What The Fork Are You Eating?: An Action Plan For Your Pantry And Plate

Paperback | December 26, 2014

byStefanie SacksForeword byKathie Madonna Swift

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It's labeled "natural," "grass-fed," or "free-roaming;" yet it might be anything but. It's time to find out what you're actually eating...

When your groceries are labeled “low-fat,” “sugar-free,” and even “natural” and "antibiotic-free," it’s easy to assume that you’re making healthy choices. Yet even some of those seemingly wholesome offerings contain chemical preservatives, pesticides, and artificial flavors and coloring that negatively affect your health. In What the Fork Are You Eating?, a practical guide written by certified chef and nutritionist Stefanie Sacks, MS, CNS, CDN, we learn exactly what the most offensive ingredients in our food are and how we can remove (or at least minimize) them in our diets. Sacks gives us an aisle-by-aisle rundown of how to shop for healthier items and create simple, nutritious, and delicious meals, including fifty original recipes.

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It's labeled "natural," "grass-fed," or "free-roaming;" yet it might be anything but. It's time to find out what you're actually eating...When your groceries are labeled “low-fat,” “sugar-free,” and even “natural” and "antibiotic-free," it’s easy to assume that you’re making healthy choices. Yet even some of those seemingly wholesome o...

Stefanie Sacks, MS, CNS, CDN,  is a culinary nutritionist—a certified chef with a master of science in nutrition from Columbia University. She is also an educator, speaker, consultant, and host of the radio show Stirring the Pot. Sacks is passionate about promoting wellness through food. After asthma, allergies, recurring bronchitis, a...
Format:PaperbackDimensions:400 pages, 9 × 5.97 × 1.01 inPublished:December 26, 2014Publisher:Penguin Publishing GroupLanguage:English

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ISBN - 10:039916796X

ISBN - 13:9780399167966

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FOREWORDMy dear friend and nutritional sounding board Stefanie Sacks is an impassioned food warrior—just listen to her wonderful public radio show, WPPB’s Stirring the Pot. She represents the yin and yang of healthy food advocacy—the love of delicious, nourishing food and the zeal for holding the food industry’s feet to the fire, blowing the whistle on the cheap sugar, fat, salt, and weird industrial chemicals getting poured into processed foods that dominate the supermarket. Now you, the reader, can make your voice heard with your fork.I first met Stefanie almost twenty years ago when I was the director of nutrition at the Canyon Ranch spa in the Berkshires in western Massachusetts. She had recently graduated from culinary school and was beginning her master’s degree in nutrition education at Teachers College, Columbia University. She sought me out, eager even then, because she recognized that we shared a common passion—we were both nutritionists (or, in her case, a budding nutritionist) who loved food and cooking. Back then, that combination wasn’t so easy to find!Fast forward ten years, and I’m at the prestigious Integrative Healthcare Symposium in Manhattan listening to a presentation given by Stefanie and another cutting-edge nutritionist friend of mine, Mary Beth Augustine, MS, RDN, CDN. They emphasized the harms that the food component gluten, found in many grains and in so much of our food supply, could do to digestion and to overall health. This was before gluten had become a trendy nutritional hot-button issue. As someone who had once suffered from an undiagnosed sensitivity to gluten, I was impressed with their marshaling of the scientific evidence and the conviction they brought to their presentation. When Stefanie and I compared notes later on, we weren’t surprised to find that we’d both struggled with chronic unwellness in our earlier years. Like a lot of the most committed people in our field, we’d been to hell with our own health and we had found our way out by changing our diet. It’s that story that drives her passion to share what she knows with her clients and now her readers. It’s what steels her backbone to challenge the nutritional status quo.I discovered Stefanie’s love of food and the joy she takes in being in the kitchen over these past five years leading nutrition and culinary workshops with her at the Kripalu Center for Yoga and Health, one of the landmark wellness centers in the Berkshires. She also brings her knowledge and culinary toolkit to the national educational course I organize every year for the Center for Mind-Body Medicine called “Food As Medicine.” Stefanie, one of my “cooks on call,” leads food demos and shares insights with the conference faculty and participants.A course taught by Stefanie is like no other. In one, we blindfolded the students to put them in closer touch with the sensory experience of food. In just about all of our shared workshops, she cranked up the music, and when we weren’t cooking, we were dancing. She was probably the most “tuned-in” person I’ve ever shared a kitchen with. Everything was beautifully organized. And she met each student where they were at, going over basic knife skills with the beginners so they could safely shed their fears and trading treasured recipes with the advanced students, some of whom had worked in professional kitchens.In What the Fork Are You Eating? Stefanie has taken on a serious and daunting project—getting rid of the bad food in our diet and replacing it with what’s better—and made it manageable for a wide range of readers, neophytes and the nutritional mavens alike. In researching and writing this book, she’s become a formidable expert on the issues, one on whom I rely for the latest and best information (I brought The Swift Diet: 4 Weeks to Mend the Belly, Lose the Weight, and Get Rid of the Bloat into this world at about the same time Stefanie was working on this book; our regular check-in phone calls were to me, and I hope to her, an invaluable resource). But for all the knowledge she’s amassed, her approach is refreshingly practical—an “action plan,” she calls it. Her goal isn’t organic purity; it’s getting rid of the crap. This book reminds me of the courses we teach. There and here, Stefanie wields a sharp knife, zealously, and with love.—KATHIE MADONNA SWIFT, MS, RDN, LDNINTRODUCTIONHaving immersed myself in the world of food, nutrition, and health since the ripe age of fifteen, I have been there, done that—raw, vegan, vegetarian, macrobiotic, special medical diets including cleanses, and yes (I am ashamed to say so), even fad diets. Let’s call it my years of necessary research. As a result, I am proud that I have become a true moderationist—I don’t follow any one food theory or fad, I don’t eat 100 percent organic, I eat some packaged foods and I eat not-so-healthy foods once in a while (a good potato chip is my vice, even the occasional gummy bear—more on this later). But at the same time, I practice no-nonsense nutrition—meaning I don’t buy into any of the hype; I believe in real food, not phony food (as in highly processed food); and I tell it like it is, always coming from a place of facts and basic logic.Suffering from asthma, allergies, recurring bronchitis, and pneumonia shaped much of my childhood, and I was determined to find an alternative to the multiple inhalers, allergy meds, steroids, and antibiotics I regularly consumed. In a nutshell, the medications that were supposed to be helping me were actually destroying me. Based on my experience as a summer chef in my local Montauk health food café, I discovered ways I could use food to help me heal. Challenged to the core, but finally getting well, I learned two things that shaped my life as I now know it:   • I truly understood the power that food has to influence a body’s ability to heal, recover from chronic illness, and stay well.   • I began questioning why more people didn’t know about this, and even if they did, I wondered whether they would have the knowledge and skills to make the shift that I did.As I figured out how to turn my food passion and fascination into a career, I also discovered my mission: to teach what I’d learned in my idiosyncratic no-nonsense nutritionist way.I am a culinary nutritionist—a certified chef with a master’s of science degree in nutrition from Columbia University. I am also a certified nutrition specialist (CNS) and a certified dietitian nutritionist (CDN). Many clients call me a food therapist. A doctor who suggests dietary change as a part of the prescription for healing typically hands over a single sheet offering minimal guidance. I work with clients to take this “nutrition prescription” into the kitchen—we chat, shop, and cook, as I aim to do with you in this book.What the Fork is a digestible read. You may move through it quickly or take it in stages. Either way, hopefully you will benefit from the information and tools offered. Learn about the things in your food or being done to your food that are just not cool with the Top-Rated Terminators, including what they are, why they are “bad,” and how to avoid them with the Better for You Alternatives (to whet your appetite for your trip to the market in Section Three). Then let’s feng shui your food with Pantry Rehab before I help you navigate the grocery store, from decoding Nutrition Facts, ingredient lists, health claims, and funny (and not-so-funny) food lingo to aisle-by-aisle actionables in Supermarket Strategies. And last but not least, learn to love what you eat in Meal Rehab—you’ll get tips on how to balance your plate as well as recipes to die for.I am not a doctor or dietitian drilling down on a weight-loss solution; I am not offering a polemic on a food system gone awry (though you will get some serious insight on that here). Rather my intention is to give you enough information to push you to question What the Fork you are eating while also giving you the tools to start to do something about it. Never forget that small changes in food choice can make big everyday differences. I promote a more conscious way of choosing food—what could be bad about that?Before taking a close look at what the fork you are eating, a little background on how the federal government regulates food is necessary. Perhaps this will shed a little light on why many of the Top-Rated Terminators are in your edibles in the first place.The 411 on Food RegulationsToday, your food is regulated through the joint efforts of several agencies. In a nutshell, the U.S. Department of Agriculture (USDA) keeps an eye on all the plants that are grown and animals raised in their natural habitat, while the Food and Drug Administration (FDA) ensures that your products (and drugs) are safe for consumption. As there are many harmful chemicals added to food, the Environmental Protection Agency (EPA) also gets involved to ensure that these substances remain at subtoxic levels so everything you ingest is positively protected.It all started in 1862 when Abraham Lincoln established the USDA, marking the beginning of some level of food regulation. Then in the early 1900s, as more products began to hit the market, so did many untested chemicals in food. These included borax (a mineral and salt that has a mild toxicity level) and formaldehyde (a gaseous compound of high toxicity), both of which were added for preservation without consideration or knowledge of potential health consequences. Thanks to Dr. Harvey Wiley, chief chemist of the USDA’s Bureau of Chemistry, Congress allocated funds to start testing the true safety of food products (with the scientific tools that existed at the time).In 1906 the Pure Food and Drug Act was passed. It prohibited misbranded or adulterated foods, drinks, and drugs as well as the addition of color that masked inferiority in foods and even some colors that were poisonous. The concept was great but there was one major problem: There was no mandatory premarket testing of foods, so how could the government ensure true safety? Food was still a free-for-all.But in 1914, after several amendments to the Pure Food and Drug Act (including regulations on what colors were safe as additives and how to label foods), the government finally decided that it was critical to show the effect that a chemical additive had on humans. Now the industry had to be accountable for the compounds they were slipping into your food.However, even with these directives in place, food companies did their darnedest to dupe the consumer with chemicals and inferior ingredients. Take Bred Spred—an imitation jam introduced in the 1920s. According to FDA historian Suzanne White Junod, PhD, “There wasn’t a single strawberry in the jar. It was made of coal tar, artificial pectin, artificial flavors, and grass seeds.”1Yet Americans didn’t really care, as they didn’t know any better—Bred Spred was packaged to perfection and cost less than the real deal. The 1920s marked the beginning of an era when packaged goods like Bred Spred gained supermarket shelf space.In 1933 the Food and Drug Administration was birthed out of the USDA’s Bureau of Chemistry, and in 1938 the Food, Drug, and Cosmetic Act (FD&C Act) was introduced to protect the consumer from deceptive foods. However, it seemed that unsavory substances were still getting into edibles, prompting the 1958 Food Additives Amendment, whereby manufacturers of new food additives had to establish said ingredients’ safety to the satisfaction of the FDA before use.Just so you are clear, according to the FDA, a food additive is a substance that has no proven track record of safety and must therefore undergo testing for approval by the FDA before it can be used in a food. However, there are plenty of ingredients in the foods you eat every day that are not defined as additives by the FDA, but as generally recognized as safe (GRAS) because they have been:   • deemed “safe” by FDA scientists for intended use based on “published studies, which may be corroborated by unpublished studies and other data and information” and   • used in food for a long period of time (with no “scientifically based” concerns); thus their use is exempt from FDA approval.2On those studies that support the FDA in deeming a foodstuff safe (see item 1 above)—in 1973 the FDA granted propylene glycol (PG) GRAS status for its use in foods such as confections and frostings, frozen dairy products, seasonings, nuts, and nut products to keep the moisture in. It can also be found in nonfood items including cosmetics, detergents, paints, and coatings. While PG appears to be safe at low levels, it is important to note that in 1996 PG’s use in cat food was banned because it causes a type of anemia that damages hemoglobin.3 But according to the FDA it’s safe for your eats—funny, because it is forbidden in food in Europe (the folks overseas are a little more stringent about what they ingest).While no long-term research has been done on PG’s side effects when consumed in food, a 2010 study published in the International Journal of Environmental Research and Public Health revealed that the presence of PG in indoor air (from water-based paints, for example) was associated with asthma, allergies, and sensitization in children.4 If PG in air can trigger a reaction, could it have some sort of effect when swallowed? Basic logic should tell you that you should run for the hills when you see this ingredient in your food.Most of the Top-Rated Terminators (TRTs) have GRAS status, while a select few are considered additives by the FDA and require premarket approval. Others are either regulated by other government agencies or not regulated at all (as you will learn in the pages ahead). But any way you slice it, the TRTs will forever be controversial among government; food industry (Big Food); industrial agriculture (Big Ag); and the biotech, science, and health communities at large. The message here: Just because the federal government declares an ingredient safe and secure for your precious body doesn’t mean that it is.Now, here’s the lowdown on the Top-Rated Terminators so you can start to make educated decisions about what goes in your mouth—a chance to make a difference in your health.Edible Regulations—Can You Stomach This?There are hundreds of substances that go into processed foods without formal approval from the FDA. While you may believe that this federal agency is meticulously monitoring your food, it is not. In other words, companies are typically the ones calling the shots as it relates to an ingredient’s safety and its use for consumption. How the Food and Drug Administration Lets Food Safety Slip Through the Holes is a wonderful infographic created by Center for Science in the Public Interest (CSPI), a nongovernmental organization (NGO) and consumer advocacy group whose “twin missions are to conduct innovative research and advocacy programs in health and nutrition, and to provide consumers with current, useful information about their health and well-being.”5For animals like cattle, pigs, and poultry, the picture is equally as bad, if not worse. A recent report from the Animal Welfare Institute (AWI), an organization founded in 1951 with the goal of alleviating the suffering of animals caused by people, suggests that claims touting “sustainably produced” on meat and poultry are anything but transparent. After three years of requesting documentation from the USDA from producers touting “Humanely Raised and Handled” to “Sustainably Farmed,” the government was unable to provide any proof that these companies were living up to their claims.6The good news is that you can do something about ensuring more stringent food regulations. See Appendix E, “Redeemable Resources,” and sign up action alerts from any one of the organizations listed under “Food Policy, Safety, Accountability.”The TerminatorsDid you know that people today consume five times more food dye than they did thirty years ago? How about that most artificial vanilla flavoring (including what is found in some bottles of “vanilla” extract) is made from wood pulp? Or that chemical preservatives such as sulfur dioxide, which are commonly used in dried fruit, fruit juices, and molasses, can cause an asthmatic reaction in many? Have you heard about the chemical flavor enhancer MSG (monosodium glutamate)? Although it’s been used prevalently in your food supply for more than a hundred years, it can cause MSG symptom complex, the symptoms of which include chest pain, difficulty breathing, headache, and nausea.These are just some of the TRTs. They are pervasive and not going away anytime soon. So if you have any interest in doing better than you are right now when it comes to the foods you choose and your health, it is your job as a consumer to know what the TRTs are, why they are “bad,” and what the Better for You Alternatives are, so you can make a conscious choice to consume or avoid.While there is plenty of science to question the safety of most if not all of the TRTs, there is not enough to deem them unsafe for human consumption—meaning a cease-and-desist on their use in anything edible. So full disclosure: Some studies assure us that many of these TRTs (and other foodstuffs) are harmless, but I tend to pay more attention to the studies that raise significant questions about whether consumption can lead to mild to severe health problems. Clearly you know where my bias lies, but look at it this way—why take a risk with your body and your health, or perhaps more important, with that of your loved ones? I prefer to teach my clients how to eat safely. Based on my experience working with people to prevent or manage illness through food, I can honestly tell you that everybody I have worked with feels better after removing (or greatly limiting) the TRTs from the foods they eat. And here’s your chance to do the same. While I am by no measure going to hit every “no-no” ingredient in food, let’s consider the TRTs—chemical preservatives, artificial flavors and enhancers, artificial colors, artificial sweeteners, sugar and its many euphemisms, trans fats (hydrogenated oils), pesticides, antibiotics, hormones, and genetically modified organisms (GMOs)—a great starting point to reshape your relationship with your eats.CHAPTER 1Have you ever made your own salad dressing with oil and vinegar, or maybe one with oil, lemon and herbs, and it keeps in the fridge for a couple of weeks? Have you noticed that putting nuts and seeds in the fridge or freezer keeps them longer? What about cookies made from scratch—how long do they keep? A few days out of the cold but much longer in. This is basic food preservation. And edibles can be preserved in many natural ways: packaging (vacuum packs, canning, bottling), storage (in the fridge, in the freezer, and even by burying them in the ground), and preparation methods (drying, smoking, pickling by fermentation, and even pasteurization—the heating of liquid to kill off bacteria).However, despite the availability of these elementary preservation techniques, the food industry often opts for chemical preservation because it’s “safer,” it’s cheap, and it keeps the “freshness,” flavor, color, moisture, and “nutrition” in for longer periods of time. But that’s not all—food companies remain profitable if products are shelf stable at room temperature for extensive periods of time. Items can be shipped long distances and sit on market shelves until sold rather than being tossed as soon as they sour.Businesses have also turned to technology like irradiation (see sidebar, “On Irradiation”) to preserve your eats. Hey, the “safer” the food is and the fresher it looks, the more likely you are to buy it. Time to understand how your eats are kept edible.According to Zapped! by Wenonah Hauter and Mark Worth, “The U.S. is rushing toward food irradiation as the panacea for preventing food poisoning.”1 Industry calls it “cold pasteurization,” but I like to refer to it as “X-rayted” food. According to the FDA, irradiation is the application of ionizing radiation to food (waves of energetic particles that change the natural structure of food). Its purpose is not only to prevent food-borne illness as noted, but also to preserve food, prevent insect infestation, and delay sprouting and ripening.While irradiation appears to neither make food radioactive nor change its nutritional content, the FDA has evaluated its safety for more than thirty years, and the USDA, the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO) all give it a thumbs-up; however, its use on edibles is highly controversial.Zapped! is an exposé on irradiation, and the long and short of it is that there is substantial evidence in multiple peer-reviewed journals (the place where you go for the scientific facts) to question the true safety of this innovative preservation process. For example, in 1975 the American Journal of Clinical Nutrition's “Effects of Feeding Irradiated Wheat to Malnourished Children” reported that after fifteen children were fed freshly irradiated wheat, they developed abnormal cells in growing number as the feeding duration increased. While the biological significance of abnormal cells was not fully understood, its association with malignancy suggested that consumption of irradiated wheat be fully assessed.2But let’s get real: The contamination of food is not something that irradiation will be able to solve—more stringent food safety rules and regulations are in order.Despite debate concerning the safety of irradiation, some foods are approved for irradiation in the United States, including the following:   • Beef and pork   • Poultry   • Molluscan shellfish (oysters, clams, mussels, and scallops)   • Shell eggs   • Fresh fruit and vegetables   • Lettuce and spinach   • Spices and seasonings   • Seeds for sprouting (such as alfalfa sprouts)While the FDA requires that irradiated food have the international symbol for irradiation—the Radura (see the figure)—with the statement “Treated with radiation” or “Treated by irradiation” on the label, foods that contain irradiated ingredients do not need to be labeled. This is alarming considering the fact that roughly 10 percent of herbs and spices in the United States are irradiated, so whether your food has the Radura on it or not, there is still a lack of transparency as to whether it contains irradiated ingredients.For the moment, the only way to truly confirm that your food is not irradiated is to know what’s in the irradiation wheelhouse and to opt into organics where you can. That is, if you feel as suspect about irradiation as I do.What Preservatives Are and Why They Are “Bad”By definition, food preservation is the process of treating and handling food to stop or slow down spoilage, loss of quality, edibility, or nutritional value, thus allowing for longer food storage.Chemical preservatives—the antimicrobials that stop the green stuff from growing, and the antioxidants that prevent oxidation (the chemical reaction between oxygen and food that cause spoilage)—could very well promote illness. So pick and choose wisely.Take a peek in your pantry, fridge, and even freezer—from the can of soup to the trusted tortillas, the hummus to the Ho Hos; most likely, somewhere on each product’s ingredient list, you will see one of the following chemical preservatives. Yes, preservatives are necessary to keep your food safe, but there are better ways to go about it than to use these synthetics (more on this later).ANTIMICROBIALSBenzoates (GRAS)Sodium benzoate (and its close relative benzoic acid) has been used in food manufacturing for a century to prevent the growth of microorganisms in acidic foods such as fruit juice, carbonated drinks, and pickles. While benzoates occur naturally in many plants and animals and appear to be safe for most people, they can cause hives, asthma, or other allergic reactions in sensitive individuals.Apparently when sodium benzoate is used in beverages that also contain ascorbic acid (vitamin C) like fruit juices, the two substances can react to form small amounts of benzene—a chemical that has been linked to leukemia and other cancers. While the amounts of formed benzene are small, leading to a minute risk of cancer, in the 1990s the FDA urged companies to eliminate the use of benzoate in products that also contain ascorbic acid, but they didn’t want to listen. So in 2006, a private attorney filed a lawsuit that in the end forced Coca-Cola, PepsiCo, and other U.S. soft-drink companies to reformulate beverages of concern—typically the fruit-flavored products. Even still, Dr Pepper cherry and Schweppes Ginger Ale, compliments of Dr Pepper Snapple Group, remains unchanged.3Sorbates (GRAS)Potassium sorbate is commonly used to prevent the growth of mold in cheese, baked goods including breads and tortillas, dried fruit, jelly, syrups, and wine. Most research deems this as one of the least offensive chemical preservatives, but a study published in 2010 in Toxicology in Vitro4 showed that potassium sorbate was toxic to human DNA in a type of white blood cell. In other words, this additive could affect your immunity. Given that potassium sorbate is one of the most common antimicrobials, watch what you eat.Sulfites (GRAS)You’ve heard this term used in reference to wine (see sidebar, “On Wine and Sulfites”). Yes, sulfites occur naturally, to some extent, in vino, but nonnatural versions like potassium bisulfite, potassium metabisulfite, sodium bisulfite, sodium metabisulfite, sodium sulfite, and their close relative sulfur dioxide are added to your eats to keep your food fresh. And while most of you may not notice a darn thing when you consume them (in foods such as cookies, crackers, pizza crust, and tortillas; dried fruit, whether solo or in trail mixes; condiments and relishes; sugar derived from sugar beets; molasses; fresh or frozen shrimp and lobster; canned clams; gelatins, puddings, and fillers; jams and jellies; shredded coconut; processed vegetables—canned, pickled, instant, or frozen; dried soup mixes; syrups including corn and maple; and citrus juice concentrates, instant tea and alcoholic beverages including beer, wine, wine coolers, and mixers), the FDA estimates that one out of one hundred people have some form of sensitivity to sulfites.Reactions can include sneezing, swelling of the throat, trouble breathing, and even anaphylactic shock in the most extreme cases. That’s enough to make me want to stay away whenever possible, especially given the fact that reacting to sulfites can blindside you—it can happen at any given time despite the fact that you may have been okay with those bright orange dried apricots (that are only neon because of the sulfites) your whole life.Sadly, regulations on sulfites are weak. Seafood often contains sulfites and while labeling is required, it is not well enforced (more on this in sidebar “A Fishy Situation”). In 1986, the FDA did ban the use of sulfites in foods intended to be eaten fresh, like fruits and vegetables (salad bars should technically be safe now), but food managers are not required to disclose whether sulfites were used during food preparation (for example, to keep potatoes fresh before cooking). The good news is that when sulfites are used as a preservative in packaged foods, they must be listed on the label if above 10 parts per million. Even so, according to the FDA, “any standardized food that, as a result of actions that are consistent with current good manufacturing practice, contains an indirectly added sulfiting agent that has no functional effect, [the chemical] is considered to be an incidental additive.”5 In other words, no labeling is required. Any way you slice it, sulfites are sneaking into your food without your knowing it.While sulfites do occur naturally in wine as a by-product of fermentation, they are also added to wine in their chemical form to prevent spoilage—mostly to lighter wines like whites and rosés. In the United States, organic wines typically don’t have any added sulfites; there are also some sulfur-free wines on the market, but in order to make them, the sulfites are typically chemically removed with hydrogen peroxide. If you have a reaction to sulfites, simply avoid wine.Sodium Nitrates and Sodium Nitrites (additive; subject to premarket approval by FDA)While fresh vegetables naturally contain nitrates (that convert to nitrites in your saliva), their chemical counterparts are used to preserve cured foods like bacon, hot dogs, jerky, lunch meats, and some smoked foods like salmon. Both sodium nitrate and sodium nitrite prevent bacterial growth and help keep the color and flavor in. According to the World Cancer Research Fund and the American Institute for Cancer Research, consumption of processed meats is linked to increased risk of colorectal cancer. Nitrosamine, a known carcinogen, forms when nitrates and nitrites marry with protein-rich foods like meats.6 Many companies are starting to opt out of these chemical additions (a good thing). Even so, they are still ever-present in the marketplace. Please do your best to avoid these likely noxious nitrates and nitrites.ANTIOXIDANTSButylated Hydroxyanisole (BHA) and Butylated Hydroxytoluene (BHT) (GRAS)BHA (which is typically accompanied by BHT in processed foods) retards rancidity in fats, oils, and oil-containing foods. This chemical is often found in cereals, chewing gum, potato chips, and vegetable oil, and its use is highly controversial. While no adequate human studies have been conducted, the consumption of BHA by rats, mice, and hamsters has a strong relationship with cancer. According to the National Institutes of Health, the specific cancers occurred in the forestomach, an organ that humans do not have.However, according to CSPI, a