Don’t Let the Numbers Fool You: A User’s Guide to Nutrition Labels

woman comparing food labels in storeEver stood in the grocery aisle, staring at the nutrition label of a can of soup or box of cereal and tried to figure out if it was “healthy” or not? It can feel like you need an advanced degree in mathematics or chemistry to decipher all the numbers and ingredients. And that’s not even accounting for any dietary restrictions. For people with diabetes or congestive heart failure, trying to read food nutrition labels can not only be confusing, but potentially overwhelming. Fortunately, there are some things you can do to decrypt the nutrition label code.

The Nutrition Puzzle

According to Lane Hobbs, Virginia Mason registered dietitian and certified diabetes educator, food nutrition labels are not an “eat this, not that” source of information. It’s always going to show a percentage of something higher than others. What the nutrition label can do is help “put together the puzzle of your diet.” The big pieces of your dietary puzzle should be the low calorie, high vitamin and mineral types of food such as fruits, vegetables, whole grains and lean meat. The little pieces are the things that are higher in calories or fat – like butter or oil. An avocado may be higher in fat than lettuce, but that doesn’t make it unhealthy. It’s just information. Nutrition labels can help make those little pieces fit in your daily dietary puzzle.

Go Low

But you say, “I’m making spaghetti for my family for dinner – how do I know which sauce is the healthiest choice?” Lane suggests you look for foods that have lower sodium, higher fiber and lower sugar. Turns out, spaghetti sauces are high in sodium. Lane recommends that when you’re looking from label to label – like with spaghetti sauce – just pick the one with lower sodium. It’s the comparing that is helpful, not picking up an avocado and saying it has fat, I can’t eat that.

Do the Math

Checking nutrition numbers – sounds easy, right? Not necessarily. Percentages on nutrition labels are often confusing. For instance, you may think a label claiming the food has 12 percent fat means the food itself contains 12 percent fat. In actuality, that number is the estimated amount of fat a person needs during one day. Meaning if you eat a serving of that food, you would be getting 12 percent of the fat you need that whole day.

That information is particularly important when looking at high sodium foods like soup – one serving size may contain a third of the amount of sodium a person needs all day. So if you are comparing soups labels, go for the one with less sodium – or better yet, make it fresh yourself.

Familiarize Yourself

If you are on a no/low sodium diet, don’t panic when reading labels or trying to find heart healthy recipes. Sodium is natural in foods. Lane advises you to simply not add sodium to your meals. Or don’t eat as many foods that have higher amounts of sodium.

But how do you figure out a recipe’s sodium component? Get familiar with what ingredients already have a lot of salt like sausage, blue or parmesan cheese, or chicken broth. If those salty ingredients are already in the recipe, says Lane, don’t add additional salt. Looking at nutrition labels is one way you can starting learning what foods have a lot of salt.

It Gets Easier

New Food Nutrition LabelFortunately, reading nutrition labels should get easier in the future. New, simpler nutrition labels will be required in 2018. There will still be a lot of information on the labels, but the goal is to make some things more transparent, like serving size. Today one container of yogurt may actually have a serving size of two servings. Going forward, the nutrition information for that yogurt will indicate one serving size.

Another improvement coming to future nutrition labels: changing “sugar” to “added sugar.” Right now, sugar numbers on a nutrition label do not have much meaning. Milk and yogurt, for example, have sugar on the label because it’s natural – sugar is part of the dairy. In the future, however, the nutrition labels will indicate when sugar has been added to the food. Thus, skim milk won’t have added sugar while chocolate milk will.

But you don’t need to wait until 2018 to get something useful from a nutrition label. Lane suggests you just learn a little at a time, and be careful about serving size. Serving size is one of the most important things on the label.


Marianne is a Web Producer for Virginia Mason who hates to do math. She’s looking forward to food labels that don’t make her have to think as much.

Easy After-School Snacks

by Ingrid Ougland ***

Every morning I send my son off to school with a lunch box filled with nutritious and tasty foods. Between the time he gets on the bus in the morning and the time he gets home, I have no idea what happens to this carefully constructed meal. Does he trade it for whipped cream filled and preservative laden treats? Is it stuffed in his desk in favor of the endless classroom supply of goldfish crackers? Most likely the contents sit idle during the 20 minute lunch period in favor of a heated Minecraft debate, then tossed in the garbage on the way to recess.

Colorful cut vegetablesOne thing is certain, my son comes home “starving” and if I don’t have a healthy snack immediately ready for consumption, my kitchen will be hit by a 10-year-old tornado in search of potato chips. For this reason, I am very careful to choose an after school snack that can help make up for his lack of lunchtime nutrition.

