Away From the Bench

The world outside of the lab

Archive for the tag “Obesity”

Five Chins

I first heard about Five Guys on NBC’s Inside the Obama White House a few years ago, in which Obama went there and picked up lunch for his staff.  I’m sure that happens all the time (ha).  It was apparently one of Obama’s favorite places to eat.  Soon after that special, I noticed Five Guys restaurants started springing up around town.  One came into our neighborhood recently, so my husband suggested we walk up the street (about a half mile) and try it out a couple of nights ago.  Boy, I’m glad we walked there.

The staff was friendly and loud, and yelled a kind of a statement-and-respond thing.  When you walked in the door, the counter guy would say, “Two in the door” and the response from the cooks was, “Got it”.  There were no descriptions on the menu, but I decided a burger was fairly straightforward.  I ordered the cheeseburger and was happy with all of the available veggies to add for free: lettuce, tomato, mushrooms, pickles, onions, and green peppers.  Then the counter guy asked if we wanted to split a fry – a regular fry, not a large.  I thought – wow, this guy isn’t trying to upsell us and I actually don’t need a lot of fries with this burger anyway.  I was wrong.  The fries came out in a cup, which was a large amount of fries, but then the whole bottom of the paper bag was covered in fries too.  It was enough fries for 4 people.  AND the cheeseburger was a double patty and double cheese sandwich.  I looked at the menu and saw they had a “little cheeseburger” which apparently means “normal size”.  So after we ate most of our burgers and only half of the fries between the two of us, we walked rolled home and I decided to look up the nutrition facts online.

I was pretty shocked.  The cheeseburger has 840 calories (500 of those from fat) and 55 g of fat (26.5 g of those are saturated).  I was actually grossed out by reading these numbers.  The most surprising part?  The fries are listed as “regular” and “large”.  The nutritional information actually states, “one serving of fries (approx. half of regular order)”.  I could not believe that they do not sell individual servings of french fries.  They don’t even offer it.  Everything was super-sized there, and it didn’t need to be.  I’m not sure how many people could even eat all of the food presumed for one person there.  I’m guessing there is a lot of food wasted at that restaurant.

They did have a Coca-Cola Freestyle machine, which was fun.  It is a machine that you can use to mix in flavors with your soda or water.  There are apparently 127 different combinations possible between the base flavors and the mix-ins (orange, cherry, lime, raspberry, lemon, strawberry, grape, peach).  This is a good marketing strategy for Coca-Cola and making Coke “new” without having to make New Coke (remember that?).  I was wondering if the raspberry Coke Zero we shared (which was pretty tasty) was still calorie-free.  Five Guys didn’t have nutritional info online for any drinks, but I did find that info elsewhere and was happy to see that all of the mix-ins were zero calories, or 5-10 calories if you drank 20 oz. of the stuff.

That said, I will probably not go back there again.  Other fast food restaurants have burgers and fries that are not healthy, but still contain less fat and calories than Five Guys.  I don’t want to support restaurants that contribute to the obesity problem in America without giving people a choice to enjoy food that is properly portioned.  When my husband wants to go there again (I know he will), I’ll suggest we go to the cafe next door that just opened and was handing out flyers when we walked by.  There’s no way their Thai veggie wrap has the majority of my day’s worth of calories and fat, but it’s probably just as tasty.

Eat Your Nerd Grenades

There is an obesity problem in America.  Educating children about eating a balanced diet is the most important thing we can do to prevent further increases in obesity.  As a child, I had to stay at the dinner table until I ate all my vegetables.  I remember one time that I sat at the kitchen table at least an hour after dinner was over, pouting over my turned-cold broccoli.  I eventually choked it down.  I learned that it’s important to eat a balanced diet, and now I choose to eat my broccoli.  Thanks Mom and Dad.  If children eat fresh fruits and vegetables from an early age, they will actually like to eat some of them.  Just ask my 7-year-old niece and 5-year-old nephew if they like beets and brussel sprouts.  (They do).  Any headway made on reducing childhood obesity depends on parents taking responsibility for their children’s diet and educating them about it.