chemical that causes cancer in at least one organ in three different species indicates that it might be carcinogenic in humans.7 That is why the U.S. Department of Health and Human Services considers BHA “reasonably anticipated to be a human carcinogen.”8 Nevertheless, the FDA still permits BHA in your food. When it comes to BHT (often found in the same foods as BHA), continuous debate surrounds its direct link to cancer, as only some studies suggest an increased risk of the big C while others refute it. The reality is that BHT typically goes hand in hand with BHA, so I would just steer clear of the butylated buddies.Propyl Gallate (GRAS)While not a super-popular additive anymore, propyl gallate is often used in conjunction with BHA and BHT to stave off rancidity in oils and fats. When used, it is found in meat products, microwave popcorn, soup mixes, chewing gum, mayonnaise, and frozen meals. While the FDA considers propyl gallate safe for consumption, a 1982 study conducted by the National Toxicology Program of the U.S. Department of Health and Human Services noted that this chemical can cause malignancy in mice and rats.9 And according to the CSPI’s Chemical Cuisine,* an online guide to food additives, propyl gallate should be avoided.10Tert-Butylhydroquinone (TBHQ) (additive; subject to premarket approval by FDA)Supposedly TBHQ is safe. Often found alongside the other antioxidants—BHA, BHT, and propyl gallate—this chemical rears its head in many oily fast foods like McDonald’s chicken nuggets11 as well as some common baked goods and cereals. Basically, the safety of TBHQ is dependent on length of exposure and consumption levels; over time it is thought to damage DNA and possibly cause cancer. And while most people won’t down enough TBHQ in one sitting to have lasting effects, its subtle presence in many foods and the danger of persistent intake should make you wary.The Better for You AlternativesLet’s get back to basics. As I mentioned, before chemical unspoilers were created, food preservation was simply done with packaging, storage, and preparation methods that required salt, acid, or sugar. There are also plenty of safer options now available, including ascorbic acid (vitamin C) and its derivatives such as sodium erythorbate, erythobic acid, and sodium isoascorbate; alpha tocopherol (vitamin E); and naturally occurring citric acid—all of which are listed as such on labels today.Although it is preferable to consume fresh food or food simply preserved with salt, acid, or sugar, food processing sometimes demands more than that. I get that you probably can’t avoid packaged foods (hey, I can’t 100 percent either), so try to do what I do—pick and choose wisely to avoid the more offensive chemicals and aim for some of the safer options mentioned here, which can be found in everything from cereal to boxed meals to snack foods today.CHAPTER 2Have you ever wondered what it means when a product says it is “artificially flavored”? Even “naturally flavored”? There are roughly ten large flavor companies worldwide (as well as many smaller ones) that shape the story of your food, and believe it or not, the New Jersey Turnpike runs through the heart of this industry, serving up roughly 70 percent of the manufactured food flavor in the United States.When a food is processed to the extent you see in packaged products, the natural flavors are largely lost. Thus a small handful of elite flavorists come up with tasty chemical concoctions that make your food—ranging from Kellogg’s Pop-Tarts to Nature’s Path organic Toaster Pastries—worth eating. You will never know what is actually in these flavors, as the “recipes” are proprietary. I call the world of flavoring the “food CIA”—we know these flavor companies are up to something, but we never really know what it is. To give you an idea, roughly sixty-three flavor agents are used to create the artificial strawberry flavor found in a Burger King “strawberry” milk shake. And for natural flavors, the picture doesn’t look much different.A couple of years ago, a small group of people came to me asking for a third-party nutrition review of a food product they wanted to bring to market. The CEO said, “I know you will keep us honest.” Well, after reviewing their product, I had many questions like, “What comprises your ‘natural’ flavors?” Very determined to get some answers, they cautiously connected me with their flavor company’s food scientist. And this is what I found out: There were roughly twenty-plus compounds in the “natural” flavor, but the food scientist would not reveal their sources other than that they were derived from something “natural.” Of course I wanted to know more, but he offered nothing. In fact, he evaded the remainder of my questions, including those that concerned the source of many other ingredients and the true process of how the product was being made. My take: There is an unspoken “Processed Food Privacy Act”—a code of honor among food and beverage makers that keeps edible creations clandestine. Most of the people making your food really don’t want to tell you how they do it because if they did, you probably wouldn’t buy it. It’s typically about their bottom line, not your health. So my advice to the CEO was, if you want to create a reputable product for consumption, you want transparency from your team. And you will not get it from these flavor savers.What They AreAccording to an article published in Scientific American in 2002, there is little substantive difference in the chemical compositions of natural and artificial flavorings—they are both made in a laboratory by elite flavorists and their many favored food scientists. “Natural” chemicals are used to make natural flavorings, and “synthetic” chemicals make artificial flavorings.1 The distinction between natural versus artificial comes from the source of these chemicals. For example (and quite simply put), natural vanilla flavor is derived from the vanilla bean itself, while artificial vanilla flavor comes from synthetic chemicals whose origin is unrelated to food (as in wood or even cow poop—more on that later).According to the FDA’s Code of Federal Regulations, the term “natural flavor” or “natural flavoring” means the “Essential oil, oleoresin (mixture of essential oils and resin), essence of extractive, protein hydrolysate, distillate or any product of roasting, heating, or enzymolysis [a tongue twister but basically means breaking down with a little help from something natural] which contains the flavoring constituents derived from a spice, fruit or fruit juice, vegetable or vegetable juice, edible yeast, herb, bark, bud, root, leaf or similar plant material, meat, seafood, poultry, eggs, dairy products, or fermentation products thereof, whose significant function in food is flavoring rather than nutritional.”In contrast, the Code of Federal Regulations defines the term “artificial flavor” or “artificial flavoring” as “Any substance used to impart flavor that is not derived from a spice, fruit or fruit juice, vegetable or vegetable juice, edible yeast, herb, bark, bud, root, leaf or similar plant material, meat, seafood, poultry, eggs, dairy products, or fermentation products thereof.”2Now that you are clear on the difference between natural and artificial flavors, it is important to know that distinct chemical components from both sources are what flavor your food. And it is often the marriage of many of these chemicals that makes food taste good. So whether you are eating an apple or drinking apple juice with natural flavors or artificial ones, the same basic chemicals are giving your eats their edibleness.Why They Are “Bad”I am not going to vilify natural flavors, but I will tell you this—they are concocted in a lab, and you will never know their true sources or how the actual flavors are derived from their “naturalness.” So I do have questions about them in general, and so should you. As Eric Schlosser so poignantly states