Tuesday, July 31, 2012

Food Prices Poised to Increase

This summer’s lingering drought—the worst in at least 50 years, with over 1,000 counties in 26 states currently qualifying for disaster relief—will inevitably cause a spike in food prices. As reported by The Wall Street Journal, corn is now 22% more expensive than at the beginning of the year, and soybeans are up 32% (see in “For Food, It’s the Bad and the Ugly”).
The World Bank also reports that wheat prices have spiked considerably—up 50% since mid-June (see “Food Price Volatility a Growing Concern, World Bank Stands Ready to Respond”).

After a period of high food prices, consumers initially got a bit of a break this year. And as the WSJ article notes, consumers haven’t yet felt the effects of this summer’s drought-induced price hike—but they will soon, first in meat prices, with packaged and processed foods taking a hit in 10 months to a year (see WSJ, MarketWatch, “Why the Fed Will Look Past Rising Food Prices”). Once that impact hits and major food manufacturers are subsequently forced to raise prices, analysts predict consumers will reduce total food expenditures while taking a renewed look at private-label products. Reduced overall spending could impact the overall economy, forcing the Federal Reserve to potentially take stimulation measures it when it meets tomorrow and Wednesday; some analysts feel that the current commodity situation will not factor into the Fed’s current thinking.
The World Bank has voiced its concern about this situation—and particularly how it might potentially impact the world’s economically disadvantaged population.

“When food prices rise sharply, families cope by pulling their kids out of school and eating cheaper, less-nutritious food, which can have catastrophic, lifelong effects on the social, physical and mental well-being of millions of young people,” said Jim Yong Kim, group president, World Bank. “The World Bank and our partners are monitoring this situation closely so we can help governments put policies in place to help people better cope.

“In the short term,” continued Kim, “measures such as school feeding programs, conditional cash transfers, and food-for-work programs can help to ease pressure on the poor. In the medium to long term, the world needs strong and stable policies and sustained investments in agriculture in poor countries. We cannot allow short-term food price spikes to have damaging long-term consequences for the world’s most poor and vulnerable.”

The World Bank reports that the impact of the U.S. drought on global markets has been exacerbated by weather-related conditions in other countries that have affected production, where a “feast or famine” polarity has emerged. Like the United States, wheat crops in Russia, Ukraine and Kazakhstan have been hit hard by a lack of rain. Europe has the opposite problem, where persistent rain is causing problems with the wheat crop. In India, monsoon rainfall is about 20% below the long-term annual average.

Friday, July 27, 2012

‘Cool Food for Kids’ Encourages Healthy Lifestyles

The National Frozen & Refrigerated Foods Association (NFRA) is gearing up for its annual Cool Foods For Kids promotion to educate millions of children and families about the many nutritious and convenient frozen and refrigerated food options. The educational outreach program takes place in October and encourages healthy lifestyles through responsible, balanced food choices, appropriate portion control, increased daily physical activity and more quality, family mealtime.

Educational curriculum specialists, Young Minds Inspired (YMI), have designed the Cool Food for Kids program and will distribute specialized curriculum materials emphasizing good nutrition and physical exercise to more than 20,000 schools nationwide. Teachers are given a lesson plan with several activities and an educational poster to get kids excited about planning healthy meals and active hobbies for their entire family.

The program will extend into the retail sector, attracting consumers with point-of-sale materials provided by NFRA and merchandising that showcases the complimentary elements of the campaign. Promotional highlights include a Ski or Sea Family Vacation Sweepstakes, the online Cool Food for Kids Café featuring kid-friendly recipes and games, Easy Home Meals on Facebook and Twitter and more. NFRA spokesperson, Mr. Food, will also be supporting the Cool Food for Kids healthy lifestyle messaging and will devote an entire show to the promotion in October.

The October Cool Food for Kids educational initiative is enhanced through NFRA’s partnership with the Healthy Weight Commitment Foundation (HWCF), a coalition of organizations fighting the growing obesity problem in America.

Tuesday, July 24, 2012

Doughnuts: the new cupcakes

The latest food craze sweeping the city is hitting the sweet spot. While cupcakes and macarons satisfy after-dinner cravings, bakers are discovering that the doughnut—a treat good from morning till night—can provide the most profit.

"I know people think it's just breakfast, but our business is throughout the whole day," said Mark Israel, owner of Doughnut Plant, which has a recently expanded headquarters on the Lower East Side, as well as a 17-month-old outpost in Chelsea and, coming soon, a site in the Grand Central Terminal neighborhood.

But these doughnuts are more sophisticated concoctions than the garden-variety glazed or cruller. They sell for up to $3.25 a pop. They come in a variety of shapes and exotic flavors, such as pistachio-encrusted with lemon curd or square peanut butter filled with banana cream. Local or organic ingredients are typically touted.

Bakers like Doughnut Plant, as well as Dough in Brooklyn's Bedford-Stuyvesant neighborhood, aren't the only ones taking advantage of the surge in popularity. So too are restaurants, such as Pies 'n' Thighs in Williamsburg, Brooklyn, and the Brindle Room in the East Village, which are boosting their breakfast business by piling on the fried dough.

"We saw we were selling out of all these flavors and realized there's a hole we can fill—no pun intended," said Sarah Sanneh, co-owner of Pies 'n' Thighs, a popular spot also known for its chicken biscuit sandwiches. "We just let our imaginations run wild."

The cost of making a doughnut is relatively low compared with other sweets—and profits are high. Experts say the core ingredients—mostly flour, water, sugar and salt—are relatively cheap, and production doesn't require a lot of heavy-duty equipment or skilled labor, leading to profits of 15% to 30% per doughnut. "They're not expensive to make and not hard to learn how to make; they can be created in great quantities; they have every opportunity to be a success," said Stephen Zagor, director of culinary management at the Institute of Culinary Education.

Of course, doughnut fads have cooled in the past. A decade ago, Krispy Kreme made headlines for its rapid expansion—and subsequent collapse as customers grew tired of its gooey wares. At one time, Krispy had nine Big Apple stores. Today it boasts only one.

Even Dunkin' Donuts, the largest New York City chain store, with 466 locations in the five boroughs, did not add any outposts last year after opening 37 in 2010, according to a study of local franchising trends by the Center for an Urban Future.

