You’re standing in the cereal aisle and faced with a difficult question – do you pick the package touting whole grains or the one with the “Sensible Solution” banner?  The one suggesting it’s a “Smart Choice” or displaying a “Smart Spot?”

Recently it seems that in an effort to make grocery shopping easier, a few too many cooks got into the kitchen and made a royal mess of it all.  The tricky part is that each of the aforementioned nutrition labeling systems, along with many others, has its own set of criteria.  They’re similar, yes, but none are perfect and they can certainly be a confusing eye-sore for those trying to get in and out of the store quickly. 

There is some good news.  The Food and Drug Administration, which regulates nutrition labeling, is working to update the famous (infamous for some) black and white Nutrition Facts Panel found on the majority of items in the grocery store.  Better yet, the FDA is planning to come down hard on the food companies that make their products look healthier than they actually are.  The FDA’s ultimate goal is to create a uniform labeling system and establish industry wide standards for  nutrition claims.  In the meantime, we’ll take a look at what’s out there today.

Nutrition labeling systems have actually been around since the mid-90s when the American Heart Association launched the Heart Check label to promote heart healthier food products.  PepsiCo and Kraft Foods followed about a decade later with their Smart Spot and Sensible Solution products respectively, which indicate “better for you” items.  Other large corporations followed suit with their own versions, and recently supermarket chains have launched their own campaigns, with their own criteria, with their own objectives of highlighting the best of the best when it comes to more waistline-friendly products.

The trouble is, we’re not comparing apples to orange, but rather Cocoa Krispies to…Fruit Loops.  

In an already overwhelming supermarket, the plethora of nutrition labeling separate from the FDA regulated Nutrition Facts Panel only makes matters worse.  So what should you do?  Keep in mind that each labeling system has its own standards for determining which products get stars or flags or thumbs up or what have you; each system also has slightly different priorities– heart healthy vs. low carb vs. low calorie vs. MUST SELL THIS.  Regardless of the standards used (some are published, but most are not) you need to keep the bigger picture in mind.  

For example, when shopping for cereal go with what you know -  a good source of fiber without lots of added sugars, and avoid the word “cookie or cocoa” in the title.  If you’re shopping for soda go with diet, if you want pasta look for whole grain, if you want something sweet focus more on portions sizes than anything else.  Get the chocolate cake if you crave it, but only eat a small slice or buy pre-portioned “diet” desserts if you don’t trust your will power. 

Most importantly, go in with a list, and come out with what was on your list.  Plan meals ahead to save money, time and calories.  Whenever possible, avoid the middle aisles.  Focus on the perimeter– dairy, meat, deli, and produce.  And when in doubt, keep Michael Pollan’s mantra in your head: “Eat food.  Not too much.  Mostly plants.”

Stay tuned next week for Part II where we’ll take an even closer look at label claims and % Daily Value. 

Tanya Zuckerbrot, MS, RD is a nutritionist and founder of www.Skinnyandthecity.com.    She is also the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

With concern over the H1N1 flu reaching an all-time high – Americans are scrambling to find ways to either prevent the virus, cure it if they get it or try to get out of getting the flu shot. And as a result, many people are turning to the Internet for help.

I have said it a thousand times and I’ll say it again: It’s not safe to buy medication over the Internet from sources that are not reputable!  There are thousands of medications available on the Web, and more and more companies are popping up each day offering fast access and delivery of both over-the-counter and prescription medications. We know the dangers associated with buying drugs online, but for some reason, people continue to do it!

In fact, it poses such a problem, that in the midst of the H1N1 flu pandemic and the hysteria it’s created, the FDA felt the need to warn consumers about purchasing products over the Internet that claim to diagnose, prevent, treat or cure the H1N1 flu virus. Trust me — nothing could be more dangerous than thinking that you can fight the H1N1 virus with unregulated medications available on the Web.

The FDA issued the warning after the agency purchased and analyzed several products online that were marketed as Tamiflu, which is an antiviral drug that slows the severity of the flu. After checking out the products, many of them were found to be unsafe.

Here is an excerpt taken directly from the FDA press release:

“One of the orders, which arrived in an unmarked envelope with a postmark from India, consisted of unlabeled, white tablets taped between two pieces of paper. When analyzed by the FDA, the tablets were found to contain talc and acetaminophen, but none of the active ingredient oseltamivir. The Web site disappeared shortly after the FDA placed the order. At the same time, the FDA also purchased four other products purported to diagnose, prevent, treat or cure the H1N1 influenza virus from other Web sites.”