Courtesy of eatnearrockford.blogspot.com

Several studies based on exposing children to healthy foods by their parents increase children’s acceptance of that food.   Giving a bite of vegetable to a child every day for 2 weeks exposes them to that food and increases the consumption and likability of that food.  Dr. Lucy Cooke of the University College of London recently demonstrated that exposure to a healthy food followed by a tangible reward of a sticker increased their intake and liking of that food as well.  (Not to brag, but I had a pretty big sticker box as a kid – and I never got any for eating vegetables!)  There has been a lot of media coverage lately on a study claiming that children’s food choices were affected when silly names were associated with vegetables. Although the authors conclude that the silly names increased vegetable intake, I don’t think the experiment was well-controlled.  The baseline vegetable consumption of the control group before the intervention was 1.8-23.5-fold higher than that of the treatment group, depending on the vegetable.  That means, the children who were served the silly-named vegetables were eating a lot less vegetables at the beginning of the study (and intake at the end of the study was still less, for 3-out-of-4 vegetables, in the treatment group than the control group without the silly names).  For example, if Paul in the control group ate 4 carrots at the beginning of the study, and he ate 5 carrots at the end, that would be a 1.25-fold increase.  If Sally ate 1 carrot at the beginning of the study, and then they called carrots “X-ray Vision Carrots” and she ate 3 carrots, that’s a 3-fold increase.  Look what happened when you gave carrots a silly name!  You just can’t compare these groups well with the simple statistics they used.  Perhaps these conclusions were made because the people who performed the study were marketing guys (and I believe, marketed loose data to the public).  Nevertheless, children are influenced to some extent by marketing, but they are influenced more by what those around them (parents and peers) are doing.  It’s the parents’ responsibility to make sure their children are eating a healthy diet.

Along the same lines, there is an uproar over the new government regulations for subsidized school lunches.  I found the clip below from The Daily Show to be humorous (and fairly accurate) – it spawned this post (and the title).  Children need to learn to eat healthier, but if parents and schools don’t teach them that, then the obesity rate will keep on rising.  Advice to children in the immortal words of John Stewart: Eat your motherf*cking lunch.

McCalories

The next time you go to McDonald’s, don’t just automatically order your #4 Extra Value Meal, take a look at the menu board.  McDonald’s just announced they will post the calories on all of their in-store and drive-thru menus this month.

I think this is a step towards educating the general consumer.  Some people who go to McDonald’s frequently may not care about this information, but for people who go to McDonald’s when they just don’t have time or are on the road and want to make smarter choices, this will be a welcome change.  In July, McDonald’s began their Favorites Under 400 Calories program, which lists menu items in 100-calorie sections.  This is a great way to attract attention to healthier options, even though some of those items are fairly small and would need other items to make a filling meal (looking at you, side salad without dressing).

For any restaurant, having nutrition information available online is necessary to make better choices (especially for people with diabetes or food allergies), but having nutrition information quickly available when you order is even better.  However, calories are not everything.  Maybe you want a cheeseburger but think to yourself, “I should really just get a salad and be healthier”.  You look at the menu board and see that a cheeseburger is 300 calories (12 grams of fat) and a Southwest salad with grilled chicken and Southwest dressing is 390 calories (14 grams of fat).  The salad may have more calories, but when other nutrient data is factored in, the salad is actually healthier with more fiber and vitamins and less saturated fat.  It might even satiate your appetite longer than the cheeseburger, which could lower your total daily calorie intake.  Even so, the calorie information on the board will probably be more useful to people who usually get a large Extra Value Meal and are shocked by how many calories they are actually eating and cause them to order something less calorie-laden.  And for this reason, I support the calorie information on the menu.

All of this, of course, comes four years after New York City required restaurants (or, technically, food service establishments) to post calories on their menu boards.  Studies (based on surveys) suggest reduced calorie choices were made at some establishments (McDonald’s, KFC, Au Bon Pain) but not others (Subway) after this law was enacted.  In one study, only a subset of people who were surveyed (15%) knowingly made lower calorie choices after calories were posted on the menu.  Socioeconomic factors seem to have a large impact on menu choices and calorie-posting did not seem to affect a majority of adolescents.  However, these studies must be looked at with caution, because they do not consider food choices in the same people before and after the calorie-posting.  When a regression model was used to control for restaurant chain, store location, sex of customers, type of purchase, and inflation-adjusted cost, there was a statistically significant decrease in average calories before and after the regulations, which was masked when all the data was pooled together.  In addition, some people may have stopped patronizing certain restaurants altogether after the calorie regulations but these surveys don’t control for that type of information.

