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Lisa Tillinger Johansen's presentation based on her book "Fast Food Vinication." At the College of Charleston Think Differently Forum on March 28, 2013.

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Introduction

• FAST FOOD VINDICATION is a response to the obesity epidemic and many people who say that fast food is the cause not only for that, but for many of the problems in society.

• With a background as an executive in the fast food industry and as a health educator for both the Be Well program and for Kaiser Permanente, I have a unique expertise on this subject.

• We need to look at the bigger picture of everywhere we eat, not just at fast food restaurants.

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Introduction• FAST FOOD VINDICATION is a comprehensive

view of the causes and problems associated with the obesity epidemic and the contribution of lack of physical activity to it.

• It takes a look at the fast food industry’s impact on society from its beginnings to now, the food it offers, employment, philanthropic efforts, legislation for menu labeling and its impact, the banning of fast food restaurants in some cities and more.

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Introduction

• FAST FOOD VINDICATION also looks at the way that we eat and compares the foods offered at fast food restaurants, sit-down restaurants and home prepared meals.

• Focus is placed on personal responsibility, balance and moderation.

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Employment

• Fast food restaurants offer jobs to a diverse group of people from teenagers, to older workers, to people with disabilities and more.

• 1 in 8 people in the United States work at McDonald’s at some time in their life.

• In 2001, McDonald’s was responsible for 90% of the new jobs in America. They hire about 1 million workers each year.

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Employment• 40% of the top 50 McDonald’s executives

started their careers in the restaurants, as did 50% of franchisees.

• 67,000 restaurant managers and assistant managers started off as crew.

• Most fast food restaurants offer training, development and upward mobility, like KFC providing employees in Britain the opportunity to take a 3 year business studies course, McDonald’s Hamburger University and employee scholarships.

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Philanthropy

• Fast food restaurants are very philanthropic.• Among many of its charities, McDonald’s top

choice is Ronald McDonald House Charities which helps more than 3.6 million families each year.

• Wendy’s is heavily involved in adoption through its Wendy’s Wonderful Kids program whose efforts have helped place thousands of children in pre-adoptive and adoptive homes.

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Philanthropy

• Taco Bell teams with Boys & Girls Clubs of America.

• Mark Wahlberg partners with Taco Bell and its Graduate to Go program, which works with teens to stay in and graduate from high school.

• Burger King champions education through its Scholars Program.

• Yum! Brands (Taco Bell, KFC and Pizza Hut) coordinated one of the largest volunteer efforts in history with its first annual World Hunger Relief Week.

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Community

• Many fast food restaurants get involved at the local level through donations to athletic teams, schools, group meetings and many volunteer efforts through their employees.

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The Weight of the World

• Two-thirds of people in the U.S. are overweight or obese.

• Around the globe in 2008, about one male in ten was obese, as was one in seven females.

• The World Health Organization predicts that there will be more than 2 billion overweight people around the world by 2015.

• Of those, 700 million will be considered to be obese.

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Health Issues Associated with Obesity

DiabetesHeart Disease

Heart Attack/StrokeGallbladder Disease

Kidney DiseaseHypertension

High Cholesterol

OsteoarthritisCertain Cancers

Sleep ApneaDepression

Increased Surgery RiskMenstrual Irregularities

Pregnancy Complications

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Fast Food

• Approximately 1 in 4 people in the United States eat at fast food restaurants.

• McDonald’s serves approximately 64 million customers in 119 countries every day.

• In 2006, KFC served more than 1 billion chicken dinners worldwide.

• Subway became the largest fast food restaurant in 2010, expanding to 33,749 restaurants around the globe.

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Fast Food Wars

• As with all businesses, fast food restaurants compete with each other for customers.

• This is accomplished through revamped core products, premium items, value menus and items, limited time menu items, special promotions like Monopoly games to win free food and money, free toys with children’s meals and renovated restaurants.

• McDonald’s recently rolled out McD TV that plays family-friendly HD programming.

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Restaurant Dining

• A survey by Scarborough Research of over 210,000 people found that 96 percent of adults in the United States eat out at a restaurant at least one time in a typical month.

• In the average 30 day time frame studied, 91 percent ate at a fast food restaurant and 84 percent dined at a sit-down establishment.

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At Home Eating

• The majority of our meals are eaten at home, not at restaurants.

• It’s important that we look at everywhere that we eat in order to have nutritious meals and maintain a healthy weight.

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Portion Sizes

• A University of North Carolina study found that portion sizes of just about everything have gotten bigger over the past 30 years.

• One example is that the average size of bagels increased from three inches in diameter to six inches, adding about 200 more calories.

• Another example is theater popcorn, which wen from 5 cups (about 270 calories) to 11 cups (around 630 calories).

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Increased Consumption

• The USDA reported that the average person in the U.S. eats 30 pounds more sugar annually than we did 30 years ago. We also consume more meat (20 pounds), more cheese (14 pounds), more white flour (35 pounds), and more fat (12 pounds).

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Increased Consumption

• In 2012, Consumer Reports surveyed 47,565 people who ate 110,517 meals at 102 sit-down restaurants chains.

• Of those earning the highest marks was an Italian restaurant that was admired for its big portions.

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Fast Food vs. Sit-Down Restaurants

• Often portion sizes at sit-down restaurants are bigger and have more calories, fat, sodium and carbohydrate than like meals at fast food restaurants.

• As an example, the Ruby Tuesday Bacon Cheeseburger has 1009 calories compared to the McDonald’s Cheeseburger that has 300 calories.

