the night before, to give us energy for the next morning’s race.  Not knowing the area well, we stopped at an Olive Garden restaurant, located just down the road from our hotel.

As we waited for seats, one of my friends – who is allergic to wheat and gluten products – asked if there was a gluten free menu she could look at.  What we received was the food and nutrition fact sheet that US restaurants are required to provide.  I still have that fact sheet, in my office amongst books entitled Fat Land, and The Obesity Myth.  I kept it, because as we read the list looking for something my friend could eat, we were dumbfounded.  The restaurant’s two featured entrees, the stuffed rigatoni (either with chicken or sausage) contained over 1000 calories for a single serving (1050 for the chicken, and a whopping 1350 for the sausage).  This was for one item of food, and if you considered that most Olive Garden customers usually consume the free bread sticks (which was not on the fact sheet), a soft-drink (100 calories, assuming non-diet), and possibly a dessert (none of which were less than 300 calories), ordering a featured meal at the Olive Garden tipped the scale at over 1400 calories!  For perspective, health officials in the US government recommend that adult males 18 – 30 years of age consume about 2200 calories a day.  After a meal at the Olive Garden, you have less than 800 calories left for the entire day – or about one Venti Mocha and Taragon Chicken sandwich at Starbucks.

As I sat in the restaurant, consciously picking through my Ceasar Salad with Chicken (850 calories, not including the dressing), I kept reading through the information guide.  Quite frankly, one reason for the extreme calorie content of the Olive Garden’s meals is due to their portion size.  And this results in huge calories:  The average Classic Entree at Olive Garden has 1045 calories per serving.  If you thought ordering a chicken entree would be better – I mean, chicken is the lean meat! – think again.  The average is 1031 calories.  To be really healthy at the Olive Garden, order a seafood entrée: An average of 780 calories per serving (the best, calorie wise, is the Seafood Brodetto – 480 calories).

I must be fair – I am leaving out the entrees that Olive Garden labels as their healthy & low-fat fares (noted with an olive leaf), which range from 430 calories per serving (the Linguine alla marinara) to 840 calories (the Capallini Pomodoro).  But how many people come to the Olive Garden thinking, “tonight baby, I’m thinking light and low-fat.”  You go to the Olive Garden for pasta – hefty, filling, saucy, pasta.

I also noticed that it was not just the servings at the Olive Garden that were big – so were the customers.  In fact, Greg Critser, the noted science and medicine author of Fat Land, tells a story from the 1980s when an Olive Garden customer phoned Ron MaGrauder – the restaurant chain’s then president – to complain that he was too large to sit in the booth and seats at his local Olive Garden.  MaGruder responded as any responsible company president would – he order new over-sized seats so that each of the 256 Olive Garden restaurants in the United States could have three.  Customers get what they want.

And apparently, we want our food big, and our bodies big too.