ZACH MOORE: Welcome to On Health with Houston Methodist. I’m Zach Moore. I’m a photographer and editor here, and I’m also a long-time podcaster.

KATIE MCCALLUM: I’m Katie McCallum. I’m a former researcher, turned health writer, mostly writing for our blogs.

TODD ACKERMAN: I’m Todd Ackerman. I’m a former newspaper medical reporter, currently a blog editor at Houston Methodist.

KIM RIVERA HUSTON-WEBER: I’m Kim Rivera Huston-Weber and I’m a copywriter here at Houston Methodist.

ZACH: And Kim, do you pay attention to food labels?

KIM: I do. I try, but I find that the grocery store really is one of the places that I am, probably, more apt to fall for marketing.

ZACH: Hmm.

KIM: Even though I know to turn the packaging around and look at the nutrition facts, if I’m in any kind of rush, sometimes I’ll just look and go, “Oh, no salt,” or, “Oh, reduced sodium.” And I’ll just put it in the cart and not think about it.

KATIE: Yeah, I agree. Cause I’m almost always in a rush at the grocery store, just mentally. Cause I’m like, “I wanna get out of here. It’s busy, there’s carts everywhere, there’s people everywhere, and I’m just like trying to get it in and out. And so, yeah, you’re not gonna always look at the back of the packaging. Like Kim, I know I should. I see things like “reduced sodium” and I’m like, “Great. It’s gotta be better than the full sodium product, and that means it’s better for me and healthy for me, right?” And I move on.

KIM: And I also think that it probably takes just a little bit more time and that extra step, so we did an episode of the podcast on the bread aisle, and I’ve learned a lot of tips in that. But, you know, you still have to look at -- turn the bread packaging over, look at it, read it and like, how many times are you gonna do that while you’re on a shopping trip?

KATIE: Yeah, and you kinda look like a crazy person sometimes. I feel like people are just like, “Why do you need to look at that, like every single bread item?” You pick up, like 20 loaves of bread by the end, and people are just like, “Man, she must be really worried about the calories.” And it’s like, “No, it’s not the calories. It’s like, what else is in here? I’m trying to get my full dietary fiber for the day.”

KIM: Exactly. Yeah.

TODD: See, I avoid this by being a boring eater and get a lot of the same stuff, so I already know what the food label says.

ZACH: Okay.

KIM: That’s a good strategy. Once you find something you like, stick with it.

TODD: Yeah.

ZACH: What is the one thing you zone in on the most when you look at it, at the nutritional facts on the back?

KIM: I probably pay the most attention to fat content and added sugar.

ZACH: Okay.

KIM: Yeah. What about you, Katie?

KATIE: I’m probably about the same, maybe less of the fat and mostly the added sugar though. I think, when I’ve talked to some of our dietitians for -- you know, when I interview some of our dietitians for the blog, that’s kind of one thing I got clued into early. I truly had no concept of added sugar before I started working here. I really didn’t. And so, now I do look. And I think I went, like way too far to the other end, to be like, “I need a bread with zero grams of added sugar.” And a couple of our dietitians are like, “Okay, calm down. There can be added sugar just, like not a lot.” So, yeah, I think added sugar is my big one that I look at.

ZACH: Yeah, I’ve never really been one to examine the back of the nutritional facts and do the math. A percentage of this, and grams of that, like it’s like, “Okay.” Cause we all kinda know, like what’s healthy and what’s not. Like, what in the journal says. So, I kinda go on for those large umbrellas, but even in them there’s so much variation, right?

KATIE: Yeah. And I think one that gets me every time is serving size, when it doesn’t fit in the context of what I’m eating. If it’s like, a candy bar and the serving size is in grams, and I’m like, “What? Do you want me to get a food scale out here? Like, I don’t know how -- I don’t know what 9 grams is right now.”

ZACH: Like, a potato chip bag, it’s like 12. I’m like, “Twelve?” Like, if you just make yourself a sandwich and then pour out some chips…40? I don’t know.

[Laughter]

KATIE: Yeah, it’s hard to only eat 12 chips. It’s just not realistic.

ZACH: Yeah. Well, as you might of guessed, that’s what we’re talking about today, food labels. And who do we talk to today about this, Kim?

KIM: We talk to Mag Ayyad. He’s a clinical exercise dietitian with Houston Methodist.