Monday, July 23, 2012

U.S. No. 1 Cheese Producer

The global cheese manufacturing sector is estimated to reach $55.3 billion in 2012, with the United States leading the market as the world's single-largest cheese producer, according to market researcher IBISWorld.
"The industry has benefited from robust global economic growth for much of the past five years, rising demand from the newly affluent economies of Southeast Asia and Latin America and clever product innovation," said IBISWorld industry analyst Naren Sivasailam. "This has been combined with falling supplies from dairy powerhouses, such as New Zealand and Australia, due to adverse climatic conditions and high feed costs."

The United States is the world's single largest cheese producer, followed by Germany, France and Italy. In the developing markets of India and China, cheese consumption has grown at a mid- to high double-digit rate due to increased urbanization, Westernized diets and rising incomes.

The global cheese manufacturing industry is characterized by a diverse range of participants, ranging from multinational giants as Kraft Foods and Fonterra to smaller dairy cooperatives and niche and artisanal producers. In the developed markets of Europe, North America and Australia, cheese production is largely a mature and saturated industry with limited growth opportunities for domestic manufacturers. The European market, for example, is highly fragmented with many small producers servicing niche domestic markets. In North America and Australia, the market is more concentrated with large multinationals and dairy cooperatives that produce the majority of the domestic cheese.

Over the next five years, industry prospects are expected to be relatively bright, driven largely by the forecast economic recovery, stability in dairy product prices and a resurgence in demand from the developing world. Product innovation in the form of functional and health-based cheese products is expected to generate renewed interest in the mature markets of North America, Oceania and the European Union.

Saturday, July 21, 2012

The Next Generation of Energy

This is not your teenage son’s energy drink. For anyone who still thinks that energy drinks still solely equate to skateboarder-style illustrated monster-sized cans of unidentifiably flavored and colored beverages loaded with sugar, it’s time to take a fresh look at this market and its great potential. And while some folks are experimenting with air shots and strips, the greatest long-term opportunities in energy likely still exist firmly in the beverage sector—but with a decidedly “natural” spirit (think whole-food ingredients, juices, tea, whole grains, etc.).

To begin with, Starbucks recently entered the retail energy drink market on a national level with its sparkling Refreshers line—and this is not an energy drink necessarily skewed toward the teen market. They combine juices with green coffee extract (made from unroasted coffee beans—an ingredient that is currently trending forward). The drinks—in raspberry-pomegranate, orange-melon and strawberry lemonade—also include ginseng. Two other flavors are solely in Starbucks stores: berry-hibiscus and lime.

Back in March of this year, Jamba Juice took control of its energy-based retail line from Nestlé USA (its previous formulation partner) and is expanding distribution of the drinks nationally. The “all natural” energy drinks differentiate themselves in the market by remaining very juice-centric. They contain 70% juice in three flavors, strawberry-banana, apple, and pomegranate-blueberry, and get their energy boost from caffeine. These products complement Jamba Juice’s other retail offerings, including smoothie kits and superfruit shots, as well as assorted food items. The company had previously only licensed out its retail offerings, but is now taking the reigns as it delves into more CPG development.

Although these canned beverages are available in retail outlets like convenience and grocery stores, they’re also for sale in the company’s foodservice chain locations. And analysts have pointed out that many fast-food consumers are also energy-drink consumers, suggesting that operators could capitalize on this market synergy by offering more energy drinks. When consumers of energy drinks were surveyed as to whether or not they would buy energy drinks in a quick-service restaurant environment, 81% responded positively.

Juice, as well as tea (tea sales are rising…), will continue to play a big role in the next generation of energy drinks. Green, unroasted coffee beans (with their chlorogenic acid content), a key ingredient in the Starbucks Refreshers line, are also worth looking into. Chlorogenic acid might have a positive impact on weight management, which would be beneficial in a line of energy drinks for women (not that men couldn’t benefit from weight-loss assistance, but it’s a harder sell…). And folks, including on Wall Street, are eating more chia (a hot ingredient all around…) for its energy benefits.

This leads to the need to expand the types of energy drinks available to target wide-ranging demographics. Aging consumers regularly cite a desire to have sufficient energy for the day’s activities. Through judicious ingredient selection—and sound marketing—you could quickly find a new audience for energy drinks there. With active men and women, sports nutrition would be a target (I’m waiting for the arrival of a whole-fruit banana-based sports energy shot after seeing the recent news on the benefits of that fruit…).
Energy drinks will continue to diversify over the long term—and specific groups of consumers are just waiting for a product that speaks to them to regularly get into their shopping carts.

Friday, July 20, 2012

Tiny Bubbles in My Food

Amid the negative reports and editorializing about the horror of Big Food and how everything we eat is likely to make us fat, unhappy or prone to develop 1,001 deadly diseases, it’s always nice to see a bit of food-science geekery pop up in the news. In this case, it’s the announcement by Nestlé that the company is using zero-gravity research to develop a better understanding of foam technology to better apply it to designing food and beverage products.

In a July press release, the company explained that scientists at the Research Center in Switzerland are working with the European Space Agency (ESA) on experiments designed using parabolic flights’ temporary lack of gravity to produce the “perfect bubble.” Why zero gravity? It turns out that one of the forces acting against a stable foam is gravity, because it causes the liquid film between the bubbles to flow downwards. Gravity can cause the film to break, which makes the foam collapse. In addition, the weightlessness in zero-gravity conditions causes bubbles to be evenly dispersed rather than floating to the top. How cool is that?

The scientists loaded six small samples of water and milk protein in an instrument that analyzes the structure of foam on the ESA plane. You’ve probably seen those aircraft where people get to experience momentary weightlessness—and sometimes accompanying nausea. The plane made 30 parabolas, each of which creates about 20 seconds of weightlessness where the measurements could be taken. “During those short periods, we study the milk protein closely to see if it makes foam and how stable the bubbles are,” said Dr. Cécile Gehin-Delval, a scientist at the Nestlé Research Center. “Gaining a better understanding of foam may help improve the texture of our products.” The stability of foams is an important factor in everything from beer to whipped topping to avant-garde culinary foams. Research is also showing that manipulating the aeration of certain products, like ice cream, can create consumer-acceptable texture and mouthfeel with a lower calorie count.

