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Suicide by Sugar has been translated into 8 foreign languages!

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Are You Fed Up?

Observed by the Staff walking home from Fed Up on 6/4/2014

Observed by the Staff walking home from Fed Up on 6/4/2014

© 2014 Nancy Appleton Ph.D & G.N. Jacobs

We might have reached the tipping point in combatting the excessive sugar in the American diet that increasingly leads to diabetes, heart disease, cancer and a whole lot of ways to commit suicide (blatant plug). Veteran newswoman, Katie Couric, just released her documentary Fed Upthat may finally be the first real shot at curbing the abuses of the Processed Food industry. The Climate Change camp had An Inconvenient Truth that changed the nature of the discussion that most of the opposition couldn’t deny Climate Change, but rather assert – It’s a natural process and human industrial activity has nothing to do with it. We have Fed Up. And, yes, you really should see the movie. Ms. Couric and her team carefully researched the recent history of how Big Food fought tooth and nail (possibly even harder than Big Tobacco) to prevent anything like sensible legislation concerning the food we eat. The industry jumped on Senator George S. McGovern and his committee, The Senate Select Committee on Nutrition and Human Needs, in 1977. Once he’d failed to enact a dietary target of 10-percent of calories coming from sugar and similar substances instead of the Food Lobby’s 25-percent proposal, the bloodletting wasn’t done. Somebody abolished the committee within weeks of the hearing (not depicted in the movie). We have no word whether the Food Industry pulled levers with Congress and/or the Carter Administration to kill the committee or if Sen. McGovern did it himself to save political capital for the next fight. Speaking of Food Industry victories, we have to toss this firecracker – the government mandated food label has never listed a number for sugar in terms of a Recommended Daily Percentage. Yes, the label tells you how much total sugar in grams, but did not render that number into a percentage so the consumer can tell how much sugar to eat in a day. It is claimed that there is no scientific consensus on sugar, but both the filmmakers and us have cited the American Heart Association’s targets of 6-9 Teaspoons per Day (less than one soda) with nauseating regularity. The label will soon change to make a distinction between naturally occurring sugar and added sugar, but there will still not be a percentage on the label. These two incidents are signposts in a decades long process where we thought (or believed the Food Industry lie? We need to see internal company documents in discovery for a lawsuit) that fat causes obesity. However, the competing opinion with quite a bit more science behind it says that sugar causes obesity, diabetes, heart disease and even cancer. And we have the intervening 37 years of our own eyeball evidence that more people in general and children specifically, who have all eaten lean, are just a lot fatter than they used to be. Robert Lustig M.D (interviewed in the film) has long asserted that when the Food Industry agreed to cut fat in the 1980s from their processed foods it meant that the industry had to add sugar, mostly fructose, (asserted to have doubled in many foods with the new recipes) because foods with fat removed suddenly taste like cardboard. Sugar can get the consumer to eat anything, even a massively salty drink like Gatorade. He and the other speakers confidently paint a picture of an industry that uses the same playbook of deny, deny, deny, call Government regulation an example of The Nanny State and then throw all kinds of money at key legislators. And like it says on the shampoo label repeat as necessary. The experts all made the point that the Agriculture Department has spent the last 37 years caught between two diametrically opposed missions: promote the sale of American foodstuffs and regulate the American diet, especially for kids. The filmmakers also include the Federal Trade Commission and its failure to regulate food advertising on children’s TV shows making the point that kids see ads and may become customers for life to an industry that only cares about selling more food. The filmmakers used a visual bludgeon to make their point, showing clips from many ads. And they made a comparison to the general success of the anti-smoking lobby that progressively banned cigarette TV ads and then decades later won a landmark judgment in court. Ms. Couric pointedly asked what would happen if a celebrity that pitched for Coke and Pepsi also had to do a pro whole foods PSA on an equal time basis? She asked if a warning label reading Warning: this product is addictive and has been linked to diseases like… Meanwhile, Ms. Couric and team chose to highlight four kids from four seemingly typical American families who are amazingly obese. They went on the yo-yo of lose some gain it all back or even more within six months. They cried on camera. More importantly, they led us to their school cafeteria’s which happened to be ones that have succumbed to the national trend where school food has been outsourced to food companies serving ready made treats (the film really went after pizza) that can be heated up instead of cooked on site. And the filmmakers made a point of showing every Coke vending machine on each campus they could find. Sugar is everywhere at school. The four families and their obese kids ended up being a microcosm of the obesity epidemic. The parents were all fat. One bit the bullet and got a gastric bypass at 13. Another lost a lot…and then gained it all back a few months after the cameras stopped rolling. The other two seemed to be doing better. But, we the viewers may not have gotten the full skinny on the addiction elements of the obesity problem; we (the staff of Nancy Appleton Books) felt that while the addictive properties of the modern diet needed as much of a bludgeon that Ms. Couric used on the policy side of the film. We’re just not sure how we would’ve done it without treating four obese kids like a certain Soviet Ambassador to the UN during the Missile Crisis – “Don’t wait for the translation…” So maybe Fed Up is exactly what it needs to be. All of the experts and children serve to make one simple point – most of the problem goes away if we find the time and basic nutritional knowledge to resume cooking real food at home! Real food comes out of the ground or (vegans should put their fingers in their ears and hum, now) meat from the closest thing possible to a freshly killed free-range animal. The film showed at the end that at a local level some change is happening, a local school principal will toss Coke and Pepsi off campus and parents with knowledge have fought with letter campaigns to make changes in the cafeteria. There is hope.