Beth Olenchek, with Virginia Mason’s Nutrition and Fitness for Life and Community Benefit programs, told me that one of the most helpful things parents can do to create healthy eating patterns is to structure meals and snacks — this means teaching kids to eat healthy meals with a variety of nutritious foods, healthy snacks at snack time, and limiting high-fat, high-sugar treat foods.

“Without this structure, it’s easy for kids to make unhealthy choices,” says Beth. “When kids skip meals or don’t eat enough of what’s served, they overdo it at snack time and aren’t hungry for the next meal. This often leads to kids eating too little of the right foods and too much of the wrong ones.”

Beth also suggests getting your kids involved as you plan the week’s meals and snacks, go grocery shopping and cook meals. “Let them choose some healthy foods and get those foods on the grocery list. Talk about what will be served at snack time and stick to that plan,” she says.

Below is a list of snack you can try with your kid:

  • Dried fruit, served with nuts or sunflower or pumpkin seeds
  • Frozen desserts, such as nonfat or low-fat ice cream, frozen yogurt, fruit sorbet, popsicles and fruit juice bars
  • Air-popped popcorn with parmesan cheese
  • Pre-chopped veggies (broccoli, cauliflower, snap peas, carrots or celery) with light ranch dressing or hummus
  • Whole-grain breads and crackers (compare labels and look for products with the highest fiber content) served with 100 percent fruit spread, low-fat cheese or natural nut butter such as peanut, almond, cashew or sesame seed (known as tahini).
  • Quick smoothie: Blend together low-fat milk, sliced or frozen bananas, peanut butter and one-half teaspoon vanilla extract.

One more thing to note: Children of preschool age can easily choke on foods that are hard to chew, small and round, or sticky, such as hard vegetables, whole grapes, hard chunks of cheese, raisins, nuts, seeds and popcorn. It’s important to carefully select snacks for children in this age group.

Ingrid Ougland is Virginia Mason’s community benefit manager.


A Farmers Market With a Lasting Impact

by Ingrid Ougland Sellie, Community Benefit Manager, Virginia Mason **

According to the Centers for Disease Control (CDC), nationwide nearly 26 million people have diabetes and 79 million people are pre-diabetic. Obesity is a national epidemic, causing higher medical costs and a lower quality of life. No state meets the national Healthy People 2020 Goal of 15 percent or less obesity. In case you’re wondering how Washington state fares, more than 22 percent of adults in Washington state are obese and childhood obesity has more than doubled in children and tripled in adolescents in the past 30 years.

Beautiful radishes and other veggies await you at the farmers market.

Beautiful radishes and other veggies await you at the farmers market.

The simple solution is to eat healthier, right? Just make a salad or fresh meal instead of hitting the dollar menu at the local fast food joint. Unfortunately, depending on where you live and what your budget is, it’s just not that easy.

Lack of access to fresh fruits and vegetables is a big concern in neighborhoods where there are no low cost stores or markets within walking distance or easily accessible via public transportation. These neighborhoods are called “food deserts.”

One solution to food deserts is starting a farmers market, which is exactly what Virginia Mason is doing. But instead of simply providing access to fresh food, Virginia Mason is hoping to make an impact on our community’s health by transforming the traditional market model into an educational event – sharing wellness information and presenting talks by medical professionals on health-related topics. And to help people figure out what to do with that odd-looking vegetable, Virginia Mason’s own Chef Jeff Anderson will create a new recipe every week and give cooking demonstrations. His recipes will be posted online and provided as handouts at the market.

Why all the extra effort for a farmers market?

“People don’t always see the connection between fresh food and what ends up on their fork,” says Brenna Davis, director of sustainability, Virginia Mason. “Our market provides an amazing opportunity to reach out to our community with not only fresh sustainably grown food, but information that empowers the community to improve their health. As an organization, we’re committed to lowering our environmental impact while improving the quality of life of everyone in the region.”

A schedule of events will be posted on the Health and Wellness blog, which will include talks by experts from the Digestive Disease Institute, nutritionists and a special children’s day with games and kid friendly recipes.

To kick off the first farmers market of the season, Cedar Grove will be on hand to demonstrate how 5 tons of food waste per year from the Virginia Mason cafeteria becomes compost. They’ll also be giving away free samples.

FlowersHere’s the skinny (no pun intended):
Virginia Mason Farmers Market
Lindeman Pavilion, Ninth and Seneca Street, Seattle
Fridays, 11 a.m. – 3 p.m., through August 30
Vendors include: local fruit, vegetables, goat meat, pickles, tamales, hummus, baked goods (including a gluten-free bakery) and flowers.