This is just one step in a line of inquiry. The science of bubbles, or foams, is actually quite complex and not entirely understood. A 2010 Scientific American article that discusses foam physics tells us that the bubbles within foams seem to somewhat inexplicably form a structure that obeys three universal rules indentified by Belgian physicist Joseph Plateau in 1873. No. 1: Whenever bubbles join, three film surfaces always intersect at every edge. No. 2: Once stabilized, each pair of intersecting films forms an angle of exactly 120°. No.3: Wherever the edges meet at a point, there are always four edges, and the angle is always the inverse cosine of -1/3 (about 109°). Bubbles that do not follow the rules quickly pop, as do bubbles that are too small to withstand the resulting surface tension.

Thursday, July 19, 2012

Chocolate can be good for you -EU regulator

The European Food Safety Authority (EFSA) has ruled that cocoa powder and dark chocolate can help people improve blood circulation - a claim made by Barry Callebaut, the world's largest maker of chocolate products.
The Swiss group, which supplies food companies such as Nestle and Hershey with cocoa and chocolate products, said on Tuesday it had provided evidence to EFSA that eating 10 grammes of dark chocolate or its equivalent in cocoa that were high in flavanols helped blood flow.

If the European Commission signs off on the EFSA ruling, the company and its customers would have the right to use the health claim on packaging for products such as chocolate drinks, cereal bars and biscuits, the company said.

"As the first company receiving such a health claim, we see new market potential both for us and for our customers," Chief Executive Juergen Steinemann said in a statement.

For the clinical studies it conducted to back up the claim, Barry Callebaut said it used a special process to make cocoa products that maintains the flavanols, which are usually mostly destroyed during conventional chocolate-making.

In an opinion posted on the EFSA website, a scientific panel concluded that a cause and effect relationship had been established between the consumption of cocoa flavanols and the maintenance of normal vasodilation, which aids blood flow.

A string of scientific studies in recent years have shown the potential for health benefits from eating chocolate. Research last year suggested it might be associated with a one-third reduction in the risk of developing heart disease.

The European Union has been clamping down on health claims for food products, approving only some 200 out of over 2,500 applications earlier this year and giving food companies until the end of 2012 to remove any rejected claims.

Wednesday, July 18, 2012

Raising the Profile of Food Science

Most Americans take food and agriculture for granted, including food scientists that are working hard to develop better ways to feed the world, according to the U.S. National Institute of Food and Agriculture (NIFA) Director Sonny Ramaswamy. In office since May 7, his mission is to raise the profile of farming and nutrition science.
In a candid interview with the journal Nature, Ramaswamy discussed NIFA research, working with a tight budget, how agricultural science needs a makeover, and the 2012 Farm Bill.

When asked if agricultural science has an image problem in the United States, he said the public perception is of small-town universities just doing meat-and-potatoes production agriculture. But the reality is the United States is home to some of the top agricultural-science universities in the world that are developing tools related to robotics, informatics, nanotechnology, biotechnology and food safety, in addition to developing better ways to feed the world.

He also pointed out that Americans take food and agriculture for granted. In fact, the average American spends 9 cents per dollar on food compared to people in India and China who spend about one-third of their income on food.

Ramaswamy is very concerned with the immensity of the challenge of feeding a global population that is projected to reach 9 billion by 2050, with diminishing water and land resources, and climate change. He noted those are big research issues the NIFA has to tackle.

When asked about 2012 Farm Bill he said he hopes its enables NIFA to invest commensurate resources to facilitate the best science to address the societal challenges of agricultural production and food security, adapting to climate change, energy, water, nutrition and food safety.

Tuesday, July 17, 2012


Rising temperatures caused by climate change possibly could lead to a decline in milk production across the United States, according to new research presented today at the Conference on Climate Change. The findings suggest dairy cows in the southern U.S. will be affected the most.

Researchers at the University of Washington found that the decline in milk production due to climate change will vary across the United States, since there are significant differences in humidity and how much the temperature swings between night and day across the country. For instance, the humidity and hot nights make the Southeast the most unfriendly place in the country for dairy cows.

The study combined high-resolution climate data and county-level dairy industry data with a method for figuring out how weather affects milk production. The result is a more detailed report than previous studies and includes a county-by-county assessment of the impact climate change will have on Holstein milk production in the United States through 2080.

“Using U.S. Department of Agriculture statistics, if you look at milk production in the Southeast versus the Northwest, it’s very different," the researcher said. “It’s reasonable to assume that some of that is due to the inhospitable environment for cows in the Southeast."

The researchers found in Tillamook, Ore., where the climate is humid and the nighttime temperature doesn’t change much, milk production begins to drop at a much lower temperature than in the dry Arizona climate. Tillamook cows become less productive starting at around 15 C, or 59 F, while those in Maricopa, Ariz., start making less milk at around 25 C, or 77 F. In humid Okeechobee, Fla., cows become less productive at about the same temperature but losses increase at a much faster rate than in Arizona.

Data also revealed dairy farmers are already clustering in the most comfortable areas for cows, such as the cool coastal counties of Washington state. But the outlook isn’t good for areas across the southern U.S. where cows are already less productive in the heat of the summer.

“Perhaps most significantly, those regions that are currently experiencing the greatest losses are also the most susceptible: they are projected to be impacted the most by climate change," they said.

While the researchers project that dairy production averaged across the U.S. will be about 6% lower in the 2080s than at the start of the century, other factors are likely to actually boost milk production.

“Management practices and breeding are on track to double milk production in Holsteins in the next 30 or 50 years," they said. “So while a 6% drop is not negligible, it’s small compared to other positive influences."

Monday, July 16, 2012

In the Age of Anxiety, are we all mentally ill

When Cynthia Craig was diagnosed with postpartum depression eight years ago, she told her family doctor she felt anxious about motherhood. She wondered whether she had made a catastrophic mistake by quitting her job, whether she could cope with the long, lonely hours stay-at-home mothers face - and even whether she should have had children.

"Anxiety is something I have always had, especially during times of change," said Craig, 40, who lives in Scotland, Ontario. "But I was never worried about the level of anxiety, and it never prevented me from leaving the house, driving, socializing or even speaking in front of people."

Her doctor referred her to an anxiety clinic, where a nurse asked Craig dozens of yes-or-no questions - are you afraid of snakes? do you hear voices? do you vomit from anxiety? - and made a diagnosis. "She said, 'Let's call it Generalized Anxiety Disorder with a touch of social phobia,'" Craig said.

That didn't feel right to her, but the clinic's psychiatrist agreed with the nurse and said Craig's concerns about motherhood constituted an anxiety disorder, a form of mental illness, and prescribed Pfizer's Effexor and then GlaxoSmithKline's Paxil. Craig says the drugs exacerbated the very anxiety that she doubted required medication.