[Sound effect signaling beginning of interview]

KIM: So, I’ve worked in marketing for most of my career, and it’s made me somewhat of a jaded consumer, but I can admit to totally being taken in at the grocery store just by the fancy packaging and branding. And if I’m in a time crunch, I’m not always turning over my packaging to make sure that I’m making the best choice, more or less. So, it seems like there are so many more choices available to us at the grocery, so when you counsel your patients, where do you tell them to start with food labels?

MAG AYYAD: Yeah, unfortunately, as you said, companies and manufacturers are not necessarily looking out for our best health. That’s not the number priority for them. It is marketing, it is, “How do I sell this product? What is going to attract people’s eyes towards it?” So, any time I’m counselling a patient, whether healthy living, normal or -- we do have a diagnosis that we are trying to narrow down something. I am gonna tell them to turn that product around to look at the nutrition label because, just cause something says, “low fat”, or “healthy”, or “low carb” doesn’t signify what we’re looking for. Maybe it’s low carb in one sense, but it has a lot of other ingredients or a lot of other calories that we’re not looking at. So, the first step for any food is turn it over, let’s break down that nutrition label. That’s the first part that I would tell any of my patients.

KIM: When they turn the package over, what are they gonna see, and what should they be paying attention to?

 MAG: Yeah. There’s a rule of five, the five main things that I want anyone to particularly look at. Serving size, I wanna know how much I’m supposed to eat of this, whether it’s crackers, whether it’s meat, whether it is cereal. Serving size plays a big role cause we’re often misled that we can eat two cups of something, but the serving size is only three quarters of a cup. So, we’re already adding almost two and a half times the amount of calories, cause we didn’t pay attention to what that serving size is. And then, look at the calories. Well, how many calories am I getting out of that serving size? Cause when we talk about nutrition and how much we’re getting in, if we don’t wanna get into too deep of a conversation about macronutrients and carbs, and fats, and protein, let’s just look at our calories. So those are probably the number -- the first and second thing I would encourage everyone to look at, and then where are we getting these calories from? We look at the fat, we look at the carbohydrate, we look at the protein value. So, those are probably the main five. Unless we have a specific diagnosis, unless we have a specific disease state that we’re trying to treat, then we’re diving deeper. Sodium levels, cholesterol levels, sugar, dietary fiber. So, if we’re healthy and living normal, those five is what I would encourage people to see. If we’re focusing on something specific, the ones after are also just as important.

KIM: So, you spoke about serving size and recently I bought a package of -- they were, like yogurt-based little ice cream, fake ice-cream sandwiches. And I looked at the label and the serving was the entire box, and there were four in it. So, for most of us that are just trying to do healthy living, when we’re looking at serving size, how can someone use that metric effectively without -- and I’m really asking for the math-challenged among us and that incudes myself. How can you use that to your benefit? Cause I don’t wanna eat a whole box of ice cream sandwiches in one sitting.

MAG: Yeah. Look at the rest of your day. What else am I gonna get in my day where, if I’m getting four ice-cream sandwiches, now I can’t have dinner because I’ve already overspent my calories. So, when I’m looking at serving size, whether the serving size is a whole box, whether it’s one ice-cream sandwich, if I just wanna have a treat, I know I’m gonna get that ice cream sandwich but I’m saving a lot of calories for the remainder of my day so I can get actual nutrients, fruits, vegetables, vitamins, minerals that we need. Just because the serving size is four ice-cream sandwiches and it’s 500 calories cause it’s no fat, no sugar, doesn’t mean I’m getting a ton of nutrients from it. And I’ll be full for maybe 30, 40 minutes and then it’s like, “Did I actually eat four ice-cream sandwiches an hour ago?”, or like, “Why am I still hungry?” So, I say serving size is just in relation to that meal you’re eating, but it doesn’t necessarily mean you have to get that serving size or that’s the suggested cause -- and we’ll probably get into this a little bit later. But we’ll talk about what these percentages and what these grams are referred from. But a lot of it isn’t based on the average consumption that you and I have, so…A lot of times, these just seem like arbitrary numbers and instead of having those four ice-cream sandwiches, you gotta look at the bigger picture. You gotta look at the whole day of, “What am I intaking throughout rather than just that one meal.”

KIM: So, you were speaking about macronutrients and taking in your whole day. So, there are a lot of eating patterns that make people pay attention to specific macronutrients, whether it be carbohydrates, sugar, sodium, fat. In general, what macronutrients should we be looking to limit, and which should we be trying to get more of in our day?

