Recently a patient of ours returned from a treatment setting where she had been presented with “challenge foods”.  In her case she had been given cheetos and soda pop.  Now I ask you, why on earth would someone encourage a child to eat such a thing?

A lot of ink has been spilled on teaching Americans in general and children in particular to make good food choices.  Just because you have anorexia nervosa as a child, and desperately need to gain and maintain adequate weight, does not mean that you will be immune from the health effects of bad eating as you get older.  This is true whether or not you get fat later on.  You can be thin and unhealthy; you can destroy a lot of things by ingesting a chemical cuisine in the place of real food. So what actually is in Cheetos?  I think you’d better find out if, as a professional, you are going to request your patients take up the” challenge” of eating them.

Here’s the list, straight from Frito Lay (a dividion of Pepsico): Enriched Corn Meal (Corn Meal, Ferrous Sulfate, Niacin, Thiamin Mononitrate, Riboflavin, and Folic Acid), Vegetable Oil (Contains one or more of the following: corn, soybean, or sunflower oil), Whey, Salt, Cheddar Cheese, (Cultured Milk, Salt, Enzymes). Partially Hydrogenated Soybean Oil, Maltodextrin, Disodium Phosphate, Sour Cream (Cultured Cream, Nonfat Milk), Artificial Flavor, Monosodium Glutamate, Lactic Acid, Artificial Colors (Including Yellow 6), and Citric Acid. Contains Milk Ingredients.

Let’s see.  Well, for starters I think we can agree that they flunk the famous “five ingredient rule” proposed by Michael Pollan.  And for a discussion of ingredient #6 “partially hydrogenated soybean oil” see this discussion from Science in the Public Interest.org. Regarding ingredient #7, maltodextrin (a sugar) Wikipedia says: “It is also used in snacks such as Sun Chips. It is used in “light” peanut butter to reduce the fat content but keep the texture (as in Kraft Light Smooth Peanut Butter). Research is underway at Virginia Tech to use maltodextrin with air to make a new kind of cheaper, refillable, biodegradable battery to generate electricity for cell phones, video game handhelds and other electronic gadgets.”  Hmmm… does that sound like food to you? Ingredient # 13, yellow 6 food dye, is apparently banned in Norway and Finland and is  a synthetic coal tar dye made from industrial waste (coal tar).  Again, from Science in the Public Interest:

“Carcinogenic contaminants:  Yellow 6 may be contaminated with several carcinogens, including benzidine and 4?aminobiphenyl. The FDA set a limit of 1 part per billion (ppb) of free benzidine, but some batches of dye have contained a hundred or even a thousand times as much bound benzidine, which is likely liberated in the colon (Peiperl, Prival et al. 1995). As reported on page 3, the FDA does not test for bound benzidine. The FDA’s 1986 risk assessment (using estimates for 1990 consumption levels) estimated a risk of 3 cancers in 10 million people, which is smaller than the official “concern” level of 1 in 1 million (FDA 1986). However, that assessment failed to consider the (a) greater sensitivity of children, (b) greater consumption of Yellow 6 by children than the general population, (c) substantial increase in per capita consumption of Yellow 6 since 1990, (d) possibility that some batches of dye contain bound forms of benzidine and other contaminants (FQPA), and (e) presence of similar contaminants in Yellow 5. FDA scientists found that in 1992 one company eliminated benzidine contamination of Yellow 5, suggesting that other companies could do the same for Yellow 6 (Peiperl, Prival et al. 1995). However, a Health Canada study found that Sunset Yellow FCF (Yellow 6 in the United States) was still contaminated in 1998 (Lancaster and Lawrence 1999). With more and more chemicals being imported, it is important that dyes routinely be tested for bound contaminants.”

Gives a whole different perspective on the garish yellow coloring of those “tasty” little cheese bites, doesn’t it?

Now, for the soda and the usual concerns about encouraging consumption of high fructose corn syrup (HFCS), Science in the Public Interest has this to say:

“Modest amounts of fructose from HFCS or other sources are safe and do not boost blood glucose levels, making the sweetener attractive to diabetics. However, large amounts promote tooth decay, as well as increase triglyceride (fat) levels in blood, thereby increasing the risk of heart disease. Also, recent studies show that consuming 25 percent of calories from fructose or HFCS leads to more visceral (deep belly) fat or liver fat. Those changes may increase the risk of diabetes or heart disease. Finally, large amounts of fructose consumed on a regular basis also may affect levels of such hormones as insulin, leptin, and ghrelin that regulate appetite, thereby contributing to weight gain and obesity. The HFCS 55 that is used in most soft drinks contains about 10 percent more fructose than sucrose. That makes most soft drinks a bit more harmful than if they were made with sugar.”

OK. One soda is not “large amounts”, I’ll give you that.  But we are modeling eating behavior for our children, especially those of us in authoritative roles: parents, dieticians and doctors.  We have a responsibility to teach children to do what is good for them, not to imitate harmful behavior because “everybody their age does it”.  How about cigarettes?  When it’s “normal” among teenagers in a given child’s environment to smoke, should we offer them cigarettes?

As everyone who reads this blog probably knows, at Kartini Clinic we do not offer our patients “hyper-palatable” foods for a year following re-feeding, but we can accept that others may make a reasonable case for having birthday cake on a birthday or pumpkin pie at Thanksgiving.  This is a far cry from implying that we “should” eat cheetos and pop to be “normal”.  Or intuitive. Children need our guidance, whether we are grown-up bears, rats, owls or humans.  Why are we afraid to give it?