Craig's case is one of millions that constitute an extraordinary trend in mental illness: an increase in the prevalence of reported anxiety disorders of more than 1,200 percent since 1980.

In that year, 2 percent to 4 percent of Americans suffered from an anxiety disorder, according to the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) of Mental Disorders, used by psychiatrists and others worldwide to diagnose mental illness.

In 1994, a study asking a random sample of thousands of Americans about their mental health reported that 15 percent had ever suffered from anxiety disorders. A 2009 study of people interviewed about their anxiety repeatedly for years raised that estimate to 49.5 percent - which would be 117 million U.S. adults.

Some psychiatrists say the increase in the prevalence of anxiety from about 4 percent to 50 percent is the result of psychiatrists and others "getting better at diagnosing anxiety," as Dr. Carolyn Robinowitz, a past president of the APA who is in private practice in Washington, D.C., put it. "People who criticize that are showing their bias," she said. "When we get better at diagnosing hypertension, we don't say that's terrible."

Critics, including other leading psychiatrists, disagree. They say the apparent explosion in anxiety shows there is something seriously and dangerously wrong with the DSM. Its next edition, due in May, would lower the threshold for identifying anxiety.

The criticism rests on three arguments. First, the DSM fails to recognize that anxiety is normal and even beneficial in many situations, so it conflates a properly functioning brain system with a pathology. Second, the DSM's description of anxiety is more about enforcing social norms than medicine.

Finally, they say, anxiety is adaptive. Its brain circuitry was honed by evolution for a purpose. Only when that mechanism misfires should a person be diagnosed as mentally ill.

"No human emotion is more basic than anxiety," said sociologist Allan Horwitz of Rutgers University. "Many forms of it simply should not be categorized as disorders, because they're the result of the way people evolved thousands of years ago, rather than something going wrong."


Horwitz and other critics recognize that when the brain's anxiety system misfires it can prevent people from functioning, as when someone is unable to leave home, interact with friends and family or walk past even a leashed dog. But the anxiety system is working properly when it makes someone afraid of heights or wild dogs or threatening strangers.

"Anxiety or panic symptoms that have been severe, persistent and cause clinically significant distress or impairment need to be diagnosed promptly," said Dr. Allen Frances, a psychiatrist who led the previous DSM revision and questions some of the new criteria. "Very effective treatments are available."

"We don't oppose people getting treatment," said Horwitz, co-author of the new book "All We Have to Fear: Psychiatry's Transformation of Natural Anxieties into Mental Disorders." "But people are much too willing to think they have a disorder that requires treatment."

Many psychiatrists don't see it that way. Under changes for the DSM-5 proposed by experts convened by the APA, symptoms such as excessive worry, restlessness, feeling on edge, avoiding activities that cause anxiety, and being overly concerned about health or finances or family would have to be present for only three months rather than six to justify a diagnosis of Generalized Anxiety Disorder (GAD). And people would have to display one physical symptom, not the current three.

"Because its threshold for GAD is set so ridiculously low, DSM-5 will mislabel as mentally ill many people who are experiencing no more than the normal and expected worries of everyday life," said Frances.

Dr. Donna Rockwell, a clinical psychologist who has organized opposition to aspects of the DSM-5 process, warned that "unless come to their senses, GAD will be identical to the existential worries all of us face as part of being human." That will bring "a bonanza to the drug companies," she added, opening the floodgates to "more inappropriate, expensive and potentially harmful drug use."

Drugmakers reported $661 million in U.S. sales of anti-anxiety drugs last year, according to IMS Health. Most psychiatrists see that as evidence people suffering from mental illness are getting help. On Thursday the Pharmaceutical Research and Manufacturers of America issued a report touting the many drugs being developed for mental illnesses, including 26 for anxiety.

"When anxiety symptoms impair a person's functioning, what's so bad about helping them get back to a normal state and using medication if appropriate?" asked Robinowitz.

The message that what used to be considered part of the human condition is pathological is getting through, at least to some people.

James Heaney, 44, told his family physician in 2000 that he often felt shy or mildly depressed in social situations - "like I saw on the TV commercial" telling viewers to "ask your doctor" about social anxiety. "There was no in-depth evaluation of my symptoms," said Heaney, then a network administrator for a school district near Rochester, New York. After a 10-minute interview, he had a diagnosis of "mild social anxiety" and a prescription for Paxil. "For such a powerful drug," he said, "it was remarkably easy to get."


Research over the past decade shows that feeling anxious is how the brain's emotion centers send signals to its thinking centers that something is amiss.

For instance, it is normal to be anxious over a sick child, a loved one's illness, unemployment or other setbacks in life, said New York University sociologist Jerome Wakefield, co-author of "All We Have to Fear."

"The feeling of anxiety tells you something poses a threat, which can motivate you to stay vigilant" - about, say, a change in a sick child's symptoms, he said.

In the Paleolithic era, when our prehistoric ancestors lived in small clans, how people were viewed by strangers and kin could determine survival. So when people fret over going to a party, giving a speech or otherwise subject themselves to judgment, it reflects an adaptive response to the millennia-old need to be attuned to other people's disapproval, researchers say. Anxiety about public speaking accounts for about half the diagnoses of social anxiety disorder.

"There is great evolutionary and survival value in anxiety, which makes it difficult to identify as an illness or pathology," said psychologist Frank Farley of Temple University.

Anxiety was working properly among survivors of Hurricane Katrina, Wakefield and Horwitz contend. Years after the devastating 2005 storm, schools, housing, policing and other aspects of life in New Orleans had still not returned to normal. Using DSM criteria, a 2007 study concluded that half the surviving residents were "mentally ill" because they experienced anxiety about those lingering effects.

"If you survived Katrina, anxiety is not a sign of mental illness; it's the brain working as it should," said Wakefield. Such emotions can spur survivors to agitate for rebuilding neighborhoods, he said.

Another concern is that by labeling normal human variation - being more anxious, fearful or worried than the average person - a mental illness, psychiatry is venturing into social control.

"To suggest that anyone who's afraid to speak in front of hundreds of strangers has a mental illness creates social pressure to change," said Wakefield. "And that pushes psychiatry away from medicine and into enforcing social values."


In retrospect, Marla Royce (who asked that her real name not be used) thinks her brain's anxiety system was working as evolution intended. A successful Texas novelist, she was upset about the death of her father in 2004. Her anxiety was compounded when her publisher did not promote her new book, leading Royce to worry that her writing career was over.