MAG: Yeah, great question. I’ll always point everyone to protein, and conflicting studies -- a lot of studies out there say Americans are over-consuming protein, too much protein in our diet. Not necessarily true, it’s just that the sources of protein that we tend to get are usually higher fat proteins, usually fried meat, usually high fat dairy. So, I focus on protein in the sense that, let’s find those lean protein sources where we can increase our protein without adding that fat to it. Let’s look at our dietary fiber. Most Americans are not getting enough fiber. Most Americans dealing with Irritable Bowel Syndrome, a lot of issues with constipation and diarrhea. And a really simple tool where we can increase our fiber intake and we clear a lot of those symptoms. On the opposite end, let’s look at our sugars. Let’s look at our sugars or fats, biggest culprits of why we have a lot of comorbidities and cardiovascular disease. So, if I’m looking at fat in particular, I’m looking at my saturated fat. There’s gonna be a line under that, and I’m trying to keep that 10% of my total fat intake. So, we dive a little bit deeper, not just total fat, but where is this fat coming from? Same as sugar. We have total sugar line, but we also underneath it have added sugar, and added sugar is where we run into trouble because everything nowadays has sugar in it. So, when I’m looking at the sugar total, I want that added sugar to not exceed 25, 35 grams in my day. Which means anything added from table sugar, to sweeteners, to anything you’re adding to a packaging to sweeten it. When I’m thinking of the natural sugar, let’s look at the fruits, let’s look at the simple sugars that come from some of the vegetables. Look at the dairy sugars. We’re looking to get most of our sugars from that. So, things to eliminate a lot of the fat content, a lot of the sugar content. Things to increase, let’s increase our protein, let’s increase our fiber. Kinda looking over the whole nutrition label as a whole, those are the things I’m trying to increase and decrease simultaneously.

KIM: Sounds good. And you spoke to percentages and when I’m looking at a food label, I’ll admit to struggling with the percent daily value to make a decision just because I’ll be looking at sodium, for example, and I’ll have a little conversation with myself and it’ll be like, “Oh, well, hmm, it’s only 18% of my day. Is that -- it’s just 18%, right? So, a little bit of bargaining with myself sometimes about that, how can we actually use that value to make a good decision? And for those who might have a chronic condition, such as diabetes, or heart disease, or even kidney disease, their daily values might not be the same as the general public, so how would you counsel someone on that?

MAG: So, I’ll make you feel a little better. Eight years into being a dietitian, and I still don’t understand the percentages of daily value, but it’s quite deceptive because you don’t have to have diabetes, you don’t have to have any illness. But any percentage on a nutrition label is based on a 2,000-calorie diet. The majority of us are not consuming 2,000 calories in our day, so you’re already throwing off those percentages ‘cause your percentages are completely different depending on how many calories you’re getting in your day. I would say the average consumption, what it should be we’re ranging between 1,400 to 1,700 calories in our diet. So, if someone is getting 1,400 calories, but is basing their percentages off of these, they’re already gonna be wrong because these are not calculated for them. It’s one thing I often steer people away from. Let’s stop looking at those percentage, let’s start looking at the actual values, the grams, the total calories, what we mentioned in the beginning because they’re not pertaining to you. If you want the percentages pertaining to you, that’s where you go see a dietitian or where you go see your clinician because you get more personalized plans. But if we’re just looking at numbers, then 5% or below is considered a low value. So, if you’re looking -- I got one right here in front of me, it’s a saturated fat, 1 grams that’s 5%. So, in a sense, even though I don’t know where this nutrition label came from, it’s a pretty low saturated fat food. On the other hand, it’s got 20% of added sugar. So, anything close to that 20%, so you’re missing something. About 18% seems low. 18%-20% is actually a high number, that’s giving -- that food alone is 1/5 of what you need to intake. So, if you want a rule of thumb, under 5% is a good level. 20% or higher is a quite high level, but you gotta remember a lot of these values are based on 2,000 calories, they’re based on specific levels that are provided to us by the dietary guidelines, and they don’t -- might not necessarily pertain to you. But as you said, if you have diabetes, high cholesterol, if you’re dealing with sodium control, that takes you even further where we need to personalize it for you, so you’re aware of what these percentages are for you.

KIM: One thing we really haven’t talked about yet is the ingredient list, it lives on the back of packaging as well. Would you say that there is any benefit to reading the ingredients list, and how would you walk someone through looking at one of those?