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Reading Labels

© 2014 G.N. Jacobs

Would you know how to read a Coca-Cola label or the similar labels on any other food product sold in America? Well, don’t feel bad, even I had had to look it up when the new labels were mandated in 1994[i].

Yes, picking on Coca-Cola by presenting two versions of the 20-ounce bottle label and our favorite whipping boy, the 12-ounce aluminum can, is an intentional act. The reason: until very recently the Coke label defined the single most glaring technique for continued confusion of consumers: the section at the top of the main label box demonstrating the “official” Serving Size and Servings per Package sold to consumers.

Before I hook that fish in a barrel, I’ll backtrack and briefly describe the label that Congress and FDA enacted for all food items sold in the United States. We start with two parts: the Nutrition Facts box and the Ingredient List (see Fig. A).

Fig. A - Generic label

Fig. A – Generic label













The Nutrition Facts box starts at the top separated from the rest of the data in the box by a thick printed bar that tells how many servings are in the package and what the recommended serving size is. Then the next section down lists Amount per Serving for Calories, Total Fat (sometimes with sub-headers for Saturated Fat, Trans Fat, etc.), Sodium, Total Carbohydrates (with sub-headers for Sugars and Dietary Fiber) and lastly Protein. Interestingly enough, Calories and Sugars can be listed without referencing the Percentage of Daily Values (%DV), which is a percentage that measures how much is in the product versus how much various experts say you should have (for Sugar, Sodium, etc.) or how much you need (for Vitamins and Minerals) based on a 2,000-calorie/day diet. Typically, the lower half of the Nutrition Facts box is given over to nutrients like Vitamin C, Vitamin A, Iron and Calcium. Coke doesn’t have any of these nutrients and so the label reads not a significant source of Vitamin A, Vitamin C, Iron, Calcium or Dietary Fiber. The box at the very bottom of the box presents text that reminds the consumer that all calculations should be based on the 2,000-calorie diet, also defined by experts. The percentages in the lower section are given so the consumer can choose to eat more instead of limiting intake like with the ingredients listed on the upper part of the section.

The Coke labels show an interesting progression from the very bad old days to almost normal days. The first 20-ounce bottle label (see Fig. B) shows two listings depending on how much Coke is consumed. The Standard Serving is 8-fluid ounces (240 mL) with 2.5 servings/bottle. The whole bottle (listed under This Package) is 20-fluid ounces (591 mL) and one serving. The similar label from a 20-ounce bottle bought at a gas station (tax deduction! See Fig. C) in the center picture only gives the same values for the whole bottle (original formula Coke is same regardless of the label).

Fig. B - Transitional Coke Label

Fig. B – Transitional Coke Label


Fig. C - Normal 20-ounce Coke label

Fig. C – Normal 20-ounce Coke label








These distinctions become important when I assert that Coca-Cola used to game the labeling law to their advantage (pity that I couldn’t find an older 20-ounce label). The trick they pulled in the bad old days would be to only list the 8-ounce serving size nutrition information on the label. The 8-ounce serving size weighs in at 27 grams of sugar and the consumer might think I haven’t had too much sugar, today. I’ll buy a bottle. And promptly drink the whole bottle.

