How Food Manufacturers are Tricking Gullible Consumers Under The Approval of The FDA
Written: 02/05/2008 | Join the discussion (0)
Most foods are required to carry nutrition labels to provide, as the U.S. Food and Drug Administration (FDA) says, "distinctive, easy-to-read formats that enable consumers to more quickly find the information they need to make healthful food choices."
But despite being regulated by the FDA and the U.S. Department of Agriculture, food manufacturers can, and do, get away with adding confusing or deceptive information to the labels. Sometimes this is done inadvertently, but often it's done with the specific intention of making you think the food is better for you than it actually is.
Reading the labels can be tricky, so here are the six top nutrition label "catches" to watch out for on your next trip to the grocery store.
- Serving Size.
Many processed foods that are packaged as a single serving actually contain two or more servings. According to the Nutrition Labeling and Education Act (NLEA) of 1990, a food item in a relatively small container may be labeled as a single serving if the entire contents can "reasonably be expected to be consumed in a single-eating occasion." However, there is often a discrepancy.
Consider "Big Grab" potato chips or Doritos and "Big Gulp" drinks. Most people buy them with the intention of eating or drinking the whole thing. But an average serving of a soft drink is 12 ounces. Some of the Big Gulp drinks can be up to 64 ounces--more than five cans of soda! As for potato chips, a serving size can vary depending on the package. A single-serving snack size bag of chips, of course, has fewer calories than a larger, but still single-serving, size of the same snack.
Other items to watch out for include large muffins (which often contain two servings), bagels, "individual" ice cream containers (some contain 4 servings), and personal size pizzas.
- Exempt Ingredients.
Food labels list ingredients in descending order. The most prevalent ingredient is first, the least is last. However, ingredients that constitute less than 2 percent can be listed in any order after the heading "contains less than 2% of the following."
Other ingredients called "incidental additives" do not have to be listed on labels. These include substances transferred to food via packaging and "ingredients of other ingredients" that are present at "insignificant levels" and have no "technical or functional effect."
Natural and artificial flavors are also often grouped together under one name, and manufacturers aren't required to disclose what "artificial flavors" really means. The exception here is a new ruling by the FDA, to begin January 1, 2006, that states any food containing a "major food allergen" must have it listed on the label (whether or not its part of flavoring or incidental additives). Major food allergens include milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat, as well as food ingredients containing proteins derived from any of these food categories.
- All Natural.
Food products that claim to be all natural may in fact include unnatural ingredients. According to Mike Adams, the "Health Ranger," "[The term all-natural] actually has no nutritional meaning whatsoever and isn't truly regulated by the FDA."
"The reality is that natural isn't always safe, and products with the 'natural' labeling are not required by law to contain only natural ingredients,'' said Linda Golodner, president of the National Consumers League. " ... Consumers think of words like 'safe' and 'good for me' when they think of natural, but across the board -- from prescription drugs to food products -- many of these natural claims are misleading at best.''
- Free From ...
The FDA allows food manufacturers to round to zero any ingredient that accounts for less than 0.5 grams per serving. So while a product may claim to be "gluten-free" or "alcohol-free," it can legally contain up to 0.5 grams per serving. While this may seem like an insignificant amount, over time this small fraction can add up.
Case in point, many food products that claim to have no dangerous trans fats list partially hydrogenated oil in their ingredients label. Partially hydrogenated oil creates trans fats, so these labels may be taking advantage of the rounding to zero option.
"If there's less than 0.5 gram of trans fats per serving, the food manufacturer may round down to zero," says D. Milton Stokes, R.D., a New York City-based nutritionist. "It's an FDA rule, and it happens with all foods."
- Unfamiliar Terms for Unsavory Ingredients.
Food manufacturers are known to use "clean labels," in which they hide ingredients they know consumers would rather not have in their foods under names they won't recognize.
For instance, if you're trying to avoid MSG, you need to look for all of the following terms, as they all contain MSG:
- Autolyzed yeast
- Calcium caseinate
- Gelatin
- Glutamate
- Glutamic acid
- Hydrolyzed protein
- Monopotassium glutamate
- Monosodium glutamate
- Sodium caseinate
- Textured protein
- Yeast extract
Yeast food- Yeast Nutrient
- Misleading Ingredient Claims.