The products that the FDA analyzed contained varying levels of oseltamivir, and were not approved in the U.S. And furthermore if you’re ordering medications from other countries, most of them will not even arrive in time to treat someone suffering from the H1N1 flu! It’s just not worth it, people! When you order medications that are not regulated, you’re putting yourself and/or your loved ones at risk for getting counterfeit or contaminated products, and the effects can be deadly.

So instead of logging onto the Internet the next time you need a prescription drug – pick up the phone and call your doctor. After all — that’s what we’re here for.

 Click here for more information from the FDA on how to protect yourself.

Recently, I attended a fundraiser for Sophie’s Voice Foundation, a charitable organization founded by actors Boris Kodjoe and Nicole Ari Parker in honor of their daughter, Sophie, who was diagnosed with spina bifida at birth. Spina Bifida is a neural tube defect that affects the development of the spinal cord in unborn infants. Each year, about 3,000 pregnancies are affected by these birth defects, and these children suffer from medical problems, psychosocial issues, learning disabilities, and multiple personal concerns including mobility, bowel and bladder control.

There is a silver lining here, however, with regards to nutrition intervention and prevention. Research has shown that the risk of having a baby with spina bifida can be reduced by up to 70 percent with 400 mcg of folic acid taken daily three months prior to conception and in the first three months of pregnancy. Click here for more research. 

Folic acid is a B vitamin, which our bodies need to make new cells and therefore, is especially important in vitro. The Centers for Disease Control and Prevention recommends that all women of childbearing age who are capable of becoming pregnant get enough of this essential B vitamin daily. Pregnancy isn’t always planned or controlled and therefore, if you are a woman in that age bracket, it is important to heed this advice.

Once pregnant, the FDA recommends you boost your intake to 600 mcg/day and although there’s no toxic level, the FDA advises you keep folic acid consumption to 1000 mcg/day. Here are three ways to ensure you are getting enough in your diet:

1. Have a bowl of folic acid-fortified cereal every morning. The FDA requires that folic acid be added to specific flours, breads and other grains.  Check the label to make sure it is fortified. It might be listed as folate, the natural form of this B vitamin but the amount, 400 mcg, which is usually added remains the same.

2. Take a vitamin. Most multivitamins sold in the United States contain the 400 mcg of folic acid recommended. If you are pregnant, your doctor should prescribe a prenatal vitamin, which also contains at least this amount.

3. Eat a diet rich in folate. In addition to the above, eating a diet rich in folate is not only beneficial for your unborn child but includes foods for overall heart health and disease prevention!

Food Source                                      Folate (mcg)*
Chickpeas, ½ cup                           141
Spinach – cooked, ½ cup              131
Kidney beans, ½ cup                      115
Orange juice, 1 cup                           74
Broccoli – cooked, ½ cup                 84
Green peas, ½ cup                            50
Orange, medium                                39
Strawberries, 1 cup                            35
Romaine lettuce, ½ cup                     32

*Source: USDA National Nutrient Database for Standard Reference

Check out the Sophie’s Voice Foundation Web site for more information on spina bifida, family outreach programs, prenatal education, surgical options, and how you can get involved!

Tanya Zuckerbrot, MS, RD is a nutritionist and founder of www.Skinnyandthecity.com.  She is also the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

Nestle USA is voluntarily recalling all of their Toll House refrigerated cookie dough products today after reports of a possible E. coli outbreak linked to the ingestion of raw cookie dough. The FDA and the CDC are investigating reports of 66 cases of illness across 28 states related to these Toll House products. Now, I’m sure we’ve all indulged in a handful of raw cookie dough at one point or another, but this recall is just another reminder (aside from the WARNING printed on the label) — that it’s not safe to eat until it’s heated!

Because of the popularity of these products, we’ve been getting a lot of questions about E. coli, its symptoms and how to prevent infection. Here’s a quick Q&A to help clear things up for you.

What is E. coli?
E. coli is a kind of bacterium called Escherichia coli that lives in the digestive tracts of animals and humans. There are many different strains of E. coli bacteria, and for the most part, many of them are harmless. But some strains can cause extreme abdominal discomfort, diarrhea, bloody stools and vomiting — while others strains can lead to urinary tract infections, respiratory illnesses, anemia, kidney failure and even death.