But hey, even if posting calories on the menu only affects 15% of consumers (although I think more-controlled studies would show a higher percentage), that is still 15% of consumers making healthier food choices when eating away from home.  So thank you McDonald’s, for at least attempting to assist customers nationwide in making healthier decisions.  The fast-food chain’s 2012 nutrition progress report also introduces their plan to include more fruits and vegetables on their menu; reduce sodium across the board; and reformulate some items to reduce sugar, saturated fat, and calories.  And don’t worry, a packet of low-fat balsamic vinaigrette is only 35 calories…and you probably wouldn’t use the whole thing on your side salad anyway.  Morgan Spurlock would be proud.

Courtesy of McDonalds USA

Shape-ups Ship Out

News broke yesterday about Sketchers settling charges against them from the Federal Trade Commission (FTC) for $40 million.  The FTC claims the company “deceived consumers  by making unfounded claims that Shape-ups would help people lose weight, and strengthen and tone their buttocks, legs and abdominal muscles”.

Now, if you’ve ever seen Shape-ups shoes, you might think they would look good with a nice pair of slacks (I’m using slacks as an out-dated term from the 80’s).  I personally would never buy shoes that look like that even if the company claimed it would tone 100 different muscles, and I wear athletic-looking shoes (I even have a different pair of Sketchers!) almost every day.  I apologize to any of my friends or family who bought these shoes (Amy) but they just didn’t do it for me.

Aesthetics aside, Sketchers made false claims about Shape-ups, Resistance Runner, Toners, and Tone-ups shoes.  Just the names are enough to get a person excited (good marketing!), but telling consumers they will perform miracles such as losing weight (without changing your lifestyle) and falsifying clinical study data is just stupid.  Great marketing always puts a shine on products, but you still “can’t polish a turd”.  (No matter what the Mythbusters say).

There will never be a miracle pill (or shoe) that will make you lose weight, get in shape, and tone your muscles without any effort from you.  The human body is an amazing organism and if you treat yours right, it will reward you.  There are so many complicated systems at work inside your body that scientists working on a ‘miracle weight loss pill’ are discovering that there may not be such a thing.  I think the best story about finding an ‘obesity cure’ begins back in the 1950’s.  A company that breeds new animal strains for scientific research, Jackson Laboratories, discovered a strain of mice that was constantly feeding, lethargic, and obese.  These mice could not get enough food and would eat until they couldn’t move.  (The blob on the right is one of those mice).

Leibel, RL (2008) International Journal of Obesity, 32:S98–S108.

When molecular biology and DNA genotyping finally caught up in the mid-1990’s, Dr. Jeffrey Friedman, Dr. Rudy Leibel, and their colleagues discovered that this mouse strain, named ob/ob (due to its obesity) had a mutation in a hormone called leptin.  They gave these obese mice leptin, and amazingly they stopped constantly eating and lost weight.  The miracle drug was found!  Even the name leptin was derived from the Greek word leptós, or thin.  Clinical leptin trials began…and ended…because people were not losing weight.  The problem was, most obese people are not obese because they have low levels of leptin.  Turns out, this hormone is made by your fat cells, or adipocytes.  The adipocytes secrete leptin into the blood stream, where it travels to your brain, finds the leptin receptors, and basically says, “hey, you, stop eating.”  So what do obese people have?  Lots and lots of leptin circulating in their blood from all of their adipocytes secreting the hormone.  Many obese people have leptin resistance, which means their brain cannot use the leptin signals they are receiving to tell you to stop eating.  So giving these people more leptin makes no difference.  This research did help some people who have similar mutations to the ob/ob mice or those that actually have a deficiency in leptin production.  However, for the majority of obese people, it could not help them.

The human body is great at adapting to its environment and working to survive.  If you help it along a little, you might be surprised at what it can do.  Don’t look for a magic pill or a magic shoe.  They just don’t exist.  So instead of buying these shoes and waiting for your calves to be toned while walking a block to your car, put on real sneakers and walk a little faster and a little farther, and then you may see some results.

How do you like them apples?