That the label posted on Coca-Cola’s website shows both and the label from an actual bottle only shows the listing for Serving Size (1 bottle) validates the efforts of many nutrition experts fighting to make the mandated label not be a pack of lies designed to trick shoppers into consuming more Coke. These trends also explain why the modern Coke labels on all packages also prominently displays in a large readable font the total calories – 240/20-ounce bottle and 140/12-ounce can. (See Fig. D) Enough people complained about the previous regime that tolerated such intentional confusion and Coke caved. Bravo!

Fig. D - Calorie listings on Coke labels

Fig. D – Calorie listings on Coke labels

In a recent development (Feb. 27, 2014), the FDA and the Obama Administration have announced new labeling regulations that will make it harder for food manufacturers to pull off the Serving Size scam. Apparently, all three major networks carried the story with NBC using it as the lead on a night when portents of severe weather and a brewing international crisis should’ve dropped it to the back of the broadcast. The summary of the changes: an across the board reduction of the number of servings per container listed on the label and clearer labeling for added sugars (sugar added during production over and above sugar native to the raw food ingredients).

This means that the generic 20-ounce soda bottle specifically mentioned in the NBC broadcast, as previously having 120 calories and 10 teaspoons of sugar per serving with two servings listed will now by law be relabeled to 240 calories and 20 teaspoons of sugar per 1 serving, the bottle. Hopefully, this more honest labeling will open more consumers’ eyes.Well, nothing can be done about Coca-Cola getting to claim that they voluntarily changed their labels ahead of the new regulation. The NBC broadcast also used a generic pint of ice cream, which was previously labeled as 4 servings, but will now list 2 servings. I’ve eaten full pints on bad days, but again it’s a start.

NBC’s version of the story included reminders from diet experts about limiting added sugars by listing the big diseases: heart disease, diabetes and so forth as being caused by too much sugar in the diet. The report included the supermarket lobby saying they support any new labeling requirements that reflect actual science, possibly a stall tactic to see if their lobbyists can do anything about it. However, the end of the report included a tidbit about a major university including accurate labels in the cafeteria and seeing a 7-percent reduction in consumption of foods that might be harmful to students. Forward progress.

But, those that see a food label as an opportunity to confuse the ignorant haven’t given up all their tricks. A good one is that the values given on the label are metric when Americans just never learned the Metric System like we were supposed to forty years ago. The values for sugar are given in grams – 27 grams 8-ounce serving, 65 grams 20-ounce bottle and 39 grams for the 12-ounce can. (See Fig. E)

Fig. E - 12-ounce Coke label

Fig. E – 12-ounce Coke label

But, do you know what a gram is relative to measuring units we actually use? Heck, I haven’t played with actual metric units since science class (a really long time ago). I couldn’t tell you what a gram of anything is, because I just don’t weigh or measure very many objects using metric units. But, I do know what a teaspoon is. We all do.

Converting grams of sugar into teaspoons for the American audience is fraught with built-in possible errors starting with grams and teaspoons measure different things: mass v. volume. There is a conversion equation that I haven’t used since high school,so you’ll just have to trust me when I assert a conversion of approximately 4 or 5 grams of solid dry granular sugar to 1 teaspoon. Coke’s “Standard Serving” of 27 grams of sugar comes in at 5 or 6 teaspoons. The full bottle of 65 grams ends up choking us with 13 to 14 teaspoons. The 12-ounce can of Coke hits us with approximately 10 teaspoons of sugar.

Teaspoons of refined sugar become important when we factor in the American Heart Association’s recommendation for daily sugar intake that as of 2009 are 9 teaspoons for men and 6 for women per day[ii]. One can of Coke will blow out our daily sugar limit such that if we were to take it seriously we couldn’t have dessert (if I’m going to take risks with my diet and it’s a choice between pie and a Coke, pie wins every time). I find it interesting that the American food manufacturer will only give the customer the metric measurement without the more accessible English units. We wouldn’t drink so much Coke if they spoke to us in teaspoons in addition to grams or milligrams.