Sometimes, foods that claim to include healthy ingredients actually don't contain them, or only contain them in miniscule amounts. Common offenders are blueberry waffles with no blueberries and strawberry yogurt with no strawberries. The Center for Science in the Public Interest (CSPI) recently asked the FDA to "immediately stop misleading food labels," including:
- Kellogg's Eggo Nutri-Grain Pancakes: The label says they're made with whole wheat and whole grain, but they're made primarily of white flour and contain more high-fructose corn syrup than whole wheat or whole grain.
- Betty Crocker Super Moist Carrot Cake Mix: Contains only carrot powder as the 19th ingredient on the label.
- Gerber Graduates for Toddlers Fruit Juice Snacks: The primary ingredients are corn syrup and sugar.
"Food manufacturers are shamelessly tricking consumers who are trying to eat more fruits, vegetables, and whole grains," said CSPI director of legal affairs Bruce Silverglade. "Too many processed foods contain only token amounts of the healthful ingredients highlighted on labels and are typically loaded with fats, refined sugars, refined flour, and salt, in various combinations."
Ryan
Many processed foods that are packaged as a single serving actually contain two or more servings. According to the Nutrition Labeling and Education Act (NLEA) of 1990, a food item in a relatively small container may be labeled as a single serving if the entire contents can "reasonably be expected to be consumed in a single-eating occasion." However, there is often a discrepancy.
Consider "Big Grab" potato chips or Doritos and "Big Gulp" drinks. Most people buy them with the intention of eating or drinking the whole thing. But an average serving of a soft drink is 12 ounces. Some of the Big Gulp drinks can be up to 64 ounces--more than five cans of soda! As for potato chips, a serving size can vary depending on the package. A single-serving snack size bag of chips, of course, has fewer calories than a larger, but still single-serving, size of the same snack.
Other items to watch out for include large muffins (which often contain two servings), bagels, "individual" ice cream containers (some contain 4 servings), and personal size pizzas.
Food labels list ingredients in descending order. The most prevalent ingredient is first, the least is last. However, ingredients that constitute less than 2 percent can be listed in any order after the heading "contains less than 2% of the following."
Other ingredients called "incidental additives" do not have to be listed on labels. These include substances transferred to food via packaging and "ingredients of other ingredients" that are present at "insignificant levels" and have no "technical or functional effect."
Natural and artificial flavors are also often grouped together under one name, and manufacturers aren't required to disclose what "artificial flavors" really means. The exception here is a new ruling by the FDA, to begin January 1, 2006, that states any food containing a "major food allergen" must have it listed on the label (whether or not its part of flavoring or incidental additives). Major food allergens include milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat, as well as food ingredients containing proteins derived from any of these food categories.
Food products that claim to be all natural may in fact include unnatural ingredients. According to Mike Adams, the "Health Ranger," "[The term all-natural] actually has no nutritional meaning whatsoever and isn't truly regulated by the FDA."
"The reality is that natural isn't always safe, and products with the 'natural' labeling are not required by law to contain only natural ingredients,'' said Linda Golodner, president of the National Consumers League. " ... Consumers think of words like 'safe' and 'good for me' when they think of natural, but across the board -- from prescription drugs to food products -- many of these natural claims are misleading at best.''
The FDA allows food manufacturers to round to zero any ingredient that accounts for less than 0.5 grams per serving. So while a product may claim to be "gluten-free" or "alcohol-free," it can legally contain up to 0.5 grams per serving. While this may seem like an insignificant amount, over time this small fraction can add up.
Case in point, many food products that claim to have no dangerous trans fats list partially hydrogenated oil in their ingredients label. Partially hydrogenated oil creates trans fats, so these labels may be taking advantage of the rounding to zero option.
"If there's less than 0.5 gram of trans fats per serving, the food manufacturer may round down to zero," says D. Milton Stokes, R.D., a New York City-based nutritionist. "It's an FDA rule, and it happens with all foods."
Food manufacturers are known to use "clean labels," in which they hide ingredients they know consumers would rather not have in their foods under names they won't recognize.
For instance, if you're trying to avoid MSG, you need to look for all of the following terms, as they all contain MSG:
- Autolyzed yeast
- Calcium caseinate
- Gelatin
- Glutamate
- Glutamic acid
- Hydrolyzed protein
- Monopotassium glutamate
- Monosodium glutamate
- Sodium caseinate
- Textured protein
- Yeast extract Yeast food
- Yeast Nutrient
Sometimes, foods that claim to include healthy ingredients actually don't contain them, or only contain them in miniscule amounts. Common offenders are blueberry waffles with no blueberries and strawberry yogurt with no strawberries. The Center for Science in the Public Interest (CSPI) recently asked the FDA to "immediately stop misleading food labels," including:
- Kellogg's Eggo Nutri-Grain Pancakes: The label says they're made with whole wheat and whole grain, but they're made primarily of white flour and contain more high-fructose corn syrup than whole wheat or whole grain.