Ask a GI Dietitian: Staying Healthy This Summer

by Samantha Woodward, Digestive Disease Institute **

Debra Clancy, RD, CD, is a registered dietitian who works with patients within Virginia Mason’s Digestive Disease Institute providing nutrition information and tools for making positive changes in their lives. In a recent chat, she gave us the inside scoop on how to make healthy choices when you are out and about this summer and surrounded by meat in buns and ice cream on cones.

If I’m trying to stay healthy this summer, what types of foods should I eat more of and what foods should I avoid?

Clancy: Instead of avoiding some of your favorite summer foods, modify their ingredients and eat smaller portions. Make small, but significant, changes to summer food recipes like decreasing fat and sugar content by using low-fat products or decreasing the amount of sugar in a recipe.

A healthy summertime meal from the grill.

A healthy summertime meal from the grill.

The typical summer gathering with family and friends lasts for several hours, so try going back to the buffet more often, each time taking small amounts of food instead of overfilling your plate on a single trip. Choose side-dishes, salads that have a vinaigrette dressing, or very little mayonnaise, and meat items that have the skin removed or have minimal sauce covering them.

At your next ballgame, don’t order deep-fried foods – or try to split a dish with someone. Other healthy choices include ordering a smaller size beverage or water. When it’s time for dessert, try a small amount, scrape off the frosting and eat just the cake or choose a fruit dish instead. Choose mineral waters or flavored waters instead of sugar-sweetened beverages.

Don’t forget to exercise by walking and participating in activities that increase your heart rate for at least 30 minutes daily.

What food choices can I make to help prevent indigestion?

Clancy: If you are prone to indigestion, the symptoms are often increased when a large meal is spicy, acidic or high in fat. Spicy foods may be the BBQ sauce on the grilled chicken breast. Tomatoes are examples of acidic foods. High fat foods include cream dishes, deep-fried items and salads with lots of mayonnaise.

Follow these simple tips to minimize heartburn:

  • Eat green salads with minimal dressing, skinless turkey and chicken, fish and seafood, melons and bananas, and root vegetables, such as carrots and potato.
  • Choose low-fat dairy products as supplements to the meal, not as the main item.
  • Eat small amounts of food over a number of hours during the event.
  • Remain sitting upright for one to two hours after each meal.
  • Avoid carbonated sodas, alcohol, chocolate and large amounts of caffeine.
  • Weight loss often improves indigestion symptoms and decreases the progression to GERD, or gastroesophageal reflux disease.

Indigestion becomes GERD when your discomfort lasts for a longer period of time or when it occurs with each meal. If you are following the above suggestions and your symptoms persist, it’s best to seek medical advice.

When it’s your turn to be the host this summer, search online for healthy alternative recipes for your favorite foods:

Enjoy your summertime BBQ’s and events!

Guiding Good Food Choices in Our Cafeteria

Guiding Stars, the nation’s leading independent nutrition guidance program, is partnering with VM to help hospital staff and guests make more nutritious choices when dining in the medical center’s cafeteria.

Guiding Stars Program at Virginia MasonVirginia Mason is the first foodservice provider on the West Coast to implement the Guiding Stars at-a-glance food rating system that helps diners quickly and easily identify foods that offer a better nutritional value. The program is part of the hospital’s comprehensive Health and Sustainable Food Practice Pledge designed to improve the overall health and well-being of patients, staff, visitors and the surrounding community.

“Virginia Mason has been widely recognized as a premiere health care center across many clinical disciplines, and adding Guiding Stars to its foodservice program is a clear indication of the priority the center places on holistic health,” said Sue Till, client services manager with Guiding Stars. “We’re very pleased to have them as our first West Coast hospital partner and we look forward to working together to help people live healthier.”

The Guiding Stars system rates the nutritional value of every item in the Virginia Mason cafeteria, including hot and cold prepared foods, salad bar, grab-and-go items and beverages. Each item is then labeled according to its value: one Guiding Star is good, two Guiding Stars is better and three Guiding Stars is best. All items are evaluated using a patented algorithm based on the USDA Dietary Guidelines for Americans and other national evidence-based nutrition policies.

“We all know that eating healthy is so important, but when you’re pressed for time or concerned about a loved one, it can be difficult to take time to figure out which items are the best choice for you,” said Virginia Mason Food & Nutrition Director Jerry Roundy. “While we always make it a priority to provide healthy options, the Guiding Stars program adds an extra layer of user-friendliness, especially for those with specific dietary concerns.”