"It was just garden-variety situational anxiety," she says now about the agitation and disorientation she felt.

Royce said she went along "trustingly and blithely" when a family physician diagnosed her with GAD. "He said the pharma sales rep had just left some samples, so he gave me Lexapro," to which a psychiatrist added Paxil, Xanax and Klonopin.

She became dependent on the drugs, taking ever-higher doses. Her psychiatrist told her that "was proof my anxiety disorder was out of control and that I would have to be medicated for life." She suffered "steadily declining mental and physical health" until she stopped the meds five years ago and shared her story with the online support group PaxilProgress.

James Heaney's shyness turned to numbness on Paxil. "It made me insular and nonresponsive to my friends and family," he said. "My mood became very variable," and co-workers told him they felt uncomfortable asking him for computer help as they once did "because they weren't sure which James they would get."

He weaned himself off psychiatric drugs in 2011. The social anxiety he still occasionally feels "is a relatively easy problem to deal with," he said.

For Cynthia Craig, the drugs she was prescribed triggered "excruciating anxiety symptoms like I had never experienced in my entire life."

"I told my doctor I don't want to be on anything," she said. "My anxiety is predictable and something I can handle."

Sunday, July 15, 2012

3 Reasons to Buy Antibiotic-free Meat and Poultry

If you’re a meat-eater, it’s better for your health and the planet to buy antibiotic-free meat and poultry. That might be tough to do, given that 80 percent of the antibiotics in use are fed to animals raised for food to keep them growing faster and to prevent them from getting sick in crowded and unsanitary conditions.

A recent poll released by Consumer Reports found a majority of people polled want more access to antibiotic-free meat. Eighty-six percent of respondents want meat and poultry free from antibiotics to be available in their supermarkets, but only 57 percent were able to find it in their local market. Seventy-two percent of those polled were extremely concerned that the extensive use of antibiotics in animals is creating superbugs that cause illnesses antibiotics can’t cure.

It’s a legitimate concern because drug resistance is already here.

Bacteria are becoming more resistant to antibiotics, making it harder for doctors to treat human diseases, including tuberculosis and pneumonia. The misuse of antibiotics is leading to a “public health crisis,” Urvashi Rangan, director of Consumer Safety at Consumer Reports told CBS News.

Here are three reasons to make the commitment to animals raised without antibiotics that you can share with family and friends.

1. Keep antibiotics effective for fighting disease

We need to keep our life-saving drugs effective for when people really need them. Overuse by agricultural companies to make animals grow faster or to cover up poor living conditions for the animals is certainly not worth jeopardizing our ability to take care of our kids, parents, neighbors, and the world community. The editorial board of The Washington Post warned that more must be done to reverse the overuse of antibiotics in livestock before a new generation of superbugs is created. The effectiveness of these incredibly powerful drugs is being undermined every day we give them to animals.

2. Invest in healthy food for your family

Purchasing antibiotic-free meat and poultry from a supermarket or restaurant is one major contribution you can make toward making the food supply safer and keeping your family healthy. Consumer Reports found 60% of poll respondents said they would pay more for antibiotic-free meats; 37% would pay up to one dollar more per pound.

Unfortunately, labels on meat don’t always make it clear when it is from animals raised without antibiotics. Look for meat labeled “organic” or “no antibiotics.”
The labels “natural” or “antibiotic-free” are not meaningful when it comes to determining whether antibiotics are prohibited.

3. Consumer action is required to make antibiotic-free meat and poultry more widely available.

Most meat-producing companies, fast food restaurants, and grocery store chains make and sell meats and poultry raised with antibiotics, according to a survey conducted by Representative Louise Slaughter (D-NY) in February. Be sure to check out Rep. Slaughter’s list of food providers’ antibiotic policies for an eye-opening understanding of how difficult it is to eat antibiotic-free meat and poultry when you’re not cooking at home.

What can you do? Whether you’re at the supermarket or eating out, check labels or ask your server whether the meat has been treated with antibiotics. And be sure to sign this petition from MomsRising asking Trader Joe’s to source their meat only from animals raised without antibiotics.

Saturday, July 14, 2012

Study Confirms Cranberries’ Role in Preventing UTIs

Cranberries are perhaps best known for the role their juice plays in the prevention of urinary tract infections (UTIs) in women, particularly those with recurrent UTIs, but now results of a new study published by Archives of Internal Medicine reveal the use of cranberry-containing products is associated with prevention of infection in some individuals.

Researchers at the National Taiwan University Hospital and National Taiwan University College of Medicine reviewed available medical literature to re-evaluate cranberry-containing products for the prevention of UTI. They identified 13 trials, including 1,616 individuals, for qualitative analysis and 10 of these trials, including 1,494 individuals, were included in quantitative analysis. The random-effects pooled risk ratio for cranberry users versus nonusers was 0.62.

They found cranberry-containing products tend to be more effective in women with recurrent UTIs, female populations, children, cranberry juice drinkers, and people using cranberry-containing products more than twice daily.

Nutritionally speaking, good things come in sweet—and tart—little packages. Research is discovering berries pack a nutritional punch due to their vitamin, fiber and antioxidant content. Click here to find out more about berry nutrition.

Friday, July 13, 2012

Calorie Foods Increase Cravings

Viewing pictures of high-calorie foods may trigger cravings for fattening foods, especially if consuming a sugar-sweetened beverage at the same time, according to new research presented at the Endocrine Society’s annual meeting. The findings suggest drinking a sugary beverage while viewing fatty foods activates appetite and reward centers in the brain, which may play a role in obesity.

Researchers at the University of Southern California’s Keck School of Medicine used functional MRI to measure the brain responses of 13 obese, Hispanic women ranging in age from 15 to 25 years. Women were chosen because prior research has shown that they are more responsive to food cues; the study group was narrowed to Hispanic women because of the high risk of obesity and type 2 diabetes in the Hispanic community.

The women’s brain responses were scanned twice as they looked at pictures of high-calorie foods, such as hamburgers, cookies and cakes, and low-calorie foods, such as fruits and vegetables. After seeing the high-calorie and low-calorie groupings, the participants rated their hunger and desire for sweet or savory foods on a scale from one to 10.

Halfway through the scans, the women drank 50 g of glucose, which is similar to drinking a can of sugar-sweetened soda. In a separate instance, they drank 50 g of fructose.