MAG: A lot of benefits. If I’m looking at the ingredient list first, then how many ingredients are on that list? The fewer the ingredients, the more natural that food is. So, if you’re walking around the outside of the grocery store, meaning you’re hitting your produce, your vegetables, your meats, your dairy, all those ingredient lists are very, very small. The more we start putting things in boxes, the more we have to keep ‘em on the shelf, the more ingredients enter that. So, if I’m looking at an ingredient list that’s on -- sitting on a shelf in a box, I’m looking at how many ingredients are there, I’m looking -- let’s take bread, for example, a lot of claims on bread. They’ll say, “Made with whole grain.” They’ll say, “Good source of this.” They’ll say, “Multi-grain.” But unless it’s 100% whole grain, they could be just mixing a bunch of flours together. So, I urge people, “Let’s turn that around. Is it made with white flour? Is it made with whole wheat flour?” So, you get a better sense of what’s in your food. And then, after that there’s a lot of names of different ingredients that we can’t pronounce, and a lot of people out there will say, “If you can’t pronounce it, it shouldn’t go in your body.” Not necessarily. There’s a lot of vitamins that just have very complex names, and they’re listing them out by the name. So, I’m looking at, “What are the main ingredients?” And it goes in order. The first ingredient means it has the most in that food. So, if sugar is your number one ingredient, then it has the most amount of sugar out of any other ingredient in that food already. So, I would probably put that down. Unless we’re talking about a natural sugar. If we’re talking about a fruit juice that has no added sugar, it’s gonna be all sugar-based. That’s normal. But look at, look at the list and make sure that what you’re buying, that the first few ingredients are actually what that entails. Otherwise, it’s probably filtered through sugar or maybe added fat, maybe added oils, and they have a little bit of that flour. They have a little bit of that natural fruit or natural vegetable that they claim. So, one, look at how many are on that ingredient list. Two, make sure that what you -- the item that you’re looking for, it’s part of the first few ingredients. And then, don’t be deceived or think that it’s a bad food because it has items that you can’t pronounce. Easy, just look it up and it might be just adding some vitamins, and maybe adding some preservatives. Cause at the end of the day, they have to add preservatives to keep it on the shelf. So, that’s how I kinda guide that ingredient list if someone’s asking me what to look for.

KIM: Yeah. And I see that a lot on social media about, if you can’t pronounce it, don’t put it in your body. Things like that. So, you encourage us to look this up, do you have any quick tips for that where the ending of words that might tip you off that there might be some nutritional value to that?

MAG: Not necessarily. Just very different ingredients. If it ends in ‘ate’ it’s probably a preservative. That’s about the only conclusive one where they’re using, like benzonate or something like that to preserve it. Or even chloride, like a salt-based preservative. But if we’re something positive or something nutritious, there’s not, like a specific name that they always follow.

KIM: Sure. Of course. Another thing that I’ll see sometimes is it’ll say, “Natural Flavors” is that something to be wary of? Or is it they don’t wanna share their…

MAG: Their secret formula?

KIM: Yeah.

MAG: Natural flavors, artificial flavors, it’s hard for us to know what’s in it. Just like you said, we don’t know what, what flavors they’re using. “Artificial flavors” means it’s made in a lab. They copied something that they were able to -- they snatched, really, and they derived it in a lab environment. Natural flavours, it’s being derived from those natural sources, but not necessarily that actual substance. Maybe there are just extracting some of it to use as flavors. And you’ll see that a lot in, like sparkling waters, filtered or made with natural flavors. They’re using that fruit flavor, they’re using whatever natural flavoring they get, but not necessarily twisting it somehow in a lab environment to call it “artificial flavours.” So, just cause it’s natural flavor, artificial flavor, not necessarily unhealthy. But again, let’s turn it over. Let’s look at that label. Let’s look at what we’re getting from it. Let’s look at the ingredients, because -- matter of fact, we’ll probably never know what natural flavors depending on the company, what artificial flavors and what they’re using. “Proprietary blend” is another one. A lot of places will put that, and that’s just a term for, “We can’t tell you what’s in it, but trust us that it’s good for us.”

KIM: Kind of to that point, let’s maybe turn the package over and let’s talk about some of the marketing claims that you can see on any given food package. So, you’ll see things like, “Fat free, sugar free, zero trans fats, low carb, x-amount of fruit servings, reduced sodium, reduced sugar.” How can we really know that it’s true? Are these claims regulated at all and are there any that folks should pay close attention to when they see them?

