What’s for dinner?

It’s a deceptively simple question, asked millions of times each day. But consider the myriad factors that go into answering it — from cost to convenience to climate change — and it’s no wonder we spend so much time thinking about the food we eat.

And that doesn’t even account for breakfast, lunch or snacks.

Quite a lot rides on Americans’ food choices, including trillions of dollars in spending and our collective risk of developing a slew of chronic diseases. That’s why the International Food Information Council conducts an annual survey on food and health.

“It’s about understanding the mindset of the consumer,” said Kris Sollid, a registered dietitian and senior director of nutrition communications for the industry-funded nonprofit.

Over nearly two decades of IFIC surveys, taste has consistently ranked as the most important factor in food-buying decisions, followed by price, healthfulness, convenience and environmental sustainability.

In the 2024 survey — which was answered by 3,000 Americans in March — about 30% of respondents said an item’s sustainability mattered a lot when making purchasing decisions about what to eat and drink.

That may seem low, considering that scientists are already scrambling for ways to feed the nearly 10 billion people expected to live on the planet by 2050 while simultaneously reducing heat-trapping greenhouse gas emissions.

But to Sollid, the fact that 30% of those surveyed gave sustainability a score of 4 or 5 on a 5-point scale counts as a strong showing.

“Of course I’d like to see that number higher, there’s no doubt about that,” he said.

Here’s a look at the state of the American diet, based on data from IFIC’s new findings.

What’s on our minds when we decide what to eat?

For starters, we are looking for something to give us energy or help fight fatigue. But health considerations are top of mind as well.

What kinds of foods are we choosing?

Protein is the most popular nutrient du jour — 20% of those surveyed said they were following a “high protein” diet in the past year, up from just 4% five years earlier. But it’s hardly the only thing we want in our food.

At the same time, Americans are trying to cut back on ingredients that are bad for us.

For instance, 50% of those surveyed said they were trying to limit or avoid sodium, or salt. Too much salt can cause your blood pressure to rise, and high blood pressure (also known as hypertension) is a risk factor for serious health problems like heart disease and stroke.

In addition, 44% of those surveyed said they were trying to limit or avoid saturated fat. This is the type of fat that can cause LDL cholesterol — the bad kind — to build up in your blood vessels, which also increases the risk of heart disease and stroke.

But Public Enemy No. 1 is sugar.

What’s so bad about sugar?

Our bodies need some sugar for energy. But when we consume too much of it at once — which is easy to do when downing soft drinks, breakfast cereals and all kinds of ultra-processed foods — it gets stored as fat, which can lead to obesity, diabetes and heart disease, among other problems.

Two-thirds of those who took the IFIC survey said they were trying to limit their sugar intake, and 11% said they were trying to avoid it entirely. Their main targets were added sugars in packaged foods and beverages, though some were also cutting back on the natural sugars present in foods like fruits and plain dairy products.

The reasons motivating this retreat from sugar were a combination of current and future health concerns.

What other concerns factor into our food choices?

We’re not just thinking about ourselves when we decide what to eat. For many people, concerns about the way our food is produced matter when they decide whether to buy a particular food or beverage.

That concern extends to animals, to the people involved in all aspects of getting food onto our plates — from farmers to factory workers to grocery store or restaurant staff — and to the planet itself.

How do we gauge whether a food was made with the environment in mind?

The good news is that this is something more than 70% of survey-takers care about. The bad news is that there’s no easy way to tell.

“There’s no true definition of what makes a food environmentally sustainable,” Sollid said. “There’s not one thing someone can look to on a food package to tell them whether or not this choice is better than that one.”

Instead, eco-conscious consumers use the following clues to guide them:

Will people pay more for an eco-friendly product?

Producing foods and beverages in a sustainable way often means added costs. So IFIC posed this hypothetical scenario:

Imagine you go to the store to buy a specific item and find three options. One costs $3 and has an icon indicating it is “not very eco-friendly.” Another costs $5 and is labeled as “somewhat eco-friendly.” The third costs $7 and is “very eco-friendly.”