The researchers found that the reward areas in the women’s brains were activated when they looked at high-calorie foods. Interestingly, consuming the glucose and fructose increased the participants’ hunger and desire for savory foods. The researchers pointed out that fructose resulted in more intense cravings and hunger among the women than glucose.

The researchers said they limited the study to Hispanic women because research has indicated women are more sensitive to food cues, and the Hispanic community has a high incidence of obesity and type 2 diabetes.

“Studies have shown that advertisements featuring food make us think of eating, but our research looked at how the brain responds to food cues and how that increases hunger and desire for certain foods," said Kathleen Page, principal investigator and assistant professor of clinical medicine at the Keck School. “This stimulation of the brain’s reward areas may contribute to overeating and obesity, and has important public health implications."

Thursday, July 12, 2012

Artificial sweeteners no silver bullet for losing weight

You’ve got a sugar craving but don’t want to put on more pounds, so you turn to alternative sweeteners. Is that a good move?

A joint scientific statement from the American Heart Association and the American Diabetes Association reveals that while non-nutritive sweeteners can be useful for limiting carbohydrates and limiting added sugars in the diet, the existing scientific evidence is inconclusive about whether this strategy works well in the long run for cutting calories, reducing dietary sugar and losing weight.

The non-nutritive sweeteners in the analysis include both artificial sweeteners and stevia, which is marketed as a natural sweetener. Because the study was not looking at the safety of sweeteners, they chose products that were regarded as generally safe by the U.S. Food and Drug Administration. The products include aspartame (Equal, NutraSweet), acesulfame-K (Sweet One), saccharin (Sweet ‘N Low), sucralose (Splenda), Neotame, and stevia (Truvia, PureVia, Sweet Leaf).

Previous research has shown that diets high in added sugar increase triglycerides and obesity, increasing risk factors for heart disease and diabetes. In 2009 the American Heart Association recommended that Americans cut back on added sugars in their diets, suggesting that women limit added sugar calories to 100 per day, and men to 150 per day.

While the AHA position on limiting added sugars in the diet was important, “the logical question was “how?”, said lead scientific statement author Christopher Gardner of Stanford University. He explained that his group was tasked with analyzing the available data on non-nutritive sweeteners in the diet and their role in cutting calories and added sugar.

“Smart use of non-nutritive sweeteners can be a tool for consumers, reducing calories, added sugars in the diet, and helping consumers maintain or reach a healthy weight that fights the risk factors for heart disease and diabetes,” but Gardner added that determining the benefits of non-nutritive sweeteners is a complex issue. For example, “if you choose a beverage sweetened with non-nutritive sweetener, replacing the 150 calories of a sugar sweetened drink, and then indulge in a 300 calorie cookie later in the day, you’re going to end up eating more calories than you subtracted.”

For consumers, Gardiner says there are three important points to take away from the scientific statement:

1. Compensation is the big issue: When people eliminate added sugars by choosing a beverage or food with non-nutritive sweeteners, the key to losing or maintaining weight is to not overcompensate by indulging in other foods that are high in calories. Non-nutritive sweeteners won’t benefit consumers who later compensate by eating other high calorie snacks.

2. Non-nutritive beverage and food products are different: Gardiner says that people don’t compensate the same way for non-nutritive beverages as they do with food containing non-nutritive sweeteners. “Here is the twist – when people eat foods with non-nutritive sweeteners, people tend to compensate more by eating more calories… it seems to be physiological,” he explained.

3. Non-nutritive sweeteners are a tool for eating fewer carbohydrates and added sugars, but it’s important for consumers to keep an eye on the big picture. Gardiner notes that one of the best ways for limiting added sugar in the diet is to follow the American Heart Association’s dietary guidelines, which include eating a diet rich in vegetables, fruits, legumes, whole grains, fish, low-fat or non-fat dairy and lean meats without skin.

Wednesday, July 11, 2012


New statistics released by the United Nation’s Food and Agriculture Organization (FAO) reveals continued economic uncertainties and generally adequate food supply prospects kept the FAO Food Price Index down although growing concerns over dry weather sent prices of some crops higher toward the end of the month.

The FAO Food Price Index, measuring the monthly change in international prices of a basket of 55 food commodities, fell for the third consecutive month in June 2012, dropping 1.8% from May to its lowest level since September 2010. The four-point drop in June brought the index to 201 points from a revised level of 205 points in May 2012.

The index now stands at 15.4% below its peak in February 2011. The average prices of all commodity groups in were below May levels, with the largest drop registered for oils and fats.

The Cereal Price Index averaged 221 points in June, unchanged from May and down 16.8% from its peak of 265 points in April 2011. Grain prices were very volatile in June, with weather as the main driver. After a generally subdued situation during the first half of the month, markets moved up in the second half amid deteriorating crop prospects, most notably for maize in the United States. The increase in maize prices underpinned wheat values, which were already experiencing some increases on downward adjustments to production forecasts in the Russian Federation. Rice prices remained largely steady, with large differences persisting across origins.

The Dairy Price Index averaged 173 points in June, down 1.5% from the revised May value and the fifth consecutive monthly decline. The June index slide was mainly on account of butter and whole milk powder, whose prices registered large drops, while those of skim milk powder and casein firmed somewhat. Since the beginning of the year, dairy prices have shed 16.1% of their value.

The Oils/Fats Price Index averaged 221 points in June, down 5.6% from May and down for the second consecutive month notwithstanding prospects for further supply and demand tightness for oilcrops in 2012/13. The recent easing in international oils/fats prices was caused primarily by larger than expected oilcrop plantings in northern hemisphere countries, as well as a sizeable decline in crude oil prices, which has weakened demand for vegetable oils from the energy sector.

The Meat Price Index averaged 174 points in June, down 1.3% from May. Prices of all the meat categories fell, because of a faltering global import demand and a weakening of currencies in some major exporting countries. Despite their recent weakness, meat prices in the first six months still averaged 1% higher in 2012 than in 2011.

The Sugar Price Index averaged 290 points in June, down 1.6% from May, and as much as 19% below their level in June 2011. Sugar prices declined for the fourth month in a row, reflecting larger availabilities in India, the EU and Thailand, new supplies from Brazil entering the market, and declining oil prices. Prices regained some strength toward the end of June on the back of unfavorable harvesting conditions in Brazil, the world’s largest sugar exporter.