in his New York Times bestseller Fast Food Nation, “Natural and artificial flavors are now manufactured at the same chemical plants, places that few people would associate with Mother Nature. Calling any of these flavors ‘natural’ requires a flexible attitude toward the English language and a fair amount of irony.”3As far as artificial flavors are concerned, I just don’t go there. In 2006, Mayu Yamamoto, a former researcher at the International Medical Center of Japan, won the Ig Nobel Prize (a parody of the Nobel Prize, granted by the Annals of Improbable Research, a science humor magazine, that is “meant to make people laugh and then think”) for developing a technique for extracting vanillin—the chemical in a vanilla bean that gives it its distinct flavor—from cow poop.4 She received her award at Harvard University in 2007 and had this to say: “At first I thought it was a joke, but came to the award ceremony hoping my research would become more widely known.”5 She suggested that widespread adoption of her method could help the environment—it would give companies a use for cow poop, which contributes to global warming. Seriously, I get the global warming thing and doing all that you can to create a sustainable environment, but what the fork? Human beings should be eating real food—as in vanilla derived from vanilla beans, not dung. While you won’t find fake vanilla from poop in your food today, maybe someday you will.So folks, you will never know what is truly in your flavorings, whether natural or artificial, what they are truly derived from, how they are derived, and whether the chemicals combined to make your food taste so good are actually safe because the U.S. government accepts these concoctions as “generally recognized as safe,” meaning that they are perfectly fine (based on loose evidence or long-term use without concern), until they are not.The Better for You AlternativesLet’s face it: Food flavorings are unavoidable for most, even me. I do eat some processed foods with “natural” flavors, as do my kids. But doing it cautiously is the key. Seeking foods without that ambiguous “natural flavors” at the tail end of the ingredient list is the way to go. Otherwise, it just feels too CIA for me. I look for specific ingredients like “strawberry juice,” “blueberry essence,” or “pure vanilla extract” on the label, which makes me a little more comfy with my choices.While buying packaged food with the artificials is cheaper all around, healthier brands are becoming widely available these days; as I always say, do you want to pay on the front end or the back end? You have that choice. Sticking with fresh food is ideal, but hey, everyone needs a little processed “goodness” in their lives.Speaking of which, it’s good to know that Annie’s—the Kraft Foods for the conscious eater, which makes everything from frozen pizza and macaroni and cheese to crackers and other snack foods—rarely uses “natural” flavorings. Rather, the taste of their products is supported by real-food ingredients like cheese, herbs, and spices.While I was watching a popular Food Network show, the featured chef was making homemade empanadas (Spanish stuffed bread that looks like a calzone). To my utter astonishment, he tossed MSG—a white granular synthetic chemical that is used as a flavor enhancer—into his commercial-size mixer while making fresh dough. What the Fork? Typically found in Chinese restaurant food whether dining in or taking out, fast food, and processed foods from soups and sauces to lunch meats and snacks, MSG is thought to improve the overall taste of food.According to the Mayo Clinic, numerous anecdotal reports show that MSG causes adverse reactions in many. These reactions include headache; flushing; sweating; facial pressure or tightness; numbness, tingling, or burning in the face, neck, and other areas; rapid, fluttering heartbeats (like palpitations); chest pain; nausea; and weakness. However, there are no large-scale data to prove that MSG is unsafe for consumption.6Monosodium glutamate is typically listed on labels if it’s an ingredient in your food. While it used to fall under “spices” or “flavorings,” meaning that you would never know whether your product contained MSG, in 1998 that all changed—it had to stand alone on labels because of its ill effects on many. However, do be wary of Chinese food and fast food as there is no transparency there unless you ask—so questioning what’s in your grub when you go out to eat is a must.CHAPTER 3A few summers ago, my friend’s son David was selling lemonade on Main Street for charity. I took my oldest boy, Jack, then four, into town to contribute to the cause. Now, I must preface this by saying that Jack has been in the kitchen with me since he was old enough to sit in a high-chair, and I have been talking to him about food—the good, the bad, and the ugly.As we pulled up we noticed that not only was David selling lemonade, but he was also drinking red Gatorade. Well, Jack took one look at him, put his little hands on his hips, and said, “That drink has Red No. 40 in it, and if you drink it, you will get sick.”David, who is four years older than Jack, had fear in his eyes. “What is Red No. 40?”Jack turned to me. “Take it from here, Mom.” I was so proud of my little nutrition know-it-all.What They AreToday, the FDA defines a color additive as any “dye, pigment, or other substance that can impart color to a food, drug, or cosmetic or to the human body.”1In 1856, English chemist William Henry Perkin derived the color mauve from coal tar—the thick black liquid produced by the distillation of coal—marking the beginning of the story of synthetic dyes, first for fabric, then for food. But today many artificial colorings come from petroleum—a naturally occurring flammable liquid that is found in rock formations beneath the earth’s surface. So, the same chemical building blocks that were once extracted from coal tar to make food dye are now being pulled from petroleum because it’s cheaper and more plentiful and efficient (not as messy as coal tar).Sadly, fake colors have been favored over their natural plant-based counterparts like paprika or beet juice because artificial colors cost less, are more stable, and much brighter. Their ultimate purpose is to keep your food vibrant—whether to compensate for color lost during processing, correct natural variations in color, enhance existing color, or provide radiance to otherwise colorless products that need to be fun, like candy. Artificial colors are classified as straights (single dyes that are not mixed with another substance), lakes (straights that are mixed with aluminum to make the dye more dispersible and that are often found in cake and doughnut mixes, candy, and gum), and mixtures (the marriage of multiple straights that can be found in confections like candy).Unlike many other common food additives, dyes require premarket approval by the FDA. According to the agency, “by 1900, many foods, drugs and cosmetics available in the United States were artificially colored. However, not all coloring agents were harmless and some were being used to hide inferior or defective foods. In many cases, the toxicities of the starting materials for synthesizing coloring agents were well known and could be toxins, irritants, sensitizers or carcinogens.”2While the regulators were busy questioning and scrutinizing the colors, people continued to get sick. In 1950, many children fell ill after eating orange Halloween candy containing 1–2 percent Orange No. 1—a color that had been approved for use. This event, as well as concerns at the time regarding the carcinogenicity of food additives, prompted the FDA to think twice about the colors; lo and behold, they found that several caused health problems. The rainbow was fading. According to the FDA, the Color Additives Amendment of 1960 finally defined “color additive” and made certain that only color additives listed as suitable and safe for a