For more information about the Guiding Stars program, visit

Vitamin D Supplements Can Benefit Puget Sound Children

Vitamin D Supplements Can Benefit Puget Sound Children

Is your child getting enough liquid sunshine?

The Pacific Northwest is famous for many things. Sunshine, however, is not one of them. My family recently relocated to the area, and I knew the local weather would affect our daily activities. I also knew the weather could affect our health. Along with new rain boots and umbrellas, I made sure my family started vitamin D supplements.

Not just for bones
Vitamin D, along with calcium, is well-known for playing a critical role in building strong bones. Without enough vitamin D, bones will be weak and soft, a disease called rickets. There is now evidence that vitamin D may be important in the health of the immune and cardiovascular systems. Providing your child with correct amounts of vitamin D could also be important in the prevention of heart disease, arthritis, diabetes, lupus and some kinds of cancer. 

Milk is not enough
Our skin makes vitamin D when exposed to the sun. With an average of only 65 sunny days per year in Federal Way and the South Sound, where I practice, the sun is not a dependable source of vitamin D for residents. Additionally, clothing and the use of sunscreen interfere with the process. Vitamin D can be found naturally in only a few foods, such as fatty fish (salmon, mackerel, sardines and tuna), egg yolk and beef liver. Milk, yogurt, cereal and orange juice often have vitamin D added to them. Even with fortification, however, it is very difficult to get enough of this essential vitamin from diet alone.

Let’s talk numbers
An infant, child or adolescent generally requires about 400 international units (IU) of vitamin D each day. One cup of milk provides 100 IU of vitamin D, which means a child would need to drink a whopping 32 ounces of vitamin D-fortified milk each day to get the daily recommended dose. Most children can’t drink this amount, nor do many of them have a taste for sardines or beef liver. The American Academy of Pediatrics therefore recommends that 400 IU of vitamin D supplementation be provided daily starting soon after birth. 

Liquid sunshine
Vitamin D supplements come in many forms and can be found at your local grocery store, pharmacy or vitamin supply store. For infants and children under the age of 3, vitamin drops are used. Chewable vitamins are generally given to children over the age of 3. Most multivitamins for children include the recommended daily dose.

As long as my children call the Pacific Northwest home, I’ll make sure they get 400 IU of the sunshine vitamin every day. Speak to your pediatrician if you have questions about vitamin D supplementation for your child.


Lauren Athay MD Pediatrician Virginia Mason Federal WayPediatrician Lauren Athay, MD, is with Virginia Mason Pediatrics in Federal Way. (253) 874-1616.

Coconut Water: Miracle (or Myth) in a Box?

Dreading a blazing day’s forecast last year, I knew to start chugging the liquids early before heading out to an all-day tennis competition. In my home that morning, I had two options: trusty water from my fridge (free) or the much hyped hydration “miracle” coconut water (certainly not free).

Reaching for anything to keep my feet moving faster than my opponent, I went with the coconut water. Hours later and about a dozen dollars poorer, I still cramped under the heat and felt thirsty and exhausted. I knew the next morning would be spent lying on the couch struggling to get around all day.

Is coconut water really the fountain of athletic youth it is claimed to be, or are all the claims simply hype? Here’s what I learned about the juice, while lounging haplessly the next morning and researching what the experts had to say:

  • Water may be just fine. Most of us won’t compete in the Ironman triathlon, so for many exercises, even strenuous routines, water is adequate to replenish liquids. Be sure to sip the stuff before, during and after a workout and watch for signs of dehydration.
  • It’s all about what you sweat.When you sweat, you lose electrolytes (such as potassium and sodium) as well as water. With increasing time spent exercising and sweating, you may need additional electrolytes and hydration.
    • Coconut water’s real asset is high potassium (300 to 500 milligrams). Yet, sodium is mostly what we sweat out and need to replace; this is what coconut water lacks.
    • Coconut waters available on the market vary in the amount of sodium they contain. Rehydration drinks typically contain 110 mg of sodium per 8-ounce cup serving, but pure coconut water beverages (not concentrate) claim to contain about 40 to 60 mg of sodium in an 11-ounce serving (one particular brand contains 160 mg per serving).
    • You’re better off drinking water and eating some salty pretzels to replenish electrolytes. You can also replace both sodium and potassium by eating some fruits or vegetables after your workout.
  • Don’t buy into all the other health claims. Can coconut water prevent cancer, help manage diabetes or even prevent aging? It is highly unlikely and not at all backed by convincing scientific evidence. You should speak with your doctor about proven ways to prevent illness through nutrition.


Dane Fukumoto enjoys playing tennis. When he is not on the court, he is working as Virginia Mason’s patient communications manager.