- Betty Crocker Super Moist Carrot Cake Mix: Contains only carrot powder as the 19th ingredient on the label.
- Gerber Graduates for Toddlers Fruit Juice Snacks: The primary ingredients are corn syrup and sugar.
"Food manufacturers are shamelessly tricking consumers who are trying to eat more fruits, vegetables, and whole grains," said CSPI director of legal affairs Bruce Silverglade. "Too many processed foods contain only token amounts of the healthful ingredients highlighted on labels and are typically loaded with fats, refined sugars, refined flour, and salt, in various combinations."
How to Avoid Allergies
Written: 02/02/2008 | Join the discussion (0)
Not sure what is causing your sneezing, watery eyes, runny nose or itchy skin? How about your upset stomach? Most Americans are, in fact, allergic to something. Over 54.3 percent of us, to be exact, between the ages of 6 and 59 tested positive for one or more allergens, according to the third National Health and Nutrition Examination Survey (NHANES III).
Yet even with all of these allergies, only 28 percent of allergy sufferers reported that they were "very knowledgeable" about their allergies, found the Asthma and Allergy Foundation of America's first National Allergy Awareness Test.
Ready to become more knowledgeable? Following are the top allergens in the top allergic areas (skin, respiratory and digestive), along with general direction on how to best avoid them.
Top 10 Skin Allergens
- Nickel
- Gold
- Balsam of Peru (a fragrance used in lotions and perfumes)
- Thimerosal (a mercury-containing additive found in antiseptics and vaccines)
- Neomycin sulfate (an antibiotic found in first-aid creams and ointments)
- Fragrance mix (used in foods, cosmetics, dental products and insecticides)
- Formaldehyde (a preservative)
- Cobalt chloride (a metal used in hair dye, antiperspirant, and medical products)
- Bacitracin (an antibiotic used in cream-form)
- Quaternium 15 (a preservative found in cosmetic and industrial products)
How to Avoid Skin Allergens
The best approach is to avoid any substances you know you are allergic to, or that cause inflammation, redness, swelling, itching, hives or other upset to your skin. This could be jewelry, cosmetic products or food.
Top 8 Respiratory Allergens
- Dust mites
- Rye
- Ragweed
- Cockroaches
- Pollen
- Mold
- Animal dander
- Dust
How to Avoid Respiratory Allergies
- When pollen and mold counts are high, spend more time indoors.
- Keep windows closed to keep pollen out.
- Wash bedding once a week in hot water -- it will help get rid of dust mites and other allergy triggers.
- Keep your home as dust-free as possible.
- If you spend time outside, change your clothes and wash your hair when you come inside to remove pollen and other allergens.
- Filter your home's air -- many allergic reactions are triggered by airborne particles.
- If pet dander is a problem for you, keep pets out of the bedroom (or don't get any pets to begin with).
- Use strategically place doormats to keep dust, pollen and other allergens where they belong -- outdoors.
- Use dehumidifiers in basements and other damp areas of your home where mold could grow, and be sure to clean them once a week.
Top 8 Digestive Allergies
The Food Allergy and Anaphylaxis Network says that eight foods account for 90 percent of all food-related allergic reactions:
- Milk
- Egg
- Peanut
- Tree nut (walnut, cashew, etc.)
- Fish
- Shellfish
- Soy
- Wheat
How to Avoid Digestive Allergies
This one can be tricky, as peanuts, soy, egg, milk and wheat can be hidden in countless foods. If you are allergic to any of these items, you will need to be a diligent label reader. Alternatively, only buy foods you know to be safe. And, when you eat out let the server know that you absolutely cannot have certain ingredients.
- Ryan
The Huge Difference the Hospital You Choose Can Make to Your Health Care (& Living or Dying!)
Written: 01/31/2008 | Join the discussion (0)
If you must visit a hospital, doing your homework first can, quite literally, mean the difference between life and death. That's because, according to the Ninth Annual HealthGrades Hospital Quality in America Study, conducted by health care ratings group HealthGrades, the quality of care at America's 5,000-plus hospitals varies drastically.