There is another dirty trick that makes use of the Ingredient List section of the food label. By law, ingredients have to be listed in descending order from most to least. Sometimes, a food maker will list several different types of sweeteners (sugar, corn syrup, maltose etc.) to disguise how much sugar is in the food. A good example lurking in the door of your refrigerator: the jar of strawberry jam.

Everybody, whether a brand name or grocery store generic seems to have similar recipes for strawberry jam (See Fig. F and Fig. G) – in order: strawberries, high fructose corn syrup, corn syrup, sugar, fruit pectin and citric acid. Savvy people who read labels might be the only people aware that when three similar sweeteners are clumped together on a label that a very strong possibility exists that the collective amount of sweeteners could be greater than the strawberries in the jam recipe! Certainly, there is no taste difference between high fructose corn syrup, corn syrup and table sugar (sucrose).

Fig. F - Strawberry jam label cut from jar

Fig. F – Strawberry jam label cut from jar

Fig. G - Restaurant pack of  brand name strawberry jam

Fig. G – Restaurant pack of brand name strawberry jam











The generic label strawberry jam assumes 26 servings of a tablespoon each with 10 grams of sugar each. In this case, perhaps this is a mostly accurate usage of the Servings per Jar feature of the label (at least how I would make PBJs). But, jam and jelly comes in many different sizes, some of which are too small for a Nutrition Facts box, but must still list the ingredients (strawberries, high fructose corn syrup, corn syrup, sugar, fruit pectin and citric acid). The average consumer would suffer a head explosion trying to decipher how much sugar they ate in their restaurant pack at the diner by comparing the tiny pack to a jar of the same brand at the grocery store. In school, it’s called a proportional relationship (ouch!).

The usage on the label of three sweeteners that all taste like sugar to disguise the amount in the recipe seems like a dirty trick that has been made easier by the up to now absence of a numerical value for added sugar. A food manufacturer only had to tell the shopper the total sugar in the jam, not how much came from the strawberries versus the added sweeteners. In the past, I would dare you to call up any food company and ask about added sugar; you’ll be told we don’t discuss our proprietary recipe in such detail. This may change with the new mandate for more clarity about added sugars on the label. We’ll see.

In comparison, Coke’s ingredients are carbonated water, high fructose corn syrup, caramel color, phosphoric acid, natural flavors and caffeine. This simple recipe suggests that Coke, secure in being one of the world’s most recognizable trademarks and the assumption that their customers may not care about sugar intake, may feel less reason to lie about the sugar they sell.

The consumer also needs to know what various nutritional claims mean. Does Sugar Free mean no added sugar at all or does it mean less than .5 grams of sugar? The FDA’s site[iii] and the American Heart Association[iv] say the latter. I encourage everyone to look up the regulations for sugar, fat and so on. Follow the links above or paste the footnotes into your browser.

The label is good from the point of view that any label is better than none, but it seems like the FDA listened to too many food companies and created a system with just enough loopholes to get away with murder. We’ve covered the Serving Size and Number of Servings scam that may be fading into history because activists have finally spoken up loudly enough to be heard asserting that no one actually drinks an 8-ounce soda. The labels need more translation into understandable English units of measurement (teaspoons) and that the consumer should beware of similar classes of food being lumped together on the Ingredient List to disguise that it might be the most plentiful substance in the food. The label comes with a lot of fudge factor to it, but imagine no label at all.







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Just Desserts

© 2012 Nancy Appleton PhD & G.N. Jacobs

From my point of view, we are on the cusp of a major advance forward in nutrition as seen in the public sphere. Hostess Baked Goods may decide to completely liquidate. Yes, you heard me – Twinkies and Wonder Bread may disappear into brand oblivion. Please give me a moment while I do the same goofy dance I did when I heard about New York Mayor Bloomberg’s decision to fight for, pass and enforce a city ordinance banning sugary drinks over 16 ounces.

In neither case can I even pretend to be objective about my opposition to people who make money selling sugar, even in the face of mounting evidence that sugar will make you fat, clog your arteries and give you diabetes. If a car company knowingly sells a defective vehicle, I might say nice things about the company if they fix the car and pay out the damages that they honestly owe in order that a company that employs many people doesn’t go splat on the kitchen floor. I can’t do this for any sugar merchant; your products hurt people with no discernable upside, so get used to oblivion and/or increased regulatory scrutiny that artfully treads the line between corporate and personal responsibility.