given use could be used in foods, drugs, and cosmetics. The FDA revamped their procedural regulations for approval, and roughly two hundred colors in use were temporarily listed and could be used only on an interim basis until their use was banned due to safety concerns or lack of industrial interest or they were deemed permissible because of their known “safety.”Today, about one hundred dyes are still listed for use by the FDA, and according to the Center for Science in the Public Interest, nine dyes are approved for use in food, drugs, and cosmetics. But just three of the nine dyes—Red No. 40, Yellow No. 5, and Yellow No. 6—account for 90 percent of all dyes used. Americans have come to expect a rainbow of colors in such foods as candy, soda, cereals, snacks, baked goods, frozen foods, and condiments. Dyes can even be found in foods you don’t expect—many jarred pickles actually have Yellow No. 5 in them even though there are plenty on the market that do just fine without the added color. U.S. consumption of food dye has increased fivefold since 1955, according to the CSPI.3 And you have paid the price.Why They Are “Bad”Over the years, many dyes have been banned because of their adverse effects on lab animals. This rainbow of colors comes with significant levels of risk—enough that in 2008, the European Food Safety Authority required that all foods containing dyes have warning labels, prompting many companies to move away from the dyes and go with natural sources of coloring. So a McDonald’s strawberry sundae in Europe gets its color from strawberries, but in the United States, it gets its color from Red No. 40. Go figure.Why did the European Food Safety Authority require those labels? Because studies have shown that these dyes trigger allergies, cause hyperactivity in children, and can even lead to cancer. In fact, the labels alone prompted many corporations, from McDonald’s to Coca-Cola (orange Fanta is now dye-free in Europe), to rethink how they were making their food. But not in this country.When confirming that an additive is safe to eat, testing should be done in long-term animal feeding studies conducted by a third party. But sadly, this is typically not the case. Trials that measure the safety of a foodstuff are often short-term and funded by the company making the product—so in the end, where is the objectivity? According to the CSPI’s extensive report “Food Dyes: A Rainbow of Risks,”* which was released in 2009, there are many causes for concern.4CARCINOGENICITY (CAUSING CANCER)Interestingly, dyes are not pure chemicals—they contain roughly 10 percent impurities. For example, benzidine—a known human carcinogen that as of 2012 was listed in the Environmental Protection Agency’s Chemicals of Concern (a list of chemicals that require action to reduce exposure)—is a common adulterant in the compounds used to make food dyes. While the FDA has established legal limits for these contaminants and those limits are supposed to ensure that these artificial colors will cause cancer in only one in one million people (which is still too many, as far as I am concerned), these tolerances were based on dye usage in 1990. Since then, usage has drastically increased (as mentioned previously). In addition, the FDA never considered the risk to children, who not only consume more dye per unit of body weight than adults but also are more sensitive to carcinogens.GENOTOXICITY (CAUSING GENE MUTATIONS OR DAMAGE)Think of your body as a house. All houses start with a blueprint, and the blueprint for all living organisms, including you, is your DNA. From these information molecules, your genes—a carefully coded copy of a small part of your DNA—are made. For the purpose of the house analogy, let’s look at these genes as very specific instructions on how to build your house, from where the rooms go to the color of the walls.Certain chemicals can cause mutations or damage to your DNA, precipitating problems within your genes (those house-building instructions). If your body is injured at the gene level, your cells can be abnormal—and abnormal cells are at the root of many cancers today. (This will make a fragile house).So what do dyes have to do with genes? Several animal studies need to be conducted to determine the safety of foodstuffs. Ideally, all (or most) studies should come back negative—meaning that the chemical being tested is “safe.” Let’s take Yellow No. 5 as an example; out of the eleven studies conducted on this dye’s safety, six of the studies came back showing genotoxicity, according to CSPI’s report. That’s pretty alarming, considering that Yellow No. 5 is the second most widely used dye, found in everything from pickles to pastries.Thus, if you are genotoxic, your genes are likely damaged. These altered genes produce abnormal cells and other mutations that can be the precursor to a spectrum of illnesses. In addition, these damaged genes can be passed down to children without their ever being directly exposed to the toxin.NEUROTOXICITY (CAUSING NEUROLOGICAL DAMAGE)The relationship between food dyes and neurotoxicity is still disputed. In 1973, Dr. Benjamin Feingold, a pediatric allergist from California, proposed that certain food additives, including food dyes, cause hyperactivity in children and even adults. He created the Feingold Diet—a food elimination program that removes dyes, along with a number of other artificial ingredients, from a person’s diet. While mainstream medical wisdom dismissed his work, stating that it lacked scientific evidence, his findings generated quite a bit of publicity. It motivated many scientists to study the cause-and-effect relationship between food dyes and hyperactivity. And in 2004, a study published in the Journal of Developmental and Behavioral Pediatrics by David Schab and Nhi-Ha T. Trinh concluded that dyes promote hyperactivity in “hyperactive” children, legitimizing the call for a broader discussion about the use of food dyes.5The Better for You AlternativesIt turns out that my friend’s son David no longer drinks red Gatorade. He has other choices, and so do you. There is now a dye-free version of Gatorade, as well as other sports drinks (or various quenchers) without fake color. If you are looking for the perfect hydrator for the active lifestyle, opt for one of my favorite electrolyte-packed bevvies—coconut water. Also check out ElectroMIX powder from the makers of Emergen-C to add some nutrients and fizz to your H2O. Choose foods without dyes (you now know what to look out for). Believe it or not, everything from Froot Loops to Fun Dip has a not-so-evil twin that is colored with natural dyes derived from fruits, vegetables, herbs, and spices, including berries, beets, annatto (though some are sensitive to it), and paprika. In fact, you can even buy natural food dyes from India Tree—although they are more costly and not widely available in stores—to color your cookies and cakes. Oh, and if you are the sort to color your kids’ eggs à la Green Eggs and Ham, purée a little spinach, and you’ve got your green plus some extra nutrition.CHAPTER 4This is just priceless! Artificial sweeteners were discovered in 1878 by a researcher working out of a lab at Johns Hopkins who noticed that a derivative of coal tar he accidentally spilled on his hand tasted sweet. His spill set the stage for the development of saccharin—the first artificial sweetener introduced to market. Sadly, saccharin and other seriously sweet substances are granted GRAS status by the FDA despite incredible controversy.As a result of studies conducted in the 1970s that linked saccharin to cancer in lab rats, saccharin once carried a warning label that said consumption could be hazardous to your health. But apparently it is now in the clear, as newer studies have “confirmed” its safety (more on this later). Scientifically speaking, nothing is wrong with this chemical despite the fact that multiple studies have linked it to cancer in rodents.