Tuesday, July 10, 2012

Babies in dog-owning families may be healthier

Dogs are no longer just man's best friend: The furry family members may also protect infants against breathing problems and infections, a new study suggests.

Researchers found that Finnish babies who lived with a dog or - to a lesser extent - a cat spent fewer weeks with ear infections, coughs or running noses. They were also less likely to need antibiotics than infants in pet-free homes.

Dr. Eija Bergroth from Kuopio University Hospital in Finland and colleagues said one possible explanation for that finding is that dirt and allergens brought in by animals are good for babies' immune systems.

The researchers studied 397 infants who were born at their hospital between September 2002 and May 2005 for their first year.

Parents filled out weekly diaries starting when the child was nine weeks old, recording information on babies' health as well as their contact with cats and dogs.

Based on those diaries and a year-end questionnaire, the researchers determined that 35 percent of the children spent the majority of their first year with a pet dog and 24 percent in a home with a cat.

Despite only a third of families owning dogs and fewer owning cats, the majority of babies had at least some contact with a dog at their house during the study period and more than one-third were exposed to a cat.

Before their first birthday, 285 of the babies had at least one fever, 157 had an ear infection, 335 had a cough, 128 wheezed, 384 got stuffy or runny noses and 189 needed to take antibiotics at some point, parents reported.

The researchers found that contact with dogs, more than cats, was tied to fewer weeks of sickness for babies.

For example, infants with no dog contact at home were healthy for 65 percent of parents' weekly diary reports. That compared to between 72 and 76 percent for those who had a dog at home.

Babies in dog-owning families were also 44 percent less likely to get inner ear infections and 29 percent less likely to need antibiotics.

The researchers said infants who spent more than zero but less than six hours per day at home with a dog were the least likely to get sick. "A possible explanation for this interesting finding might be that the amount of dirt brought inside the home by dogs could be higher in these families because (the dog) spent more time outdoors," the researchers wrote Monday in the journal Pediatrics.

Bergroth told Reuters Health in an email that the dirt and germs a dog brings into the house may cause a child's immune system to mature faster, which makes it better at defending against the viruses and bacteria that cause respiratory problems.

That theory is commonly referred to as the "hygiene hypothesis."

"In many ways, (the study is) saying, if you're exposed to a natural environment… your immune system recognizes that you don't fight the normal allergens," said Dr. T. Bernard Kinane, the chief of the pediatric pulmonary unit at MassGeneral Hospital for Children in Boston.

Kinane, who was not involved with the new study, told Reuters Health not all research agrees that exposure to dogs and cats helps protect against kids' breathing problems. But he said there is an overall trend in that direction.

The researchers also can't rule out the possibility that people who own dogs are less likely to get sick for another reason, and not due to protection offered by pets, Bergroth noted.

Monday, July 09, 2012

Study examines health effects of eating fast food

Eating fast food can lead to a fast exit, University of Minnesota researchers contend. And it’s as true in the East as it is in the West.

School of Public Health researchers found that people who consume fast food even once a week increase their risk of dying from coronary heart disease by 20 percent in comparison to people who avoid fast food, a news release from the university’s Academic Health Center said. The risk increases by 50 percent for those who eat fast food two to three times each week and by 80 percent for those who eat fast food four times or more per week.

Eating fast food two or more times a week also increased the risk of developing Type 2 diabetes by 27 percent.

The researchers reached their conclusion after examining the eating habits of residents in Singapore. Their findings were published online on Monday by the American Heart Association journal Circulation.

The few previous studies on the association of fast food and health risks focused almost exclusively on the United States, the researchers said. Lead researcher Andrew Odegaard said they wanted to look at a Southeast Asian population that has become a hotbed for diabetes and heart disease.

“What we found was a dramatic public health impact by fast food, a product that is primarily a Western import into a completely new market,” Odegaard said.

Sunday, July 08, 2012


Motivations driving morning food and beverage choices vary by age and gender, according to results of a new NPD Group Morning MealScape study. The study examines morning meal and snack occasions and marries the attitudinal with behavioral motivations to reveal the “whys" behind morning selections.

When asked what factors contributed to their morning food and beverage choice, men aged 18 years and older said they are seeking to save money and watch their diet for things they’re trying to avoid, while women of that age cite losing weight most often. For children under age 13 it’s all about having something they like. The same is true for teens, but foods that look good have more importance with this age group.

“Food manufacturers interested in connecting their products with consumers in the morning should align product benefits with consumer needs," said Dori Hickey, NPD director of product development. “Understanding the why behind food and beverage selections provides the knowledge to message to your consumer targets in a way that resonates with their individual motivations."

The No. 1 and No. 2 most consumed morning meal food choices—cross age and gender—are cold cereal and fruit, respectively, but the choices after these two items vary by age group and gender. Scrambled eggs are next on the list for kids; males 18 years and older choose a banana; and females 18 and up prefer hot cereal. Many of the same foods are selected by the gender and age groups but rank differently in terms of most frequently consumed.

“The morning meal is a growing but fragmented meal occasion," Hickey said. “For food manufacturers and retailers to operate successfully in this meal space, they need to understand the ‘why’ behind consumers’ morning meal behaviors."

Saturday, July 07, 2012

Wire Grill-Cleaning Brushes Can Pose Food Safety Hazard

Wire bristles from grill cleaning brushes are finding their way into people's food -- and down their throats, according to a new report.

Between August of 2011 and June of 2012, six people went to the hospital with internal injuries from wire bristles lodged in their necks or stomachs, according to this week's Morbidity and Mortality Weekly Report, published by the Centers for Disease Control and Prevention.

All six of the victims reported eating grilled food before their injuries occurred. Three of them experienced immediate pain upon swallowing the adulterated food, and were later found to have a piece of wire lodged in their throats.

These three people included one woman age 46 and two men ages 50 and 64.

The other patients -- three men ages 31, 35 and 50 -- experienced abdominal pain shortly after eating.

In two of these patients, the bristle was found lodged near the small intestine, having punctured the intestinal wall. Doctors performed immediate surgery on both patients to remove the foreign objects. In the other patient, the wire had not broken through the intestine but was pushing on the patient's bladder. That wire piece was removed through a colonoscopy.

"Awareness of this potential injury among healthcare professionals is critical to facilitate timely diagnosis and treatment," says the report.

CDC also warned the public to use caution to avoid ingesting wire bristles while grilling. Consumers should make sure to check grill surfaces for wire pieces before cooking, it says. Retailers are also urged to examine brush designs to minimize the likelihood of pieces coming loose.