Yes, the consumer really must take responsibility for what goes into their mouths, but at some point companies like Hostess must show the same corporate responsibility forced upon the cigarette companies by a landmark class action suit that perhaps if the products kill people then it isn’t good to sell them. Ironically, current anti-tobacco ads depict tobacco as killing a third of its customers in any given year mostly with the effects of long term usage catching up to the unfortunate. But, I maintain that Big Sugar kills nearly as many of its customers with the effects of sugar lurking to shorten lifespans. Except for the few at the cutting edge, we didn’t know about sugar in 1950 so you can make an excuse then, but we can’t make that excuse now. We need to see the same types of ads dealing with Big Sugar’s death rate, but…

Hostess is teetering on the brink of insolvency because of a vicious labor dispute. I must admit a lifelong general support for organized labor as defending workers from management who want to grind wages, conditions and benefits in their favor. I had always assumed that if both parties acted as rationally as possible in their own best interests and weren’t interested in going nuclear then both sides would compromise so that everyone gets their half-loaf victory. And sometimes, I’m said to say, workers do have to take a pay cut, especially if they are already well paid under previous union deals to keep the company competitive. I have no idea if this concept applies to Hostess.

The greatest irony during the countdown to the November 16, 2012 decision to liquidate the whole company to avoid the wage concessions is that ultimately both sides want to win in the game of chicken so that the company will continue to sell sugar to the public. The bakery unions want their higher wages and benefits so that they can feel valued for their work and get paid appropriately. The company wants more profit. However, this means that nutritionally speaking both sides earn the nastiest words my ghostwriter can think up to put ink to paper. Obviously, unlike for companies that sell a better class of products, I’m hoping that both sides will demonstrate the most arrogant intransigence forcing Hostess to implode in a puff of smoke.

Will we see less Twinkies or Wonder Bread bleached so white it really shouldn’t even be called bread? Probably not. It is still my job as a health researcher to keep publicizing why many aspects of our modern diet are bad for all of us. If a market still exists for the Twinkie, Ding Dong and Ho-Ho after the liquidation decision then Hostess can simply sell the brands and recipes to another company with a different labor agreement and the dance begins again. But, if we start getting our sugar from natural sources like whole fruits and vegetables and buy less sweets, maybe we’ll see the previously impossible: a failed sugary food company.

There is some hope that may happen. Buried in the articles explaining why labor and management are seemingly even more bitterly divided than Republicans and Democrats was this statement that sales of Hostess products are on a slow decline in part due to people making healthier eating choices. Imagine that.

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I Told You So

© 2012 Nancy Appleton PhD & G.N. Jacobs

If you have been watching the news recently, you’ll understand if I take a moment to enjoy that the tide may be turning on sugar. Perhaps, I should pull a Sally Field Oscar Speech and thank everybody on the planet, including CBS News. Okay, I’m fine now.

The magazine show 60 Minutes recently ran a story mostly based on Dr. Robert Lustig and his YouTube video that represented the opening broadside against refined sugar in general and fructose specifically. Dr. Lustig took the position that sugar is toxic and should be regulated the way nicotine and narcotics are regulated. Sign me up. Oh, that’s right, I already did and I told you so.

I have minor differences with Dr. Lustig that won’t affect the basic program of getting off sugar. Where he says fructose, whether bound as half the sucrose molecule or served up straight as High Fructose Corn Syrup, causes all the damage, I say to include excessive glucose in the regime. No one will get healthy replacing excessive fructose with even more glucose. Part of the diabetes/heart disease/hypertension disease cycle is simply run on too much sugar, whatever the type.

In short order, the show hit the high points of cancer, obesity, and heart disease and linked sugar to all of these diseases. The sugar spokesman tried to say Americans just need to exercise more to counteract the sugar, which flies in the face of our common experience that says many of us did exercise more and still got fat. However, many sugar addicts report that excessive sugar makes them mentally unready to exercise, making us even fatter. Lastly, the piece covered sugar’s addictive properties using the same stark terms as with cocaine or heroin. Again, I told you so.