Where does it come from?
Contaminated food:
The most common way people in the U.S. become infected with E. coli is from eating contaminated food. In fact, the CDC estimates that 85 percent of E. coli infections come from ingesting infected food or water. Because E. coli bacteria live in the intestines of healthy animals, like cows, it is possible for processed meats to become contaminated. If the contaminated meat is not heated to 160°F during preparation, the bacteria can survive and infect you when you eat it.
Raw foods can also carry E. coli. It’s important to check the labels and make sure that all your dairy products are pasteurized, or heated to kill off bacteria before hitting the store shelves. Raw fruits and vegetables can become contaminated if they come in contact with manure or animal feces.

Contaminated water:
While not as common as foodborne E. coli infections, people can also become ill from drinking or ingesting contaminated water that has not been properly treated. And sometimes, accidentally swallowing lake or pool water that has come in contact with human or animal feces can put you at risk for becoming infected with E. coli.

Person-to-person:
E. coli can also be spread from person-to-person if someone does not wash their hands thoroughly after a bowel movement. This is not as common, but it’s especially important for people who work in the restaurant/food preparation industry because they can spread the bacteria from their hands to other objects — including your dinner! I know it’s not a nice thought, but it happens more often than you think, so it sounds simple, but washing your hands is one of the easiest ways to prevent all kinds of infections.

What are the symptoms?
Symptoms usually start 3-4 days after exposure to the bacteria and can include:

• Stomach cramps
• Diarrhea
• Bloody stools
• Nausea
• Vomiting
• Mild fever
• Dehydration

Who is at risk?
People of all ages can become infected with E. coli, but the risk for serious complications is higher for young children, the elderly and those with compromised immune systems or underlying health problems.

How is it treated?
E. coli infections will usually clear on their own in about a week in a healthy person and treatment involves resting and staying hydrated. Often, people just assume they have a stomach bug and don’t go to the doctor, so they don’t know that E. coli caused their illness, but a simple stool test can diagnose the condition. As a rule of thumb, you should contact your physician any time there is blood in your stool.

• How can E. coli infection be prevented?
  Wash your hands thoroughly after using the bathroom and before preparing or eating food;
• Cook meats thoroughly at a temperature of at least 160°F/70°C (use a thermometer to test the meat if you’re not sure);
• Do not drink raw milk, unpasteurized dairy products, and unpasteurized juices (like fresh apple cider);
• Avoid swallowing water when swimming or playing in lakes, ponds, streams or swimming pools;
• When traveling abroad to countries that may have unsafe drinking water, don’t drink tap water or get ice in your drinks. Also, avoid raw fruits and vegetables, except those with skin that you can peel yourself;
• Wash your hands often, and always wash them after you use the bathroom or change diapers — it’s the best way to prevent infection with any bacteria.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

The Food and Drug Administration, which has received criticism in the past for allowing risky devices like electronic muscle stimulators to go into the stores uncontested, has just given its approval for Palomar Medical Technologies to go over-the-counter with its light-based LED laser. This new toy uses a light-emitting diode to supposedly stimulate normal skin growth and reduce wrinkles.

I spoke to three top dermatologists at NYU Langone Medical Center — which has one of the top dermatology programs in the world — and all three said the same thing. They said the laser was most likely quite safe, and it’s very unlikely it will damage the eye — but it is not likely to be effective, is expensive, and may only remove the tiniest wrinkles with prolonged use 20 to 30 minutes, twice a day. So in evaluating the FDA’s performance here, score one for safety, but zero for effectiveness and cost. And don’t expect National Health Insurance to cover the cost of this one.

If you really want to help your skin and decrease your chance of wrinkles, then use sunscreen, eat and sleep properly, exercise and don’t smoke.

Dermatologists are now using new kinds of lasers to remove wrinkles, known as fractionated CO2. These are VERY effective, but can only be done by highly-trained doctors.

If you are serious about your wrinkles, (or have to appear on High Definition TV) see your dermatologist. Do-it-yourself lasers that are now being marketed for home use may be used for attacking the tiniest wrinkles, but should not be a primary treatment. The FDA needs to crack down on the devices they approve. This one is okay, except that it is expensive (several hundred dollars) and largely placebo.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.”  Read more at www.doctorsiegel.com

In today’s world, there are so many ways to fight the lines of time. But by far, one of the most popular is Botox.

