Monthly Archives: March 2015

Why the Swiss Can Eat So Much Chocolate and Stay Thin (& We Can’t)

Living in Switzerland many years ago should have been prepared me for the onslaught of chocolate bars displayed in the Zurich supermarket during a recent visit. Perhaps the upcoming Easter holiday had amplified the shelf space devoted to this particular confection; chocolate bunnies and chicks in all sizes vied for space with seemingly miles of chocolate bars, boxes of expensive chocolate truffles, and elaborately wrapped balls of melted chocolate encased in slightly bitter chocolate shells. “This must be Swiss chocolate heaven,” I murmured to my husband as we gathered up armfuls of chocolate bars to take back to the States. “They eat all this chocolate, and yet they stay thin.”  Earlier that day, as I scanned the crowds of commuters exiting the central railroad station, as well as the pedestrians strolling near the lake in the unexpected spring-like weather, I saw only a handful that might be called obese. This contrasted dramatically with the travelers and airport personnel when we arrived back in the U.S. a few days later. There it was difficult to find anyone who was thin.

How to counter the so-called obesity epidemic in the States has occupied panels of obesity experts, researchers analyzing trends in nutrient intake, physicians prescribing the latest weight-loss regimens and/or medications, and enough Internet space on the best way to lose weight to fill a small planet.

The latest recommendation to cut back on sugar consumption (as that nutrient, not fat, seems to be what causes us to become obese) is yet one more attempt to solve what seems to be an insoluble problem. Although a casual reading of this recommendation might lead one to stop consuming anything that has sugar from milk (lactose) to apples (fructose and glucose) to ketchup (sucrose), the recommendation is an attempt to make people stop consuming soda and drinks that are high in fructose. A corollary interpretation from these recommendations could lead one to assume it is all right to eat butter, salt pork and pork rinds along with heaps of mayonnaise, heavy cream and bacon grease, because it is sugar, not fat, that is causing us to balloon into supersizes.

Which brings us back to the Swiss and their chocolate.

Chocolate contains a substantial amount of both fat (cocoa butter) and sugar. Eating small amounts of it may confer some health benefit because of some tiny amounts of antioxidants, but it hardly competes as a diet food compared to, for example, kale or broiled salmon. Indeed, reading the label of a bar of dark (72% cacao) chocolate bar purchased from the Swiss supermarket, I noticed that the 100 gram bar (3½ ounces) contains 591 calories. So how do the Swiss stay so thin, munching on their fat and sugar-filled snacks?

The answer, of course, has nothing to do with how much sugar or fat they eat. It has everything to do with portion size and exercise.

Like so much of the world outside the U.S., the Swiss do not eat the gigantic portions of food that we Americans typically consume. Dinner one evening at this conference we were attending was a buffet, but unlike those in American restaurants, diners did not serve themselves. Everything was served, even a sauce or salad dressing, and the portions were, to my American eye, exceedingly small: a few ounces of the entrees and tablespoon-size amounts of side dishes and desserts. Obesity specialists in the U.S. have pointed to our enormous portions as a major contributor to weight gain, but that has not yet translated into smaller burgers or bagels.

Exercise probably trumps portion size in preventing the Swiss from becoming fat from chocolate, because they never stop moving. Children are put on skis as soon as they can walk, and the elderly even hike in the summer and cross-country ski during the snow months. Sunday afternoons find entire families out walking, climbing, biking, sledding, sailing, or doing something other than watching sports on television or reading the newspaper in an armchair. They do not consider this exercise as in, “I have to workout or run in order to stay in shape and not gain weight.” Instead, all this national physical activity is their lifestyle, as basic to their routine as sleeping or brushing their teeth.

When we lived in Switzerland, and went for our own hikes, we noticed a fork and knife on signs along with the number of minutes it would take the hiker to reach the restaurant.  Of course.  After all, there had to be chocolate at the end of the road.

Isn’t it time to stop the battles over how much is too much, of what we are eating? Is it too much to ask that moderation in nutrient intake be promoted as a goal, rather than eliminating or excessively consuming one nutrient or another as a way to stay healthy? And isn’t it time to alter our work/leisure schedule to insert physical activity as a basic part of our lifestyle? If we stopped sitting in a chair, obsessively searching the Internet for a solution to obesity and started to move instead, we, like the Swiss, could enjoy our chocolate and stay thin.


Lydia Pinkham, Snake Oil and Herbal Supplements

,If you were an American woman living any time between the mid-19th and early 20th century, and if you suffered from women’s troubles, then you may have dosed yourself with Lydia Pinkham’s Vegetable Compound. Developed from a recipe sold, as the story goes, to her father for $25.00 as payment for a debt, the herbal-alcohol mixture was transformed through aggressive marketing into a wildly successful product. Lydia’s picture was on the label, as it should have been, since she concocted the potion in her kitchen. Eventually its manufacture moved into a commercial facility.