Editorial Reviews

"Essential reading for anyone interested in eating a clean, healthy diet.  Stefanie Sacks explains the additives in food and how to avoid the harmful ones. This book will guide you in cleaning up your pantry and refrigerator, shopping wisely, and storing food properly. All this and easy, appealing recipes too!”—Dr. Andrew Weil, founder and director of the Arizona Center for Integrative Medicine and author of True Food "While Sacks writes in a similar style to Marion Nestle and ­Michael ­Pollan, her book is more accessible and practical for people seeking the motivation and tools to follow a healthier lifestyle, emphasizing that even very small changes in diet can make a big difference in health.... This is a valuable guide to evaluating, choosing, and preparing food for wellness."—Library Journal“An approachable, sensible guide that delivers on its promise of helping readers make healthier choices without breaking the bank or alienating family members.”—Publishers Weekly“This is a good primer for those who want to give themselves and their families a nutrition makeover. Sacks, a chef with a master of science in nutrition degree, provides can-do ways to make healthier choices.”—Booklist"Stefanie Sacks shines a bright light on the dark side of our food supply, but she doesn't resort to fear-mongering and she doesn't leave you hanging. Rather, she offers a sensible, step-by-step plan for making the best food choices in the real world. Her non-judgmental, balanced approach and inspiring recipes are just what we need to make healthy changes that last."—Ellie Krieger, MS, RDN, host of the Food Network’s “Healthy Appetite” and bestselling author of Weeknight Wonders“Stefanie understands how we need to nourish ourselves. She has helped me shift food choices to support my mind, body, and spirit, and I believe she can do the same for you.”—Donna Karan“In a time when labels are meaningless, Sacks cuts through consumer confusion and tells the truth about our food system. What the Fork Are You Eating? is an informative, accessible guide on how to choose healthy—and safe—food. A must-read for anyone who cares about what they put in their body.”—Anthony Fassio, CEO, Natural Gourmet Institute           “Stefanie reminds us to slow the fork down, encouraging us to learn the story behind our food so that we can make better food choices that will truly nourish our body, mind, and spirit.” —Richard McCarthy, Executive Director, Slow Food USA® “In a world where our children are expected to have shorter lifespans than ourselves and where the leading cause of death for children under 15 is cancer, it is imperative that we are all educated on our food choices. What the Fork Are You Eating? is an invaluable tool to help you feed yourself, your family, and your friends the ‘best,’ healthiest food possible. With Stefanie Sacks as your guide, you can positively impact the health of your family, our food supply, and possibly our planet as well!”—Ann Cooper, founder of the Chef Ann Foundation and author of Lunch Lessons: Changing the Way We Feed Our Children “Stefanie Sacks really stirs the pot in her must-read book, What the Fork Are You Eating?  With wit, wisdom and authority, Stefanie clearly lays out what nasty additives are hiding in our food, and empowers us with concrete solutions on how to make cleaner food choices. This book is a must-have for all of us looking to enhance our health and wellbeing.”—Rebecca Katz, MS, author of The Cancer-Fighting Kitchen and The Longevity Kitchen “There’s a revolution coming, and the most powerful weapon is your fork! You choose—is your fork a weapon of mass destruction, or does it wield food as medicine? In What The Fork Are You Eating? Stefanie Sacks tells you what the fork to do to ward off the top-rated terminators and get yourself to pantry and meal rehab for a longer and healthier life!”—Mary Beth Augustine, MS, RDN, CDN, Director of Nutrition, Saybrook University, and author of The Detox Prescription “Stefanie Sacks asks the pressing question, ‘When will the food industry and the government stop playing roulette with our health?' She elucidates myriad ways they are doing so, as well as how we can navigate a healthy route through our food system. This book is an invaluable resource in guiding each one of us to be part of the solution.”—Mary Cleaver, chef and owner of The Cleaver Company and The Green Table “Stefanie Sacks has given us an eminently practical guide to help us navigate the windy road of healthy eating. Her expertise in this field is evident on every page as she lays out in straightforward language the dangers of the artificial food industry and the ‘better for you alternatives.’  Her good-natured approach is a refreshing change from the fear-based messages we find so often in books about nutrition. As a pediatrician, I will be recommending this book to all my families to support mindful healthy eating.  Enjoy each chapter of What the Fork as you would a good meal. Bon Appetite.”—Stephen Cowan MD, FAAP, author of Fire Child, Water Child: How Understanding the Five Types of ADHD Can Help You Improve Your Child’s Self-Esteem and Attention.