Botox is basically a neurotoxic protein produced by the bacterium Clostridium Botulinum.  It was originally used to treat muscle spasms — but in 1997 it earned FDA approval for cosmetic treatment.  The American Society of Plastic Surgeons (ASPS) reported that there were more than 2.8 million procedures performed with Botox in 2008.  (Just more proof about how wildly popular this anti-wrinkle treatment is.)

A Botox Cosmetic injection can do a few things. It can help soften the overall look of your face and reduce the animation in some of the muscles in the upper part of the face. (This results in a younger, more youthful appearance.) It can also treat facial lines caused by repetitive muscle movement, which we frequently do in my practice. We also use Botox to help prevent new lines from forming. Common injection sites for erasing wrinkles and lines include:

• Glabella (region between eyebrows)
• Forehead
• Outer corners of eyes (crow’s feet)
• Either side of mid-chin, for down-turned mouth
• Neck, for neck bands or visible chords

We also use Botox to treat:

• Facial asymmetry or other facial conditions that result from muscle action; this is called “facial shaping”
• Hyperhidrosis (excessive perspiration); common injection sites are underarms, palms, scalp and soles of feet

Remember — An experienced injector makes all the difference

Today, people often take the wrong shortcuts when seeking facial rejuvenation with Botox and other injectables. If the injector administers too little Botox Cosmetic, the results will not be fully visible. However if the injector injects too much, the appearance can be a frozen or stunned look. On occasion there may be some unevenness, meaning that one brow is higher or lower than the other. This is easily corrected with a touch-up or the patient can wait for the toxin to lose its effect. Usually the patient will look better within a few weeks.

Keys to successful Botox Cosmetic treatment include going to a doctor that injects regularly.  Also, it is important to articulate to the physician your exact goals. For example, if you want your eyes to be more open, to look less tired or to raise your brows, be specific. It is always my advice to seek a more natural look and have some animation.

Alternatives?

In the battle against aging, there are several alternatives to Botox Cosmetic.  One such option is GFX, a radiofrequency procedure that lasts approximately 1 year or more. This is due to ablation of the nerves which cause muscular contraction of the glabella — more commonly known as the region between the eyebrows.  Other options include Reloxin and Puretox — neither of which is FDA approved.

http://www.fda.gov/WOMENS/getthefacts/botox.html

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Flip through any fashion magazine and you’ll see models donning long, dark, full eye lashes. So, how can ordinary women get the same glamorous look?

Well, there are always reusable false eyelashes, layers of thick mascara or a trip to the salon for individual lash extensions.  But, these are temporary solutions, which may come with some risk.

With the application of false eyelashes, patients often come in to my practice with complications.  They may have an allergic reaction to the glue, an eye infection due to reusing strips of false lashes, or skin allergies from the false lashes, which can collect and accumulate dust and germs. 

At the other extreme, we also help patients who come in because they have cut their own lashes in an effort make the false lashes look better.  Patients ask us if natural lashes grow back after they’ve been plucked or cut.  Sometimes they do – and sometimes they don’t.

The good news is — these ‘long lash’ problems could become a thing of the past with the help of a new treatment. In December 2008, Allergan, Inc., the company behind Botox, announced FDA approval for LATISSE™, a new treatment for growing longer lashes. Today, with help from a doctor with prescribing rights, consumers may be able to grow long, striking lashes. 

Latisse is a product with the same formula as a solution used to treat glaucoma patients.  A side effect of the treatment is that it tends to make the lashes longer and fuller.  Some experts are already worried about the side effects of Latisse which may include: red, itchy eyes and changes in eye pigmentation (especially on lighter eyes). 

However with that said, many women are overjoyed by its arrival and hope to lose dependency on other temporary eyelash solutions. 

So far, my patients are seeing very positive results from the use of this new product.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

Hey, guess what? You have probably been eating foods colored by ground-up insects for quite sometime now.  I’m sure you did not know this. Carmine (a red food coloring made from beetles) has been used as a coloring agent in many foods from yogurt, ice cream, juices, candies, and even in cosmetics. 

University of Michigan allergist Dr. James L. Baldwin reported a number of patients with an apparent life-threatening allergic reaction to the insect-based food coloring.  Cases of asthma and hives and even anaphylactic shock, have been described. The carmine food dye may be a risk for those individuals that are sensitive or allergic to the ground-up insects. 

The NY Times reported a recent rule change at the Food and Drug Administration (FDA) that will mandate food manufacturers list carmine on a food label.  At present, the FDA does not require the components of food coloring agents to be named on a label. 