As is written in the study's executive summary, "hospitals are in fact not the same," and neither is the care you'll receive at a one-star hospital as opposed to a five-star one.
HealthGrades analyzed 40.6 million Medicare hospital records from 2003 to 2005 in order to evaluate the quality of care at more than 5,000 U.S. hospitals. The team rated hospitals using a five-star system (with five stars being the best, three stars "as expected" and one star "poor") that was based on patients' risk of dying or having serious complications from various procedures.
Pick a Good Hospital: It Means You're Nearly 70 Percent Less Likely to Die
Though overall death rates declined 8 percent since the 2005 report, the gap between good and bad hospitals widened by 5 percent. So, patients who were lucky enough to attend a five-star hospital were found to have a 69 percent lower chance of dying than those who went to a one-star hospital.
Meanwhile, even when compared to an average U.S. hospital, those who visited a five-star hospital were 49 percent less likely to die.
The discrepancy was so distinct, in fact, that if all the hospitals in the study had performed at a five-star level, the researchers say 302,403 Medicare patients' lives could have been saved from 2003 to 2005. Of these preventable deaths, half of them were due to just four diagnoses: heart failure, sepsis, community-acquired pneumonia, and respiratory failure.
To put things into perspective, if a patient needs coronary bypass surgery, the study found they have nearly a 73 percent lower risk of dying if the procedure is performed at a five-star hospital as opposed to a one-star hospital. Had all Medicare patients who needed this procedure from 2003 to 2005 had it done at a five-star hospital, 5,308 lives would have been saved, the study found.
Five-star hospitals not only had lower death rates during all three study years, but also, when compared to last year's study, they improved patient outcomes 19 percent more than average U.S. hospitals and 57 percent more than one-star hospitals.
Distinguished Hospitals for Clinical Excellence
Further proving the point that Americans should pay very close attention to the hospital they choose is a separate study by HealthGrades, The Fifth Annual Hospital Quality and Clinical Excellence Study.
This report identified the top-performing hospitals in the nation, which earned a "Distinguished Hospital for Clinical Excellence" designation. Only 266 hospitals out of nearly 5,000 received this honor.
The researchers then compared patient outcomes between the Clinical Excellence hospitals and all other U.S. hospitals from 2003 to 2005 and found patients attending a Clinical Excellence hospital had a:
- 28 percent lower overall risk of dying
- 40 percent lower risk of dying from diabetic acidosis and coma
- 36 percent lower risk of dying from pancreatitis
- 33 percent lower risk of dying from community-acquired pneumonia
- 32 percent lower risk of dying from heart failure
- 5 percent lower overall risk of complications
What's more, the researchers found that if all patients had been treated at a Distinguished Hospital for Clinical Excellence during 2003-2005, 158,264 lives may have been saved and another 12,410 complications may have been avoided.
How to Find Out What YOUR Hospital is Rated
If you want to find out what grade your hospital received, HealthGrades.com has free hospital ratings for all 50 states.
You can also check out their list of America's 50 Best Hospitals for 2007, which is based on an analysis of 90 million hospitalization records from close to 5,000 hospitals over the years 1999 to 2005. A sampling of hospitals from the list include:
- Alexian Brothers Medical Center in Elk Grove Village, Illinois
- Christ Hospital in Cincinnati, Ohio
- Hamot Medical Center in Erie, Pennsylvania
- Lawnwood Regional Medical Center and Heart Institute in Fort Pierce, Florida
- St. Johns Hospital Health Center in Santa Monica, California
- Rio Grande Regional Hospital in Mcallen, Texas
- Genesys Regional Medical Center in Grand Blanc, Michigan
- Ryan
Errors in Your Health Records Can Cost You Big-Time: How to Check and Change Yours
Written: 01/30/2008 | Join the discussion (0)
Every time you visit a doctor's office or hospital, a record is kept detailing everything from your weight at the time of the visit to the diagnosis. Depending on how often you see a doctor, your health records can become very lengthy and complex.
While it may not occur to you to check on what's been written in your medical records, it should. Your health and life insurance premiums, and whether you're denied or granted coverage, are all at stake, as insurers turn to health records as a major source in how to price your policy.
Coding System Leaves Much Room for Error
In the United States, a series of codes known as E&M (evaluation and management) codes are used to record diagnoses and treatments. The coding system, however, is extremely complex and hard to use, even for professionals, and many grey areas exist.