MAG: You know, the shocking answer is yes. These -- all of these claims that any company wants to throw out, they’re actually regulated by the FDA. So, if you wanna say you’re calorie free, you just gotta be less than five calories in that product that you’re using. If you want it to be fat-free, sugar-free, it’s gotta have less than a half gram of whatever it is. So, it’s not necessarily zero, but as long as you’re qualifying with less than that half gram, you can stick a “fat free” label, you can stick a marketing that says, “Sugar-free, sodium-free, less than 5 mg.” If you wanna say something is reduced calorie or reduced sugar, it’s gotta have 25% less than what its original counterpart has. So, a lot of these claims have to be regulated and can get in a lot of trouble if you’re just claiming things on your label. But again, just cause it’s a fat-free food, if I turn over that label, then it might be packed with a ton of sugar. So, we’re not necessarily -- we’re creating a healthy option for one, but we’re adding through it on the other end, so. And I see that a lot with peanut butter, for example. Peanut butter is a high fat food, and it has a good amount of protein. A lot of times, you’ll look at that front label and it says, “Oh, it’s a low-sugar food.” But I’m not looking for sugar from peanut butter. So, it's almost tricking us into thinking, “I’m not consuming sugar.” But it is adding my fat, it is adding my protein and I’m not thinking about it? That can increase a lot because of that label. So, that’s why I always tell people, “You can look at all the health claims on the front, but you gotta look on the back to see what your values are supposed to be.” Same thing with cereals. You’ll see a lot of low-fat cereals, but what is it mainly we’re getting from cereal? It’s a lot of sugar. So, it’s in the -- a lot of these claims are regulated, but sometimes they’re deceiving cause you can pop out saying one thing, but it’s packed with a lot of the other things on the back.

[Music plays to signal a brief interjection in the interview]

ZACH: Food packaging has claims and information listed on the front, side, and back. Front of packaging can display symbols or graphics that highlight certain positive nutritional claims, whether it’s being lower calorie or high in fiber, but may leave out unfavorable info such as higher saturated fat or added sugar. Front of packaging labels are currently voluntary, and the U.S. Food and Drug Administration doesn’t closely monitor these graphics, which gives food companies the ability to market their products as healthier than what’s listed on the nutrition facts label. The FDA is working towards testing front of packaging nutritional labels, which may make it easier for consumers to make healthier choices on the fly. The side and back of food packaging is much more regulated. The FDA requires the nutritional facts label on most packaged food and beverages, as well as oversees the ingredients list on all food labels. Packaged foods must list ingredients in order of weight, but the ingredients that weigh the most listed first. Food allergy information for major allergens including milk, fish, tree nuts, peanuts, shellfish, wheat, eggs, soybeans, and sesame must be listed near the ingredients list. These “contains statements” will read like, “Contains wheat and eggs,” or “Contains tree nuts.” There are also advisory statements that let consumers know if a product may have been exposed to cross contamination. These statements read such as, “May contain peanuts,” or, “Produced in a facility that also uses wheat.” Additionally, the term “gluten free” can only be listed if the products contains less than 20 parts per million of gluten. The lowest that can be reliably detected in foods. If you want to know the truth about a packaged food, turn it on its side or back to get the full story.

[Music plays to signal resumption of interview]

KIM: In your experience of walking the aisles of the grocery store, are there certain aisles that are worse than others for these kind of claims?

MAG: Just don’t walk the aisles. Just stay on the outside. I would say cereals, crackers, cookies, that aisle. Like, where you have your candies, and baked goods, and granola, even. I would say those are the biggest culprit aisles where you’re gonna have a lot of marketing. Because if you think about it, one, they’re making it look pretty cause kids wanna see it and that attracts them to it. And then, the second thing is the parent is looking at it, is it healthy? And like you said, a lot of us are not turning that around to see the nutritional label. So, they’ll say, “Oh, it’s made with whole grains and it’s low fat, so it’s fine. Let’s get that as a treat.” But I would say it as culprits, yeah, let’s look at those cracker aisles, let’s look at cereal aisles, granola bars, they’re all kind of -- if you walk down the aisle one, two, three and you pace through them, that’s probably right next to each other. And those are probably the high, big culprits of marketing to attract our eyes, but not necessarily honest in what is inside of them, unless we’re turning it around and looking at that label.

KIM: And kind of along those lines, some consumers prefer buying products that are listed as organic or natural because they believe them to be healthier. Can you speak to how standardized any of those terms are and is there a benefit to buying organic or natural even if a lot of those items might come with a higher price tag?