Natural food colorings can be added to foods and this new rule change is set to begin in 2011 (although food companies may voluntarily list the components of natural food coloring agents sooner).  It is highly likely that ingesting natural food dyes won’t cause any particular health problem, however if you experience an allergic reaction after ingesting a food product with carmine food dye, it may be something to discuss with a food-allergy savvy allergist.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

This past Friday, FDA officials stated that less than 1 part per million of the industrial chemical melamine found in infant baby formula is safe. This announcement came after trace amounts of the industrial chemical were found in U.S. formula, and it came two months after 50,000 infants were sickened in China from large amounts of it being put directly into milk. 

The FDA had previously not set a safety limit.                                

Doing so now, with no recent research to back this conclusion, makes no sense.

While I don’t think the amounts found in the U.S. should be sufficient to scare mothers away from formula (esp. those who aren’t able to breast feed), I am very concerned about the FDA’s continued inability to properly police our food. Also, the precedent of allowing ANY amount of this chemical to reside in our food is wrong.

- What is melamine? Melamine is a white powder used in plastic-making. It was first synthesized by a German scientist in the 1830s. Its most common form is melamine resine, a mix with formaldehyde, where it used in the manufacture of formica, floor tiles, whiteboards, and kitchenware. Adding melmine to watered-down milk makes its protein level appear higher because it is high in nitrogen. Criminal merchants use this process to fool inspectors.

- Why the concern? Melamine can be harmful. Since it was discovered in infant formula in September in Asia, more than 50,000 infants have been sickened and 4 have died. It has been tested in animals in small amounts and found not to be toxic. But in high amounts it can be toxic to the kidneys and urinary tract, causing  stones and blocking ducts, manifesting with bloody urine, especially when it mixes with another cheaper chemical, cyanuric acid. Cyanuric acid (a chemical stabilizer in swimming pools) is also used to falsely raise protein content in milk and infant formula, to make them look protein rich.

- Should parents be alarmed? Parents should always be cautious, but the chances of currently available formula causing a problem in your infants is very low.

- What should the FDA do? The melamine problem is a wake-up call to the FDA to set more precise standards and to back them up with increased regulation of products, esp. those coming into the U.S. from other countries. With our current economic troubles, it would be nice to see domestic production favored, especially when the chances of a toxic chemical originating here and going undetected is far less likely. The melamine-contaminated infant formula now found in the U.S. likely originates from a powdered milk ingredient from Asia.

- Is the FDA effective? Keep in mind that there is no real purpose whatsoever to have melamine in food except to fool inspectors. The FDA has been inconsistent and ineffective on melamine risk. The agency needs more teeth – more regulatory power and a larger staff to implement it.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News Medical Contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: the Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic”. Read more at www.doctorsiegel.com

With Halloween approaching, kids will soon be considering bright orange cupcakes and otherworldly candy. Though I am all for limiting artificial ingredients in favor of more natural dyes from carrots and beets, at the same time, it is difficult to prove that artificial colors are unsafe.
   
Many studies have been done which have NOT shown an association between food dyes and hyperactivity in children. The FDA has previously stated that these dyes are safe based on a 1980s report. A 2004 study from Schwab at Columbia reviewed available data and concluded that neurobehavioral changes may be due to artificial food colors. BUT a clever 2004 study in the American Family Physician showed that parents perceived a difference in behavior after kids tasted artificially flavored beverages, whereas independent observers did not. So it appears that the parents were either not trained to judge hyperactive behavior, or possibly biased.

A year ago the flood gates opened when the reputable British Journal Lancet published a study which looked at 153 3-year olds and 144 9-year olds and game them drinks containing either artificial colors or placebo.  They were then assessed by parents in terms of concentration, fidgeting, and restlessness. After this study came out, the UK Food Standards Agency asked manufacturers to pull the synthetic colors involved in the study. Here in the U.S., the Center for Science in the Public Interest is now petitioning the FDA to demand that 8 synthetic blues, yellows, greens, reds, and oranges be removed from the market. Yet the current evidence would still appear to be flimsy at best.

BOTTOM LINE: To draw a conclusion on this seemingly conflicting information, I turned to director of the NYU Child Study Center and world expert in Attention Deficit Hyperactivity Disorder, Dr. Harold Koplewicz. “There have been multiple studies,” he said. “There is no evidence that the artificial colors effect children.”

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News Medical Contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: the Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic”. Read more at www.doctorsiegel.com