Host: Welcome to Northern Inyo Healthcare's Mountain Medicine. Next up, we're heading into the grocery store, at least in spirit. With so many labels shouting things like all natural, low fat or heart healthy, it can be overwhelming to know what really matters. Today, we'll cut through the noise and learn how to make food labels our allies instead of our enemies. No worries, because NIHD dietician, Denice Hynd, is here to guide us. Denice is the administrative Head of Clinical Dietician Services at NIHD.

Denice Hynd: Good morning. Thank you for having me.

Host: Denice, when someone picks up a package, what is the very first thing on the nutrition label you suggest that they look at?

Denice Hynd: So, the first thing we should look at when we're reading the ingredients list, so we have a label and then we have an ingredients list just adjacent to the label, I always recommend looking at the very first ingredient. And the reason for that is because everything is listed in descending order based on their weight. So, whatever is most prevalent in that item. So if we are looking at a box of cereal, if the first ingredient is sugar, then you are buying mostly sugar. But if the first ingredient is whole grain rolled oats, then the majority of that ingredient in that box is whole grain rolled oats. So, this allows us to compare products. Do you want to buy this cereal or this cereal? One is mostly sugar and one has mostly whole grains. And so, it allows you to make an informed choice as a consumer, therefore allowing you to essentially have a better quality product.

Host: Some products look healthy because of marketing, like they look great in the picture, but then turn out not really to be the best choice for nutrition. How can shoppers spot those differences quickly?

Denice Hynd: Absolutely. So, definitely be wary of anything that has, you know, your stereotypical farm picture with a dog running and the red barn and anything that looks like it could be somewhere, you know, made up country because it might be misleading you. What you want to look for, again, is turn the package over and you're going to be looking at the ingredients list or on the nutrition facts panel. And I would always say to look to see if in the ingredients it contains something called high-fructose corn syrup. And if it does contain high-fructose corn syrup, you just want to be aware that this is a type of sugar that is contributing to the non-alcoholic fatty liver disease in our country. And we see high-fructose corn syrup in soda, in yogurt, in cereal, peanut butter, jelly jam, even in pasta sauce, ketchup, barbecue sauce. So, high-fructose corn syrup is in a lot of our food. So, we want to just be aware as consumers how much high-fructose corn syrup we're eating, because, again, it is leading us into a lot of non-alcoholic fatty liver disease. And for those of us with diabetes, it's also raising our glycemic index. And so, we just want to be aware of those things.

We also want to be aware of trans fats on the label. So, on the label, it'll have a little line, and it'll show you how much trans fats. Those are the most lethal fats in our diet because they're man-made. So, there's saturated fats and then there's trans fats. But there's a loophole. So, the manufacturers are allowed to say something has zero grams of trans fat, as long as it has 0.5 grams or less. So, it'll say zero grams. So technically, it could have trans fats, they just round it down as long as it has less than half a gram. So in order to be a good detective, all you're going to do is look at the ingredients list and you're going to look for the ingredient partially hydrogenated oil. You'll see this in things like shortening, spreadable cheese, spreadable frosting, spreadable shelf-stable peanut butters, the filling of some cream cookies, things that are soft, things that are spreadable and malleable and shelf-stable. And so, you just want to look for partially hydrogenated oils. That is your first indicator that that product has trans fats. But it might not label it as trans fats because it has 0.5 grams or less per serving. So, the moment you eat two servings, they would've had to label it contains trans fats. And therefore, the consumer's going to say, "Oh, no. I can't eat that." So, that is a loophole that manufacturers are allowed to do.

So, that would be my thing, is just to caution against the farmhouse label, and turn it around and really look for those two ingredients, high-fructose corn syrup and partially hydrogenated oils.

Host: That is so sneaky, Denice. The added sugars, sodium and the serving sizes you were just talking about, which of those tends to surprise people the most once they start reading the labels more carefully?

Denice Hynd: Yes. So, both of them really. But what is really interesting is, in our home kitchens, we don't speak in grams. So on the nutrition label, sugar is listed in grams, 4 grams, 10 grams, 30 grams, 50 grams. And unless you're a pharmacist or you're in some kind of business where you speak in grams, you don't really know what that means. And so, how does grams translate into volume, teaspoon, tablespoon, cups? So, what I always tell people, or I always teach people, is the magic number is four. Every time you see a label, you're going to divide it by four, and that equals a teaspoon. So, four grams of sugar equals one teaspoon. So, one 12 ounce can of soda has 40 grams of sugar. We take four, divide it into 40, you get 10. That's 10 teaspoons of sugar in that one can of soda, okay? So when you understand how to convert, that is very alarming.