Creative Commons copyright msr via Flickr

An apple a day keeps the doctor away.  Remember the good ol’ days when maxims like this were all you needed to live a healthy and long life?  Now, the public is bombarded with confusing messages about their health every day.  The latest example is 60 Minutes report on “Toxic Sugar”.  I had several people ask me about this because they wanted to know my opinion – so here it is:  just because Dr. Sanjay Gupta says something does not mean it is true…or any one scientific study for that matter.  Dr. Richard Lustig has been in the limelight recently, as his idea to tax sugar was the basis for my Boston Sugar Party post.  Let’s look at the “facts” Lustig and others presented in the report:

“Sugar is toxic.”  Sugar itself is not toxic.  You actually need sugar to live.  Your brain needs 6 grams of glucose (a type of sugar) per hour to work properly.  In addition, when your muscles and other tissues cannot take up glucose to create energy, as in the case of type 1 diabetics, you will starve to death.  Think of it this way:  you need water to live, but if you drink massive amounts of water, you will die within hours.  If you drink massive amounts of sugary drinks, your pancreas will pump out more insulin to remove the sugar from the bloodstream, and after a while you might become obese, then you may become insulin resistant, some people might become diabetic, and only then will you cause major organ damage.  Considering the time it takes to kill you after overconsumption, water is more toxic than sugar.

“There is no foodstuff on the planet that has fructose that is poisonous.”  Lustig was trying to make the point that humans WANT to eat fructose because of evolution and we instinctively know it’s safe to eat.  I’d like to see his analysis of fructose content on holly berries, sweet peas, and the other poisonous foodstuffs listed by a poison control center in Philadelphia.

“We were born this way.”  He is obviously a Lady Gaga fan, promoting her song, “Born This Way”…ok, that’s untrue, just trying to add some levity here…he just states that we are born to love fructose.  Yes, we may enjoy eating fructose (it has the highest sweetness out of all of the natural sugars), but I still don’t buy the claim that we are prone to it because of evolution and poisonous things.

“Fructose causes heart disease and stroke.”  This is new research coming out of the Dr. Kimber Stanhope lab, and any new hypothesis must be thoroughly tested before it becomes consensus.  The amount of fructose consumed is astronomically high, at 25% of daily calories.  This is not too unusual for scientific studies trying to determine effects from diets, but not many people are actually drinking this many calories every day without any type of exercise.  She states there is are increases in LDL cholesterol and “other risk factors” for cardiovascular disease.  No mention of whether these increases are statistically significant or if sugar is ACTUALLY “just as bad for their hearts as their fatty cheeseburgers.”

“[In the 1970’s] a government commission mandated that we lower fat consumption to try to reduce heart disease.”  This is true, governmental attempts to lower fatty foods did not make us healthier.  Some foods were processed down until the fat was removed, but all the sugar, salt, and calories were still there, and usually some chemicals added in to replace the fat.  However, there was no real regulation of fatty foods and many ‘low-fat’ items on the shelf were always considered ‘diet foods’ that people did not eat consistently.  People still gravitate toward high-fat foods.  Sugar alone did not increase American adult obesity to 36%.  You can order a Double Quarter Pounder with Cheese from McDonald’s which has 740 calories, more than half of those calories coming from the 42 grams of fat.  But it only has 9 grams of sugar!  It won’t make you fat!  Again, this is just not true.  (Just to be fair to other fast food chains, an Extra-Crispy Chicken Breast at KFC will set you back 510 calories, 290 of those come from the 33 grams of fat…but only 1 gram of sugar!)  You need a well-rounded diet of protein, carbohydrate, and fat for your body to function properly.  Telling people that sugar is toxic creates the next “scare” that Lustig said happened with fat 40 years ago, and obesity rates will keep increasing.

“If you limit sugar, it decreases the chances of developing cancer.”  Dr. Lewis Cantley’s example that cancer cells have insulin receptors and will therefore take up excess glucose from the bloodstream and grow into tumors was probably the most shocking to me.  Insulin receptors bind insulin (which is secreted from your pancreas and into the bloodstream after every meal) and if cells have certain glucose transporters, insulin ‘tells’ those transporters to move from inside the cell to the cell surface.  This results in increased glucose entry into the cell.  Many cells in your body have insulin receptors such as muscle, liver, fat, and brain.  Muscle (skeletal and heart) and fat cells have the glucose transporters that are ‘activated’ by insulin.  There is no data that I am aware of which claims cancer cells can take up more glucose than any of the other cells in your body.  Also, insulin signaling (what happens inside the cell after insulin binds the insulin receptor), once activated, is eventually downregulated by a negative feedback system.  Insulin cannot just sit on an insulin receptor and hang out, causing cancer cells to keep sucking up the sugar, or blue dots, as the schematic on the television show would like you to believe.