Which would you choose?

What’s the relationship between food and stress?

It goes in both directions, the survey found: Stress affects the foods we choose, and the foods we choose can cause stress.

It’s a topic IFIC began asking about following the onset of the COVID-19 pandemic, which created both economic insecurity and food insecurity.

“COVID uncovered a lot of angst or potential sources of stress that a lot of people had to face,” Sollid said.

Four years in, nearly two-thirds of those surveyed are grappling with a significant amount of stress, up from 60% in 2023.

What are we so stressed about?

Money and health issues remain the biggest sources of stress among those who said they were “very” or “somewhat” stressed. Food choices are weighing on the minds of nearly 1 in 4 people in this category.

Are we eating our feelings?

Some of us are. Nearly two-thirds of people said their mental and emotional well-being had a significant or moderate impact on their diet.

Among those who were at least somewhat stressed, about half said their food and beverage choices suffered as a result. However, a small number responded to stress by seeking out healthier options.

Allergist and immunologist Dr. Gideon Lack’s first inkling that some peanut allergies might be preventable came more than 20 years ago while he was giving a talk in Tel Aviv.

Lack, a professor of pediatric allergies at King’s College London, asked an audience of roughly 200 Israeli allergists how many children with peanut allergies they had treated in the last year. When he asked that question during similar talks in the U.S. and U.K., nearly every hand in the room shot up. To his surprise, only two or three Israeli doctors raised their hands.

He did some research and zeroed in on a key difference: Parents in the U.S. and U.K. were told not to give their infants any peanut products until the age of 3 as a precaution against future peanut allergies. In contrast, puffy peanut snacks were a favorite staple of many Israeli babies’ diets.

Lack and colleagues decided to test the theory that early oral exposure could actually prevent children from developing peanut allergies. After tracking hundreds of children from infancy to early adolescence, they recently concluded that babies who eat the stuff early and often in their first five years of life are 71% less likely to be allergic to peanuts at age 12.

The Learning Early About Peanut Allergy (LEAP) clinical trial ultimately overturned the official guidance given to new parents and has potentially prevented countless new cases of a serious and potentially deadly allergy.

“It was revolutionary,” said Dr. Rita Kachru, a UCLA allergist and immunologist. “It really completely shifted the paradigm and the understanding of food allergy.”

The team recently published the third and final report of their longitudinal study.

In the first phase, whose results were published in 2015, the team recruited 640 babies between the ages of 4 and 11 months deemed at high risk for developing allergies, either because they were already allergic to eggs or had severe eczema.

Half the babies were prohibited from consuming any peanut product in their first five years. The other half had to eat at least 6 grams of peanut protein per week.

At the five-year mark, 13.7% of peanut-avoiding kids who had no sensitivity to peanuts at the start of the trial had peanut allergies by the end.

But only 1.9% of the peanut-eaters in this group did — an 86% relative reduction in peanut allergy risk. For kids who showed some initial sensitivity to peanuts at the start of the test, eating peanuts was associated with a 70% relative reduction in developing a full-blown allergy.

“The results have the potential to transform how we approach food allergy prevention,” Dr. Anthony Fauci said at the time. Fauci was then director of the National Institute of Allergy and Infectious Diseases, which helped fund the study.

In the second phase, the researchers asked 556 participants from the original study to avoid peanuts entirely for a year, to see if continuous peanut exposure was necessary to prevent allergies from forming. Only a few kids who had previously eaten peanuts without issue developed an allergy after going without them for 12 months.

In the third phase, published last month in the New England Journal of Medicine, the researchers tested 508 children who had participated in the first two studies.

Participants had been free to eat or avoid peanuts as they wished in the six years since they were last studied. The team found that 15.4% of participants from the group that avoided peanuts in early childhood had peanut allergies at age 12, while only 4.4% of those who ate peanuts early on did.

“It was doubly gratifying because our hypothesis was correct, but more importantly, we now have a strategy to prevent — and I would argue, nearly eradicate — the development of peanut allergy in the population,” Lack said over Zoom from London.