• Coco’s Original Burger has 760 calories, while Burger King’s Hamburger has 290 calories.

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Fast Food vs. Sit-Down Restaurants

• A salad at a sit-down restaurant can have hundreds more calories than a salad at a fast food restaurant.

• Many sit-down restaurants offer unlimited fries with their sandwiches.

• At a sit-down restaurant, often a chip or bread basket is put in the center of the table and refilled by request. We can eat more calories out of the middle of the table than we should in an entire day.

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Fast Food vs. Sit-Down Restaurants

• A RAND Corporation study found that entrées at sit-down family style restaurants had more calories, fat and sodium on average than meals at fast food restaurants.

• David Zinczenko, editor-in-chief of Men’s Health magazine and co-author of the Eat This Not That! Series stated that sit-down restaurants are “considerably worse for you than the often-maligned fast food fare.”

• His menu analysis found that the average sit-down restaurant entrée had 345 more calories than the average fast food entrée.

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Heart Attack Grill

• Located in Arizona, Las Vegas and Dallas, this sit-down restaurant serves up very unhealthy fare, with a focus on hamburgers.

• Menu items include the Quadruple Bypass burger that has 8,000 calories.

• Customers who weigh 350 pounds or more eat for free.• Two spokespeople for the restaurant, one in his 20s,

died. He was 575 pounds.• Several customers have suffered heart attacks at the

restaurant, one while eating the 6,000-calorie Triple-Bypass burger.

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Heart Attack Grill

The restaurant’s slogan is “A Burger to Die For.”

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Portions at Home

• A study of more than 63,000 subjects reported in the Journal of the American Medical Association found that portion sizes of desserts and hamburgers were larger when prepared at home rather than in a restaurant.

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Cooking at Home

• A Cornell University study found that the serving sizes of many recipes found in the 70-year-old book the Joy of Cooking have gotten bigger over the years.

• Calories in this cookbook have increased by 40% for most of the book’s classic recipes.

• That’s about 77 extra calories per serving!

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Ban or Band-Aid

• Some cities, like South Los Angeles have banned new fast food restaurants.

• The goal was to get more healthy food establishments and grocery stores.

• Since the ban went into effect in 2008, only one new grocery store has opened in the affected area.

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Ban or Band-Aid

• A 2009 RAND Corporation study found that banning fast food restaurant expansion in South Los Angeles wouldn’t affect the obesity rate or associated lifestyle diseases like diabetes.

• It found that the convenience stores and gas stations in the area should receive more focus.

• A 15-year study of thousands of people found that improved access to grocery stores didn’t lead to healthier diets.

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Physical Activity

• Although the numbers are improving, only around 22 percent of adults in the U.S. vigorously exercise at least 20 minutes or more, three or more times per week.

• This percentage lowers to only about 15 percent of U.S. adults who exercise at least 30 minutes five days or more per week.

• Approximately 40 percent of adult Americans don’t engage in any vigorous exercise.

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Physical Activity

• Only about half of those aged 12 to 21 exercise vigorously on a regular basis.

• Only around 25 percent engage in even light to moderate physical activity (for example bicycling, walking).

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Healthy Eating Tips• Eat 3 meals per day plus appropriate snacks.• Don’t skip meals.• Monitor portion sizes.• Read nutrition facts labels.• Choose a variety of healthy foods, including

lean meats, fish and poultry, whole grains, low fat/nonfat dairy, fruit, vegetables and healthy fats.

• Don’t drink your calories.• Monitor fat and sodium intake.

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The Healthy Plate

• Aim to have half your plate non-starchy veggies prepared in a healthy manner.

• The starchy veggies are potatoes, peas, beans, corn, winter squash and pumpkin. These and all other starches should be one-quarter of your plate.

• The other quarter of your plate should be your protein (2 to 3 ounces for lunch and dinner, about 1 ounce for breakfast.)

• One piece of fruit and a low-fat dairy product can also be included.

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Healthy Substitutions

• Use nonfat or 1% milk instead of 2% or whole milk.• Try nonfat/low-fat cheeses instead of regular

cheese.• Use egg whites or egg substitutes instead of whole

eggs.• When using oil use unsaturated oils like olive,

canola and peanut oils instead of saturated oils like coconut and palm kernel oil.

• A serving size of oil is one teaspoon.

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Healthy Fast Food Choices

• Grilled chicken sandwiches, no mayo• Single hamburgers, no mayo• Turkey Burgers• Salads with grilled chicken and low

fat/nonfat dressing• Parfaits• Apple slices• Oatmeal – with appropriate toppings• Baked potatoes

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• A recent study of close to 5,000 adults 18 and over found that engaging in certain bad habits, such as inactivity, poor diet, drinking too much alcohol and smoking, can age you by 12 years.

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Next Steps

• When eating out in restaurants, look for more nutritious items. Order your food how you want it prepared, i.e. no cheese, no sauce, no mayo, no gravy, dressing on the side, etc. Make these healthy choices when eating at home as well.

• Use food diaries, like the online www.myfitnesspal.com to determine what you’re eating and to help you make healthy changes. Nutrition facts labels also provide info.

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Next Steps

• Exercise a minimum of 30 minutes most days of the week.

• If you need to lose weight, aim for 60 minutes most days of the week.

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Social Media

• On Facebook at Lisa Tillinger Johansen• On Twitter @LisaTJohansen• Web site – www.fastfoodvindication.com• Web site – www.consultthedietitian.com• Respond to questions asked through my Web

sites.• Weekly blog that is posted on both of my

Web sites and on a variety of other sites.

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