Approximately 80,000 people were treated at hospitals after ingesting foreign objects in 2010, according to CDC. Before 2012, only two incidents involving ingestion of a wire bristle from a grill-cleaning brush had been reported. This most recent report indicates that this type of injury may be more common than officials initially suspected.

So far, no specific brand of grill-cleaning brush has been identified as more likely to shed bristles, but the Consumer Product Safety Commission (CPSC) is currently studying data on injuries related to these products to see whether some might be more dangerous than others.

Friday, July 06, 2012


Individuals who consume 4 servings of vegetables a day reduce their risk of developing acute pancreatitis by 44% compared to those who eat less than 1 serving of veggies a day, according to a new study published online in the journal Gut.

Pancreatitis refers to inflammation of the pancreas, which releases digestive enzymes to break down food. Acute pancreatitis is a potentially life-threatening disease that occurs when those enzymes begin to eat the pancreas itself.

Researchers at the Karolinska Institute investigated whether an imbalance in antioxidant levels, associated with dietary factors, might make the pancreas more sensitive to the effects of free radicals and so increase the risk of acute pancreatitis. They tracked the health of a population-based sample of 80,000 adults living in central Sweden between 1998 and 2009. In 1997 each of the participants completed a comprehensive questionnaire on how often they had eaten from a range of 96 food items over the preceding year.

On average, those surveyed ate just under 2 servings of fruit and about 2.5 servings of vegetables daily. During the 11-year study, 320 people developed acute pancreatitis that was not associated with the complications of gallstones, a relatively common cause of the condition. The amount of fruit consumed did not seem to influence the risk of developing acute pancreatitis, but this was not the case for vegetables. After taking account of factors likely to influence the results, the analysis showed that those who ate the most vegetables-more than 4 servings a day were 44% less likely to develop acute pancreatitis than were those who ate less than 1 serving a day.

They also found overweight people and those who consumed more than one alcoholic drink per day appeared to get the most positive benefit from eating a lot of vegetables.

The researchers said the most likely explanation for the protective effect of vegetables is the high level of antioxidants they contain. The reason why fruit, which also contains high levels of antioxidants, did not seem to affect the risk of acute pancreatitis, may lie in its fructose content, which might counter the effects of antioxidants.

Thursday, July 05, 2012

Consumers are searching for stores versus product-specific coupons when using online coupon search engines

ShopAtHome.com, the largest coupon search engine that connects upwards of 12 million consumers each month to the best deals and cash back savings, today released its first Buy-havior Report. The report, which tracks consumer search habits on the site, found that when consumers search for online coupons and savings, 62 percent searched for store-centric deals, 24 percent for product-specific coupons, while only 14 percent search specifically for brand name product discounts online.

Nearly half of U.S. consumers – 88.2 million – will use online coupons and codes during 2012, according to a recent analysis done by eMarketer. By the end of 2013, 96.8 million U.S. adults will have used such discounts. With over 18,000 retailers and a 110 percent cash back guarantee, ShopAtHome.com delivers the most effective shopping experience by combining all savings tools in one online destination – saving these consumers time and money.

"Consumers are really creatures of habit when it comes to looking for coupons – they go where they know they can consistently find the best deals," said Marc Braunstein, co-founder and CEO of ShopAtHome.com. "At ShopAtHome.com, we make it easy for people to find these deals, regardless of what they are looking for, by showing them the best coupons from the widest variety of retailers and brands."

An analysis of the Buy-havior Report shows the following:

·                                 Savvy spenders are creatures of habit: 73 percent of consumers using ShopAtHome.com used it between 7:00 a.m. and 6:00 p.m., regardless of the day of the week. Only 18 percent used it after 6:00 p.m.

·                                 "Toilet paper" was the most-searched term on the site and has been for the past two months.

·                                 Consumers are more likely to be searching for deals on items they consistently buy. Half of the top ten searched terms were for consumable goods like toilet paper, laundry detergent, coffee and butter.

·                                 Following toilet paper, "laundry detergent" was the next highest search, with 16,307 consumers looking for online savings.

·                                 Animal lovers were equally fond of discounts, with 13,120 of online coupon and savings searches done for pet food and supplies.

·                                 Of the 62 percent of consumers looking for store-centric savings, Wal-Mart was the most-searched for retailer followed by Kohl's and Target respectively.

·                                 Sony was the most-searched for brand out of the 14 percent of consumers searching for brand names. It was searched three times more than the next brand on the list: Swiffer.

·                                 New York City residents used the site most followed by Houston, Chicago, Los Angeles and Denver respectively.

·                                 The average ShopAtHome.com user receives $41 in cash back per month. As much as 10,000 checks are mailed out each month to users.

ShopAtHome.com differentiates itself from other coupon sites with its cash back incentives. Unlike coupons, which are provided by the retailers, all of the cash back offers on ShopAtHome.com come directly from the site itself and show up right alongside the coupons. To make things even easier for shoppers, last month, ShopAtHome.com launched its free Coupon Codes Plus app for the iPad. The app lets consumers shop for the best possible price at over 18,000 retailers, as well as offering some exclusive app-only deals.

Wednesday, July 04, 2012

Weekly challenge: think diet and exercise, not pills, to shed those extra 10 pounds

Last week, the US Food and Drug Administration approved lorcaserin (Belviq) to fight obesity, and another fat-fighting drug may be approved later this month, but that doesn’t mean you can rest easy, pop a pill, and forgo efforts to improve your diet and activity levels.

“These drugs won’t work without behavioral interventions,” said Dr. Caroline Apovian, director of the nutrition and weight management center at Boston Medical Center. Lorcaserin, in particular, produced only modest weight loss -- about 5 percent on average -- in those who took the drug during clinical trials. That’s because some of the initial weight loss was reversed in study participants who took the drug beyond a year.

What’s more, lorcaserin and other drugs to treat obesity are meant for, well, only those who are truly obese -- which means they have at least 30 or more pounds to lose, not 10 or 20. No one knows how well prescription drugs work if you just want to shed an extra 10 or 20 pounds because the drugs haven’t been tested in those who aren’t obese.

The American Council on Exercise recommends that those who are obese consider prescription drugs to be “a supplement to -- rather than a replacement for -- diet and exercise”. Given that these drugs have possible side effects such as heart risks, the rest of us would be better off reducing portion sizes, eating a low glycemic index diet, and taking more steps throughout the day.