MAG: Yeah, so opposite of how the FDA controls a lot of the labels that we put, the organic umbrella is actually governed by the USDA. So, there are a lot of regulations of farmers, of people producing meats, of how it has to be raised, of what feed they can have, of what pesticides they can and can’t use. So, from a regulation standpoint, it is also regulated, very regulated. From a “is it worth it?” standpoint, and this might be not a popular belief, but I think organic products are kind of, kind of a bigger scam for people putting this fear into others, where it’s like, “Oh, I can only afford conventional food. Am I still healthy or am I putting pesticides in my body that are gonna cause diseases?” And this, probably, I would say in the last decade this has boomed, where organic everything is -- like, you have to buy organic products where…Most studies are showing that there’s not a ton of more pesticides in, you know, conventional products. And even if there are, like through the washing process, through the consumption, through the filtration of our own system, it’s not affecting us on a level where someone pushing an organic agenda is showing you. So, if you don’t have the means for it, more importantly, let’s get your fruits and vegetables, let’s get your lean meats in and let’s not try to steer away from them because I can’t afford organic or I can’t buy grapes that are $5 more than what their counterparts are thinking that it’s not healthy. If you have the means, then by all means go for it. Maybe you are saving a little bit of pesticides that are going inside your body, but it has become such a culture where we need everything to be organic for us to say we’re healthy. But then, you know, we go through these questionnaires with patients and you’re like, “Do you smoke? Do you drink? Do you, like -- even the environment that we’re in, whether you’re living close to a oil plant environment releasing gases. So, let’s try to control all of these things first, before we throw the organic down the pipeline and say everybody has to purchase things that way.

KIM: I believe, and this is a dumb personal belief, but I believe in every single household, probably in America, there is one person who absolutely swears by expiration dates. If it says the 15^th, they’re throwing it out the 16^th. And then, the other person is doing the sniff test…

MAG: Yeah, let me taste it.

KIM: Yeah, let me taste it. Is it…Ugh, is it sour? I don’t know. I bet it’s fine. And so, there’s always the expiration date person and the “it’s fine” person. So, there’s a lot of terms that are used on packaging, whether it’s “sell by,” “enjoy by,” “use by,” “best if used by.” Are any of these terms that we should actually pay attention to for food safety reasons? And which ones can we ignore? So, we can limit some of that food waste that we have happening.

MAG: Okay. Yes and no to your question, I guess. Dates are not actually not required by federal law on anything except infant formulas. So, any date that is put on a package, is put on voluntarily by the manufacturer, and none of them mean that the food is going bad at that time. But to kind of highlight the points that you said, there’s a lot of best by dates. Best by dates is dependent on where the food is distributed, the ingredients in it, and the packaging they’re using. So, they’re coming up with a formula assuming that that’s the best by date to consume that and guarantee the freshness of that product. Doesn’t mean you’re gonna get sick if you eat it afterwards, it just means, might be a little stale, might not have the same flavors as it was if you ate it a few weeks ago. So, you’re not getting sick from it, but it’s not -- it’s just a way for them to guide you to when you should not be consuming this product beyond the specific point. Something I would ignore as a consumer is your sell by date. Your sell by date is more for grocery stores. It’s more for people carrying a product to know, “Hey, I gotta start rotating this product. I gotta know when I can keep it on the shelf and when I can’t have it on the shelf.” So, I’d say that’s more for the non-consumer aspect of people purchasing wholesale goods and keeping it on the shelves. There’s a use by date. Use by date is almost just similar to best by, but it’s recommended to not use past that date. But again, all of them, I would say do the sniff test, do the taste test, and if it’s good, you’re most likely okay. A lot of culprits, I would say, like if you mishandle the food, if you get raw beef out for a day in 100-degree weather, don’t eat that. It’s safe to assume. But if it’s a packaged good, if it’s a processed good, if it’s sitting on the shelf already, a lot of the dates, if you consume them afterwards, you’ll still be fine. Now, let’s not go years and years and try that food. But again, if you open it, you’d be surprised maybe it’s still okay because of the preservatives that they use. So, a lot of them are kind of use your best judgment, but they provide dates. And just know that it’s not regulated, it’s just from the company voluntarily to write those dates on there.

KIM: So, you might be a little bit safer with that can of corn sitting in your pantry versus letting your chicken hang out in the fridge forever, probably.

MAG: 100%. Yes. If it’s preserved, it’s got sodium in there, most canned vegetables, most frozen goods, all of those. Let’s stay away from, from the meats, from a lot of the products that are sitting out there, and you can visibly see there’s some discoloration, there’s things growing on them. Probably, just skip the sniff test, just throw it away.

KIM: You’ve really calmed my fears, cause I am…

MAG: I’m so glad.

KIM: I am the person in the person in the household that’s like, “Ugh, it’s the 16^th, it’s gotta go.” I can’t believe I’ve done this.