"I've certainly heard plenty from that particular community about how difficult it is to get it right," said Leslie Norwalk, Centers for Medicare & Medicaid Services deputy administrator and chief operating officer, referring to Medicare carriers.
In one study cited by the American College of Physicians, the Health and Human Services Office of Inspector General asked eight Medicare carriers to code five hypothetical patient visits. Every one of the eight carriers coded the visits in a different way.
Record Keeping Sent Abroad?
To add to the confusion, in the UK certain hospitals -- in an effort to save money -- have been sending medical notes to India, South Africa and the Philippines to have them typed up.
The potential for error is high enough when notes are typed up by medical secretaries in hospital, who can check with a doctor if they can't understand a note. Abroad, there is no one to check with plus the added variable of language barriers.
The most common errors included:
- Trouble distinguishing between hypertension (high blood pressure) and hypotension (low blood pressure)
- Urological (urinary tract) used instead of neurological
- Below knee amputation called "baloney amputation"
- Mix-ups with numbers such as 15 and 50
"Lives are being put at risk by hospitals desperate to save money. Patients' medical records must be absolutely up-to-date and accurate. The consequences of typing errors are too frightening to contemplate. The government has to rethink this latest idea that medical typing can be done at a distance without risking patient health. It is ridiculous and is a step too far," said Unison, a union for nurses and non-clinical staff, general secretary Dave Prentis.
Tiny Errors Add up to Thousands
Tiny errors in medical coding, or the simple misreading of a diagnosis, can add up to thousands of extra dollars to you for insurance premiums. For instance, according to "Pick Out Costly Errors in Your Health Records" in Money Magazine's July 2006 issue, the code for a benign cyst is 685.
With just one minor typo, that diagnosis can easily become chronic kidney failure (code 585). In dollars, this error could cost you $48,100 more for a $500,000 term policy.
Inaccuracies in your medical records can even make you seem like such a risky customer that insurers will simply deny you any coverage.
How to Get Your Medical Records
Checking your medical records for accuracy is not as simple as checking your credit report. While you can visit one Web site and have your entire credit report sent to you, you will need to contact your doctors' offices, hospitals and pharmacies individually to request your records. There may be a charge for assembling the records, and you will likely have to sign release forms first, but you do have a right to request and receive them.
Those who have individual insurance should also request a report from the Medical Information Bureau (MIB), which is a non-profit group that works on behalf of insurers collecting information from previous insurance denials or coverage decisions.
What to Look For
Once you've compiled your health records, there are several things you should automatically check for.
Diagnoses: Make sure all the diagnoses are accurate and refer to something that you've actually had. Then, make sure they are not exaggerated. For instance, if you told your doctor you were tired at your appointment, he or she may have listed fatigue in your health records. This is not nearly as interesting to insurers as a mention of the more serious chronic fatigue syndrome, so be sure the description is correct.
Updates: You should also check for conditions that have improved (heartburn, cholesterol, obesity, etc) or circumstances that have changed, such as quitting smoking, and have your file updated.
How to Correct Errors
If you do find errors in your medical records, the first step is to send a certified letter, with return receipt requested, to each doctor's practice that has the health records you need to correct. Include an explanation of the error and any proof you have to the contrary.
Another option, particularly if your health records are complex, is to hire a claims-assistance professional, who can search for errors for you using their highly trained eye.
Once the errors are corrected, it's up to you to bring them to the attention of your insurance agent and ask for a better rate.
The Next Generation of Medical Records
The buzz around the health care world is that electronic medical records (EMR) will soon replace most all paper versions, and will drastically improve efficiency while reducing errors.
One report published in Health Affairs even found that "effective EMR implementation and networking could eventually save more than $81 billion annually -- by improving health care efficiency and safety."
Though still in the planning stages, there is growing concern that electronic records could put patients' personal information at risk.
"How well privacy can be safeguarded in a national electronic system is the $64,000 question," said Carole Klove, chief compliance and privacy officer for UCLA Medical Sciences.
She pointed out that electronic records have their plus-side, such as allowing patients in New Orleans to fill prescriptions during Hurricane Katrina, " … but certainly there are risks in having all your records electronic," she says. "Risks can result in inappropriate access."
References:
Money Magazine, July 2006, p. 45
The Dallas Morning News June 27, 2006
Medical News Today: Primary Care Troubled by Coding Errors
Health Affairs, 24, no. 5 (2005): 1103-1117
- Ryan