“Every cell in our body needs glucose to survive, but the problem is, these cancer cells also use it to grow.”  Once again ALL CELLS that have the insulin receptor use glucose to grow.  Period.

“Sugar is much more addictive than we thought early on.”  These scientists seem very careful with their wording.  Dr. Eric Stice showed that dopamine was released in Gupta’s brain when he drank some soda.  Activation of taste receptors on your tongue cause dopamine to be released in the brain, no matter what the food.  If a person likes spinach, the same dopamine receptors will light up in MRI brainscans, especially if the person is hungry at the time.  Dopamine regulates feeding behavior, and not just for sugar.  Maybe sugar can be addictive, but so can so many other things (including suntanning, as I mentioned in my Tanners Anonymous post).  We can’t possibly regulate every choice people make.

As a scientist, I believe the scare tactics that Lustig is using are not within the ‘unwritten rule’ of putting the science first in research.  I am all for new ideas, but a scientist cannot go on national television to state untested claims as fact and contribute positively to the field of science. You’re probably thinking, “he must be a first-hand expert to make these claims on television, right?”  During my scan of his last 27 papers published in peer-reviewed journals since 2009, I calculated only five that were original work coming directly from his lab (where he was last author and they were not review articles).  These five papers had nothing to do with ‘toxic sugar’ and its effects on the human body.  The most recent concerns growth hormone deficiency in children after radiation treatment, and the other four are about the efficacy of lifestyle intervention (behavioral) programs in obese children.  In the other 22 papers, he either contributed to another lab’s work, or they were review or opinion articles on sugar, fast food, and obesity.  Something about this seems fishy to me, and it isn’t Friday.  You can’t be an objective scientist and (what seems to me)  to be striving for fame at the same time.  He wrote an article about ‘toxic sugar’ in the journal Nature a couple months ago, and that’s when the mainstream media started to interview him and publish articles on his opinions.  There are 5 other articles in subsequent issues of Nature that refute his claims.  Here are some quotes from these articles:

Our meta-analyses of controlled feeding trials indicate a net metabolic benefit, with no harmful effects, from fructose at a level of intake obtainable from fruit (Nature. 2012 Feb 23;482(7386):470).

To describe sugar as “toxic” is extreme, as is its ludicrous comparison with alcohol…Nutritionist Jennie Brand-Miller of the University of Sydney is not alone in her disgust that you published this opinion piece (The Australian, 4 February 2012). The Dietitians Association of Australia believes that it is simplistic and unhelpful to blame sugar alone for the obesity crisis. Alan Barclay of the Australian Diabetes Council notes in the same article in The Australian that sugar consumption in Australia has dropped by 23% since 1980. But he adds that during that time, the number of overweight or obese people has doubled, while diabetes has tripled (Nature. 2012 Feb 23;482(7386):470).

Overconsumption of foods that have a high glycaemic index (that trigger a rapid and sharp increase in blood glucose), such as wheat, potatoes and certain types of rice, also contributes to obesity and diabetes. Emphasis on sugar alone is therefore too narrow a basis for devising policies to curb these problems (Nature. 2012 Feb 23;482(7386):471).

Rather than demonizing sugar, the authors would have better served public health with recommendations to manage a balanced diet with exercise (Nature. 2012 Feb 23;482(7386):471).

The Food and Agriculture Organization of the United Nations, the US Food and Nutrition Board, and the European Food Standards Authority have all considered the issues now revisited by Lustig et al. and find no reliable evidence that typical sugar consumption contributes to any disease apart from dental caries. Without evidence that reducing sugar consumption would improve public health, Lustig and colleagues’ policy proposals are irrelevant. Scientific controversies should be settled by consideration of all the available evidence, not of a seemingly biased selection (Nature. 2012 Mar 8;483(7388):158).

I appreciate the attention the ‘Western Diet’ is getting (the diet high in refined grains, sugar, fat, and red meat), as there are major problems with it that lead to obesity and diabetes, but presenting hypotheses as fact to scare the public is not the way to do it.  This is how fad diets are created and may cause people more harm than good.  Educating the public with real information and making it easier for them to make good dietary choices is the best way to battle the bulge.  I say, it probably is best if you don’t drink sugary drinks everyday, but having one every once in a while will not kill you.  And enjoy that apple.