MAG: But if you get sick, you can’t come back and tell me that I told you so.

[Laughter]

KIM: I wanna circle back and, obviously, turning the package over is the most important thing that any consumer can do. So, is there a best way to read a food label? Maybe thinking about someone with a disease state such as diabetes, or someone -- just a general consumer.

MAG: It’s hard to answer that ‘cause it’s just individualized. If you’re a normal, healthy living consumer, most of us are just looking at calories. Let’s look at your calories, let’s see how many calories you’re eating in your day, let’s see how many calories you’re burning in your day. Are we getting exercise? Are you getting some steps in? And if your weight is relatively managed and you’re not gaining a bunch of weight or losing a bunch of weight, and you’re fine with that you don’t have a goal of losing or gaining, then let’s just stick to the serving size and the calories. Because beyond that, if everything is managed, we’re not trying to achieve anything. Versus if you’re a diabetic patient, we dive more into let’s look at your carbohydrates, because maybe you’re dependent on insulin, and in order to get the right dose, we gotta know how many carbohydrates we’re intaking, we gotta know how much sugar we’re intaking. Versus someone with a high cholesterol level. If that’s your focus, let’s look at the calories in your total fat. So, very individualized from person to person, but for the normal, healthy, living individual if you’re not trying to achieve a goal pertaining to weight loss, weight gain, or any sort of body composition, just be aware of your serving size, be aware of how many calories you’re getting from that serving size, and something that you mentioned, look at the ingredients. Just make sure you’re getting quality food. And that’s probably the only place where you’ll see that, where the nutrition facts and ingredients are.

KIM: Wrapping up, is there any single-minded message that you’d like to leave us with today?

MAG: I think you covered pretty much everything. The basics of what a nutritional label is there for. I still encourage most people to do more of their shopping on the outside of the grocery store, because you’re taking a lot of the guess work out of it. We’re not looking at natural flavors, artificial flavors, we’re not looking at low fat or claims done by manufacturers. But if we’re going into the aisles, we’re looking through them, turn that over, look at the calories, look at your sugars, your fats, your protein. Focus on quality food and just - if you’re looking for individualized, if we’re looking at percentages, seek out help. And it doesn’t necessarily have to be making an appointment with a clinician and sitting down and carving everything out. We live in a world where if you type something in Google, it’s gonna tell you the answer because many other people have looked at it. So, try to get an idea of how many calories I should be getting and that will kind of make you more aware of, what am I getting from that nutrition label. Cause if I don’t know the total then, the numbers that I’m looking at don’t really mean much. But other than that, just stay healthy.

KIM: Mag, thanks so much for sitting down with us to talk about food labels.

MAG: Yeah, it was a pleasure. Happy to be back anytime.

[Sound effect signalling end of interview]

ZACH: Alright, for me what stuck out the most is the discussion on expiration dates. Because when I see an expiration date, you know, I kinda take that as absolute truth. I’m like, “Well, it says it’s expired, so I should probably throw it away.”

KATIE: Guess it’s a safe answer.

ZACH: Yeah, right? I mean, why are they there if not to be followed, right?

KIM: Yeah. I know. I was very, very surprised by what he had to say, because I am the person that will -- and I am a bit ashamed about it just because, you know, no one wants to be contributing to food waste. But I see that date and I see that date and I’m like it haunts me, it haunts me.

ZACH: Well, all it takes is one good case of food poisoning to be like, “You know what? Throwing that away.”

KATIE: Yeah. I mean, I was about to say, I think it’s because, like you know what the outcome could be if you, like push it to the limit and you’re just like, “Yeah, not for me. Not for me. I don’t want that.”

ZACH: Is it worth the six dollars?

TODD: Well, he and I were simpatico on this one. I had always felt the way he talked, so.

KATIE: That doesn’t surprise me.

TODD: Yes, I know.

KATIE: Yeah.

[Laughter]

ZACH: So, how long really? And we talked about this a little before in our preview for this topic. How long will you keep something past an expiration date?

TODD: Well, I don’t really look that closely at the expiration dates.

ZACH: Well, that’s part of the problem, really.

TODD: But if it were like a couple years, that would be too much for me.

ZACH: Yeah, I would say so.

TODD: But six months, probably. It depends on what kind of food it is, obviously.

ZACH: And you give it a sight and smell test, I’m sure as well?

TODD: Yeah.

ZACH: Okay.

KATIE: A couple of years?

[Laughter]

Oh, my goodness.

TODD: If it’s in a box, do you really care about what the expiration date is?