Pinkham’s Vegetable Compound promised to cure, or at least relieve, ailments that at the time had no treatment.1 Women with menstrual difficulties were treated with leeches, or even surgery, and premenstrual syndrome was often ascribed to either hysterical personalities or water on the brain. And of course, many women did not want to go to a male physician for their female problems. Treating themselves with the vegetable compound maintained their privacy and probably, through its placebo effect, took away some of their distress.

Today we chuckle at the naiveté of Lydia Pinkham’s’ customers and the many others who purchased products that in our modern eyes were clearly fake, and had nothing in them to relieve symptoms or cure disease. Patent medicines, aka Quack Medicines, claimed to cure or prevent ailments ranging from venereal disease to indigestion to cancer. Their promises were outrageous. One well-advertised product supposedly contained snake oil, an ingredient reportedly miraculous in its ability to cure. Subsequently if someone tried to sell an obviously fake medicine, he stood accused of selling snake oil. 2

Of course this could never happen today; we are much too sophisticated and medically knowledgeable to believe in such nonsense.

Or are we?

Lydia Pinkham’s Vegetable Compound contained many of the ingredients–like black cohosh root, fenugreek seed, dandelion root, motherwort, and gentian root–sold today to help women with menstrual and/or menopausal symptoms. However, unlike today’s elixirs for female problems, Pinkham’s beverage contained a substantial amount of alcohol, which may have relieved some of the stress the women were feeling from their cramps and bloating.

A recent issue of a popular tabloid magazine directed to women and sold at the supermarket checkout counter reported these medical claims:

A 500 mg dose of a flowering plant called Rhodiola (not sure if one is supposed to eat just the flowers or the stem and leaves as well)  will decrease stress and accelerate weight loss by making more serotonin (stress relief) and increasing energy output (weight loss). Fact:  Serotonin is made from the amino acid tryptophan. There is no evidence that this flower increases energy output.
Holy basil, which related to mint, will relieve stress by making a soothing hormone, dopamine. 

Dopamine is like amphetamine. It energizes and stimulates when it is released; it does not soothe. Also, it is not a hormone.

Siberian ginseng will reduce your tension, assuming that holy basil and the Rhodiola flower has not already done so. It soothes your adrenal gland, in case you were wondering. Really?

There are many more of these fascinating tidbits of ‘snake-oil’ recommendations, and this magazine is not alone in describing them. Just go to the Internet.

The Quack Medicines of the last two centuries were not only ineffective; many of them were dangerous and could even cause death. Morphine, opium, cocaine, and alcohol were added, sometimes in substantial quantities and given not only to adults, but also to babies and children who might have colic or were fussy because of teething. Not surprisingly, physicians and medical societies were skeptical and critical of this ‘alternative’ medicine and those who did not want alcohol and drugs like opium to be included in these potions reinforced their criticism. But also, not surprisingly, there was pushback from manufacturers of the quack goods, as well as from the newspaper owners who benefited from the advertisements. Finally, in l908, Congress passed the Pure Food and Drug Act under President Theodore Roosevelt’s administration and prohibited the sale of products with misleading advertising and unlabeled or mislabeled ingredients. 3 So the era of Lydia Pinkham and similar patent medicines came to an end.

Or did it?

More than 100 years later, the New York Attorney General investigated the contents of what we now call herbal supplements. And like the Emperor’s new clothes, whatever was supposed to be there wasn’t. Herbs like St John’s Wort and ginseng listed on the label were not in the bottles; only the fillers like starch were to be found.4 Was the testing accurate? The manufacturers fighting the inevitably swift to arrive class action suits claim that the testing may have been flawed.5 However others stated that this was not the first time the content of an herbal supplement was missing or the dose incorrectly stated.

What is the consumer of such products to believe? At least Lydia Pinkham’s beverage contained enough alcohol to give the user a slight buzz, even if she did not get relief from menstrual cramps. But what if you were taking Echinacea to prevent getting a cold, or St John’s Wort to help your depression? And now you find out that the Echinacea was missing from the bottle and it was filled with ground houseplants instead, or that your St John’s Wort bottle contained only rice, garlic or beans?

There are two conclusions: The first is that a placebo is mighty powerful and rarely causes side effects, so be happy you stayed healthy, didn’t get the cold and your depression got better, even if you were ingesting ground rice. The second is that it is time to hold the manufacturers of herbs, twigs, grasses, and root supplements to the same standards to which pharmaceutical manufacturers must adhere. And maybe we should bring Lydia Pinkham’s beverage back on the market. At least she labeled her potions correctly.