With the sodium, I always say, let's do green light, red light, just like at the stoplight. With the sodium, we want to try and buy foods where the sodium is less than the calories. That would be green light, go, enjoy. If the sodium is greater than the calories, red light, slow down, be informed. It doesn't mean you can't eat them, it's just you need to be an informed consumer. This is very high in sodium. You might run out of your allowance for the day by breakfast time.

Host: So, sugar, the rule of four. And sodium, greater or lesser than the calories.

Denice Hynd: Yes, exactly.

Host: Now, when we talked a little about the farmhouse label, are there certain other marketing ploys ingredients or phrases on packaging you suggest people be cautious about?

Denice Hynd: Yes. You know, the term all natural, that's not regulated by any kind of government agency. Anybody can say something is natural. What does that mean? It means nothing. It might say something like "now cholesterol-free." Well, cholesterol only comes from animal products. And I see this a lot sometimes where it'll say like peanut butter, cholesterol-free. Well, peanut butter was always cholesterol-free because peanuts are not an animal. And so, it's misleading. So because maybe the name-brands can afford to add extra words on their label, you might buy the name-brand peanut butter because it says a cholesterol-free food, but the store-brand may not have the money or want to put that on there because that's how they keep their prices low. And so, you might say, "Well, why doesn't my store-brand say this is a cholesterol-free food for the peanut butter, but the name-brand does. I'm going to buy the name-brand just to be safe." So, things like being careful on knowing where cholesterol comes from. Cholesterol is made by the liver. So, only animals produce cholesterol; humans and beef, pork, chickens, turkey, things like that. So, caution around those kind of things.

And then, just be wary of anything that says grass finished versus grass-fed, are two different things. Grass-fed means an animal was fed grass, but perhaps at slaughter was then fed corn, which is not its natural diet to fatten it up, and then it weighs more so then the rancher gets more money at slaughter. So, that's not necessarily the diet of the cattle, for example. So, grass-finished means that cattle was given grass throughout its lifetime. And it was finished with the natural diet, which is clover, alfalfa, whatever the grass may be. So, grass-fed versus grass finished are two different scenarios on the label.

Host: Okay. And for families who are budget-conscious, and you sort of touched on this, talking about the store-brand peanut butter versus the name-brand, can paying attention to labels actually help stretch dollars while keeping nutrition a priority?

Denice Hynd: Yes, definitely. So when you buy canned beans, for example, you're going to have three options, or even buying canned vegetables, you're going to have three options. You're going to have your traditional option, which is canned black beans, canned corn. Then, you're going to have the low sodium option: low sodium black beans, low sodium corn. Then, you're going to have the third option, which is no salt added black beans, no salt added corn. You want to purchase the one that says "no salt added black beans," "no salt added corn," because that one will have literally no salt added. And then, you can drain and rinse those vegetables, and then use the corn and the beans to stretch out things that might be a little bit pricier, like ground turkey, ground beef in your tacos, in your chili, meatloaf and things like that.

Of course, not everybody has high blood pressure. There are some people in our community that have low blood pressure and they do need a little bit of extra sodium. So again, nutrition recommendations are unique to the individual, but the majority of our community does need to bring down our sodium intake.

Host: So, it sounds like overall you can pretty much eat the same foods you eat, but you look for the ones without hydrogenated oils or high-fructose corn syrup. And be aware of the all natural versus something more specific like grass-fed. You can eat pretty much what you normally eat without those things, I'm hearing.

Denice Hynd: Yes. I mean, and the recommendation really that dieticians would give the community is eat your intuitive natural diet, things that you enjoy and really aim to just fill your plate with as many colors as possible. And if you're always reading labels, then that means that you're eating a lot of packaged foods, right?

And so, we want to also try and eat foods that don't necessarily have a package. So, obviously, some foods have to have a package, like eggs need to come in a carton. Some canned vegetables and canned beans have to come, but there's also some rice and some beans come in a plastic bag. But for the most part, the perimeter of the grocery store, those foods don't come necessarily in a package. All your bulk beans, your bulk rice, your produce, maybe the fresh animal proteins, those kind of things don't come in a package. So if you're always reading boxes or of wrappers, then that might be an indicator that we need to shop more around the perimeter of the grocery store.

Host: And now, we know what to look for and what to avoid in terms of the labels of the foods that we do buy. Thank you for breaking that down so clearly, Denice. Reading labels really can feel intimidating, but with your tips, it suddenly feels doable.

Denice Hynd: It's my pleasure.

Host: A little knowledge really does go a long way toward making healthier, smarter choices. For more health and nutrition resources and updates on our community programs, follow Northern Inyo Healthcare District on Facebook, Instagram, and YouTube, or visit us at nih.org. Thanks for listening to Northern Inyo Healthcare's Mountain Medicine.