KATIE: I would give something, like maybe a month or two. Couple of years seems a little…I don’t know. For me, that’s a lot.

TODD: Well, I said I wouldn’t do two years.

KATIE: Yeah. Okay.

ZACH: To me, coming away from this, I do feel better about maybe bending those expiration dates. They’re not quite the absolute truths that I thought going into it.

KATIE: Yeah.

ZACH: But I am gonna throw something away if it’s two years old.

[Laughter]

But what were some of your biggest takeaways, Kim?

KIM: I liked what he had to say about serving sizes, so and really the entire interview just really re-thinking about what your nutrition day looks like. Because when you’re standing in front of the fridge, you’re not really thinking, or at least I don’t, about, “Okay, well this is what I’m going to eat right now at this moment. What is the rest of my day going to look like?” So, being able to contextualize that a little bit to make both good choices in the moment, but then down the line. So, if I want to have my little yogurt ice-cream sandwich, I can enjoy that with a little less guilt.

KATIE: Yeah, I actually had the same thought. I was like, “Oh, interesting.” I truly have never been like. “Well, I need to think about this snack in terms of my whole day.” I’m thinking like, “Hm, that kinda sounds like a lot of calories, but I don’t know,” and then you just move on, and you make a yes or no decision on what you think. But I liked that, yeah, framing it into, like, “Well, I know what I’m probably cooking tonight, and I know I’m probably gonna want some dessert.” And, yeah, I liked that. It was helpful, because again, I kinda touched about portion sizes in the beginning. It’s overwhelming to try to make sense of it in the moment, so I liked that step back kind of take on it.

KIM: Yeah, because I think just by the nature of, like looking at food labels, you can really get caught up into what the macronutrients are and what the specific numbers are. But really, the most important thing is like, what’s your nutritional day look like? What’s your nutritional week looking like? And so, it gives a little grace when you’re choosing and making decisions for yourself.

KATIE: I need that too.

KIM: Yeah. Definitely.

TODD: I liked that he was organic skeptic. I’ve always felt that way myself.

KATIE: Yeah. I mean, and pretty tough, pretty tough on the organic label I would say.

TODD:  Just always struck me as kind of a buzz word that caters to a certain audience that I didn’t think had that much meaning.

KATIE: Well, and he brought up the cost difference. It’s so different.

ZACH: It is.

KATIE: And so, it’s just like, yeah, people are not eating enough vegetables as it is, let’s not make them spend $5 more than they need to for something that is not actually any better anyway. Like, that part of it is, like, it’s a little frustrating, I would say. But yeah, I agree, Todd. I found that to be helpful. You second guess yourself a lot when you’re picking up your $1 of carrots instead of your $5 of carrots.

[Laughter]

And it’s good to know that nutritionally, I’m getting all the same thing. So, I’m getting my fiber, nothing else is different inside of it. Maybe it’s been farmed a little differently, but like he said, the pesticide amounts, by the time it hits your gut is about the same. So, that was nice to hear.

KIM: Yeah, just wash your fruits and vegetables.

KATIE: Yes!

ZACH: Yup.

KATIE: Some food safety stuff there too.

KIM: Yeah.

ZACH: Todd, it sounds like all your preconceptions have been confirmed and you really don’t have to make any changes after listening to this.

TODD: That’s sort of true.

ZACH: Yeah.

TODD: I mostly focus on the added sugars, the salt, and the protein.

KATIE: Well, yeah, that’s literally the things he said to focus on, so. You’re the star pupil over here.

TODD: Thank you.

[Laughter]

KATIE: I liked his comment when you, Kim, when you asked him like, “How would you guide someone if they’re walking through the grocery aisles?” And he was like, “Don’t walk through the middle aisles.”

ZACH: Yeah. Stay on the outskirts, yeah.

KATIE: So, Todd are you, are you not walking the middle aisles?

TODD: That’s pretty much true.

KATIE: Okay, well, yeah. A-student.

TODD: Yeah, thank you.

KATIE: Yeah.

[Laughter]

ZACH: Alright, well, words to follow moving forward next time you’re at the grocery store, just stay on the outskirts.

KATIE: Yeah, except the processed meat is on the outskirts, so just hop around that. Cause you know, we did our episode on processed meat and its problems. So, if you haven’t listened to it, go listen to it.

ZACH: It’s great. That’s right, processed meat, gets you every time. Two hot dogs a day, not recommended by the FDA. So, that’s gonna do it for this episode of On Health with Houston Methodist. We drop new episodes every Tuesday morning. Until then, stay tuned.