Through the Magic of Television

I’m guessing no one could have read the news a few weeks ago without glancing upon Paula Deen’s announcement that she now has Type 2 diabetes.  I’m not sure why this was such big news, other than she was making it that way for personal profit.

I understand that celebrities have avenues such as advertising to use their fame for a paycheck and professional gain.  I have a problem with her shilling for a drug company, for a treatment of a disease that she has, yet she contributes to that disease with her work.  I recognize branding and her desire to not hurt her career, but she got herself into this conundrum.  She could have kept her health issues out of the public eye (as she has for the past three years since her diagnosis) and kept her brand alive, or even *gasp* slowly change her brand to a healthier one?!?  However, her choice to get paid by a drug company AND tell the world:

You know, people see me on TV two or three times a day and they see me cooking all these wonderfully Southern, fattening dishes. That’s only 30 days out of 365.  And it’s for entertainment. And people have to be responsible. Like I told Oprah a few years ago, honey, I’m your cook, not your doctor. You are going to have to be responsible for yourself.

Her saying, “I have always encouraged moderation” of unhealthy foods hurts many more people than her recipes ever did.  A healthy diet and exercise can alleviate the symptoms of many cases of Type 2 diabetes, and there is currently no drug on the market that cures this disease.  Of course moderation is key to a healthy lifestyle, but moderation is not the technique people use to top 300 pounds.  People need tools other than pure self-control when they are making lifestyle changes.  If you are going to publicly promote diabetes awareness and treatment, you cannot tell them you’re not their doctor, so don’t listen to what you have to say and watch what you do on your cooking show every week.

I’ve seen The Next Food Network Star and I know you are never supposed to say, “Through the magic of television I have this baked Alaska right here.”  However, I feel as though that’s exactly what Paula Deen has done.  She is basically saying, “Through the magic of this one drug for diabetes, you can eat whatever you want and there will be no dire consequences.”  Did Tracy Morgan send out a press release when he was diagnosed with diabetes?  He lost a kidney because of this disease, even after he lost weight and tried to control his blood sugar better.  Perhaps stories like his should be front-page news as a warning to those who do not manage their diabetes properly and eat all the gooey butter cake that Paula Deen teaches them how to make.

Copyright pauladeen.com

Boston Sugar Party

As a diabetes researcher, I’m well aware of the atrocities that high sugar and fat consumption wreak on the body.  We have an obesity and Type 2 Diabetes problem in this country, there’s no denying that – have you seen the CDC heat maps over the past four years?  Yet, I disagree with those in the field that are calling for a tax on sugar.  Setting age limits and taxes on sugar and sugary foods will not protect Americans from obesity and diabetes.  Have age restrictions and excise taxes on alcohol decreased the number of alcoholics in this country?

First of all, the government is currently keeping production and importation of sugar high.  Domestically, farmers get subsidized for corn production, a portion of which is processed into high fructose corn syrup (although much of it can be used for other things such as ethanol…and…corn).  Internationally, sugar is imported from other countries tax-free.  The U.S. Sugar Program Fact Sheet, yes there is such a thing, states, “Sugars that receive preferential tariff treatment under free trade agreements such as the North American Free Trade Agreement (NAFTA), the Central American/Dominican Republic Free Trade Agreement (CAFTA/DR), the Caribbean Basin Economic Recovery Act, the Andean Trade Preference Act, or the U.S. Generalized System of Preferences enter at a zero duty.”  That’s nada, nothing, zilch, zip, in other words, no tax on imported sugar.  If the government were to institute a substantial consumer tax, that would theoretically decrease demand and keep supply high with subsidies and tax-free trade.  This would not be a logical step for the government nor towards reducing America’s dependence on sugar.

You also have to think about consumer habits.  People pay for Starbucks coffee because they enjoy it, they know the quality and consistency of the product, and they can buy it practically anywhere.  People buy Ding Dongs for the same reasons.  They will not change their lifestyle because they have to pay a few cents more.

I do applaud the idea behind encouraging people to eat healthier, but there needs to be proactive changes in communities and families, such as increasing access to healthier food and ease of preparing it, rather than government restriction of unhealthy food.

I know the Boston Tea Party was mainly about taxation without representation, but I can still imagine all the marine life that would die of hyperglycemic complications when all that sugar gets dumped into Boston Harbor in protest of high sugar taxes.

Creative Commons copyright bee wolf ray

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