My one quibble with the piece is that either because of time, professional timidity, or lack of research before air is that the producers only covered the high points of degenerative disease. My I told you so includes a lot more diseases than obesity, heart disease, cancer and addiction. I would’ve liked someone to explain the Mineral Wheel describing how the nutrients we take relate to each other and how sugar upsets the apple cart.

Sugar makes the body highly acidic causing the body to pull calcium out of the bones to act as a base to remain in homeostasis. In one fell swoop, I have just linked osteoporosis to sugar because what else is calcium taken out of the bones? But, I have also continuously asserted mineral relationships (calcium meets up with phosphorous just so and so on) as an indicator of the health of the body’s various hormone-based systems, which includes digestion and the immune system among others. If a person doesn’t fully digest food and can’t fight off a cold, can you think up a host of other medical problems to afflict us because of sugar?

I can. I did. And then I listed them. The only things in human medicine that sugar doesn’t seem to directly affect are accidents and other mayhem. Though, less sugar can help you recover faster.

Lastly, I would like to mention that CBS News and other outlets have also reported on the latest research from Harvard University that sugar adds a 20-percent risk of heart attack among men that drink one sugary drink per day. The tide is turning. Cities begin to ban sugary drinks from public vending machines. We begin to understand just how dangerous sugar is and I told you so.

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Paula Deen Follies

© 2012 Nancy Appleton PhD & G.N. Jacobs

 I’m not sure how to react to celebrity chef Paula Deen’s delayed announcement of contracting diabetes. Do I give full vent to the same schadenfreude as when I learned that many tobacco executives die of lung cancer? I don’t think I can pull off kicking that woman when she’s down with a straight face.

Ms. Deen bakes with sugar on the Food Network. We would seem to be natural enemies; the sugar lady with a signature recipe for Key Lime Pie vs. the anti-sugar lady who had to stop baking her mother’s recipe for Christmas coffee cake. If you’d ever tasted that coffee cake, you’d understand and forgive if I might be a little snotty about other people’s enjoyment of sugar. Truthfully, sometimes I’m exactly that person.

Ms. Deen even before her announcement had always hedged her bets telling her audience to practice moderation. I wonder if moderation can be taught by people who don’t look like they walk it like they talk it. I have never expected total abstinence and a life without a little chocolate or Key Lime Pie in it makes you extremely boring. So does this make her the food TV equivalent of a professional football player willing to spend the rest of her life in extreme pain in return for fifteen years of gridiron glory as an example for the rest of us? She doesn’t score touchdowns or do funny endzone dances, so I don’t think her fans will give her the same free pass for the apparent stupidity of wrecking your body for other people’s entertainment.

As soon as she let her diagnosis of Type-2 diabetes into our collective headspace, the media wolf pack circled for the kill. Some reports went right at the “southern comfort food” on Ms. Deen’s show enjoying with straight up vicious glee the irony that a chef promoting a diet rich in butter and sugar would suddenly contract diabetes, an apparent poetic justice. Fellow celebrity chef/travel host Anthony Bourdain weighed in calling her “the most dangerous woman in America.” Well, maybe she could be if a person actually ate her dishes at the rate at which Ms. Deen presents them on her show.

News shows found pictures of Ms. Deen posed with stacks of butter and suddenly scrutinized every meal. Oooooooooooh! She had a cheeseburger and fries! I’m not going to defend that plate as healthy, but no one eats perfectly. I still occasionally bust out the real whipped cream for the once a year pumpkin pie. I pay for it a few days later and go back to my normal regimen. I suppose this sort of thing could be what Ms. Deen meant by moderation, striking a balance between her Key Lime Pie and living long enough to enjoy the experience.

It wasn’t just the media having fun with apparent hypocrisy, but the announcement also included an agreement with a drug company to sell their top shelf diabetes drug. The jackals closed in all over again because we hate corporations and the very thought that a celebrity would sell out on a medical condition for money. At least, we know her maintenance care will be essentially free.

The coverage did also need more balance concerning the health advice for diabetes patients as butter’s being bad for people is under debate. Some (like the Atkins Diet and me) say naturally occurring dairy fat with limited lactose so eat responsibly because there are no substitutes, except that comes from a chemistry lab. Others (American Diabetes Association) say No Never. Even so that stack of butter sticks made for a great photo with which to smack around a celebrity. I suppose it’s now time for all of us to be distracted by the next dress to walk down the runway.

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