Incidence of food allergies began rising sharply in the 1980s, particularly in industrialized Western nations. In 1997, 0.4% of people in the U.S. had diagnosed peanut allergies. Today, about 1.8% do.

Amid the search for explanations, one 1989 study found that infants whose exposure to common allergenic foods was severely restricted in their first two years of life ended up with fewer allergies than those in a control group.

Largely based on that research, in 1998 the U.K. instructed women to not eat peanuts during pregnancy or while breastfeeding if they or their partner had a family history of allergies, and to prevent their child from eating peanuts until the age of 3. The American Academy of Pediatrics adopted similar guidelines in 2000.

After the first two LEAP reports came out, both the American Academy of Pediatrics and British Society for Allergy and Clinical Immunology issued new guidelines in 2017 incorporating the results. They now advise children at greater risk of developing a food allergy — those with eczema, egg allergies or both — to start eating peanut products between 4 and 6 months. For children without risk factors, the AAP says, peanuts can be introduced whenever the baby starts eating solid foods.

“Previous guidance and recommendations prior to the LEAP study, where we were just avoiding peanuts because we were afraid of peanut allergy, was completely thrown out the window,” said Dr. Jenny Lee, a UC Irvine allergist and immunologist. “It changed the way that we practice.”

Nine years after the initial findings were published, there are signs that the approach is preventing new allergy diagnoses. In Australia, where guidelines also now encourage early peanut consumption, a large study published in 2022 found that 2.6% of 1-year-olds were allergic to peanuts in 2018-2019, compared with 3.1% in 2007-2011.

Despite the strong evidence, the updated AAP guidelines haven’t translated into clear communications to all parents that early peanut introduction prevents allergies, said Dr. Katie Marks-Cogan, an allergist and immunologist who practices in Culver City.

Marks-Cogan says she asks parents of children with newly diagnosed food allergies if their pediatrician talked to them about early introduction of allergenic foods. Most of the time, they say no.

“They will still say … ‘Aren’t you supposed to wait until a year for milk, and three years for tree nuts and peanuts?’ So a lot of parents still think that, and it’s because it’s slow to change things in medicine,” Marks-Cogan said. “Introducing early is actually safer and it’s better.”

Times staff writer Karen Kaplan contributed to this report.

New cases of mpox in Los Angeles County rose considerably in the last two weeks, local health officials said Monday.

The “concerning increase” of the disease took reported cases from an average of fewer than two per week — a level that had been consistent for several weeks — to a total of 10 in the county in the last two weeks.

The virus, formerly known as monkeypox, spreads through “close contact with body fluids, sores, shared bedding or clothing or respiratory droplets,” the county health department said. A multi-country outbreak that began in May 2022 spurred the declaration of a public health emergency by the U.S. and the World Health Organization. Cases subsequently declined with vaccines and treatments.

Like COVID-19, mpox can be spread through droplets, especially when an infected person kisses someone else or coughs or sneezes near them.

Symptoms of the virus include “rash or unusual sores that look like pimples or blisters on the face, body and genitals,” as well as “fever, chills, headache, muscle aches or swelling of lymph nodes.”

Mpox is not life-threatening but can lead to severe illness, according to the Centers for Disease Control.

The public health department advises:

• testing for those with symptoms
• prevention measures around sexual activity
• vaccination, especially for those in at-risk groups

Those with symptoms should be tested, the statement said, and healthcare providers should report any suspected cases to the department.

Many of the prevention tips issued by the county are standard safe-sex practices, including wearing condoms and exchanging contact information with sexual partners.

Jynneos, the two-dose vaccine recommended by county health officials, is the best way to prevent the spread of the virus, the statement said.

Though the vaccine is available to all, specific subgroups especially at risk of exposure to mpox are “highly encouraged” to get vaccinated: those who have sex with transgender people, those who engage in “commercial and/or transactional sex” and people living with HIV.

Partners of those listed above are also especially at risk, the county said.