Friday, March 27, 2009

Wellness Weekly

The News:

Supplements: A study that compared the results of over 70,000 persons who completed food frequency questionnaires (FFQ) between 2000 and 2002 which recalled a decade of their lives, found a disturbing trend. The people in the group, who took certain supplements daily over time, had more cases of the most common type of lung cancer than those who did not take these supplements. In the past it was learned that smokers who took beta carotene supplements had high incidence of lung cancer, so this adds to that research. In this case, the supplements included beta carotene, lutein and retinol. People may take these supplements as they hope to increase the amount of antioxidants available in their bodies. Antioxidants are meant to clean up damage that is left behind after some cellular interactions. The scientists point out a few things. One is that no harm was found when people took a multivitamin with these compounds, only when taking more than the recommended dose. Also it is advised that people not take these three supplements to prevent lung cancer as it appears to increase that risk and more so in smokers. Finally, I would like to suggest that when epidemiologists point out a health promoting behavior, such as they do when they talk about the long lives of people in the Mediterranean, that you try to copy the life style and not fall victim to the sensationalism. I mean, do not believe that a long life is achieved through anything but diet, exercise and the avoidance of high risk activities and maybe a little luck.
HPV: The human papillomavirus has gotten a lot of attention in recent years. I believe that is due to Merck’s creating a vaccine that can prevent the contraction of some of the strains of HPV. I have also been vocal about my concern that Merck calls its’ vaccine a cervical cancer vaccine at least when they market it to women. It is important that women continue to receive PAP smears whether they have had that vaccine or not and because the vaccine is really meant for children… well.. that just opens up a whole new issue.. in regards to safety. Now another method of possible HPV reduction has been discovered. Circumcision. This week it was reported that circumcised men had less incidence of both HPV and herpes. It is said that having herpes makes one more susceptible to HIV but I am not sure if that is because of the illness or the frequency of unprotected sex. I don’t know that I have more to say about this issue. STDs are a big part of public health, but my area of expertise is obesity prevention. I do encourage the use of condoms… of course.
Meat Meat Meat: Too much red meat is bad for you. It has been said before and I have noticed that meat eaters are VERY sensitive about this issue. In fact, people often say that they think I should eat meat… I guess meat eaters like company. I am not against anyone else eating meat.. just so you know. The evidence to support a link between colon cancer and red meat is strong. What is new this week is a study that looked at all cause mortality and found that for any disease, the more red and processed meat a person eats, the more likely they are to die of that disease. For instance, if the no-excess risk is 2 three ounce servings a week (and I am NOT saying it is) then anyone who eats four ounces 2 x a week is at greater risk for heart disease death than the person who ate three ounces, and the person who eats more is at even greater risk. Get it? The study involved six states and includes NC, PA and Fl. No clear recommendations were given but the healthiest ate less than a ½ an ounce per 1000 calories per day. There is no need for processed meat and it should be avoided as much as possible.
Fiber for Men: I wanted to spotlight this new ad campaign because I think it is a great idea. The makers of Grape Nuts and the marketing firm they hired are targeting men in these new ads even though women will probably do the shopping. Of course, I am still an All Bran girl and think my cereal bars are the way to get your fiber.. but this is clever. The spots involve a discussion of some challenging endeavor and the slogan, “Now that takes Grape Nuts.” Too funny.
GERD: This is the signature piece for today. Gastroesophageal Reflux Disease. My father had GERD and I remember some of what he said about it, mostly that it was very uncomfortable for him. More over, my well liked coworker also has GERD and she has mentioned a few things. If I remember correctly she has said that she is trying to get off the medications she has been taking for this condition. Of course, any reader of this blog will know that I am in much support of her efforts. This week however, she asked me to look into that a little more, not just for her, but for anyone who reads the blog and has GERD or has wondered about it. Let me tell you the first thing that I realized. If you do not yourself have GERD nor have researched GERD.. you DO NOT KNOW GERD. I went to several sources and have some technical information that I would like to try to repeat in plain English. First, heart burn can be a symptom of GERD but that you have had heart burn does not mean you have GERD. (People should be mindful of heartburn however because 20 to 40% of persons who experience that DO have GERD). After reading the description, I am not sure I have even had heartburn. I have had indigestion.. a stomach ache… but not a burning behind my breast bone that might be similar to angina or a heart attack. Second, GERD involves repeated episodes of this burning, a taste of bile in the throat and the need to avoid certain foods. In fact, it disrupts ones lifestyle .There are tests to diagnose this disease. (a small number of people are asymptomatic) and there are medications to treat it. Surgery is another option and there are several types. The surgery has significant risks, including that one has to continue to take the medicine anyway. The most important thing to know, I think, is the mechanics. There is a flap at the end of the esophageal tube, it is called the lower esophageal sphincter or LES and it has to have normal length and pressure and episodes. The tube must also be located at a junction in the abdomen just so, clearance and neutralization of gastric juice must occur and the stomach must empty properly. If all this is correct, the digestive juices stay where they belong and the esophagus is protected. It is hard to determine what causes GERD though there is data on what aggravates it, including certain foods and obesity. [there are some medications that also make one more susceptible to this disease, instead of rewriting all that I have learned, I am going to include a link at the end of this blurb to the best website I found]. The goal of treatment is to stop the gastric juice (which contains not only acid, but also bile and pancreatic secretions) from entering the esophagus. Remember, this is a digestive juice, it is meant to break down food for processing and eliminating.. it is caustic. For this reason, medication treatment is nearly always a chronic and life long necessity. It breaks my heart to say that. There is research ongoing of course and there may in time be a surgical option that has a minimal risk of complication or failure. The adverse outcomes of untreated GERD include stricture, Barrett Esophagus and adenocarcinoma.. or cancer. Medications that are used are of two popular types and the concern has been that stopping the acid from being secreted or neutralizing it once secreted over the long term is dangerous. The acids have a job to do. Though most people have to return to meds that does not mean it isn’t worth trying the lifestyle modifications. That includes avoiding tomato based foods as well as citrus juices and coffee, not caffeine, but coffee and also chocolate. Losing weight can help as well as eating small meals.. It is important to not overfill the stomach as that puts pressure on the LES. Right now I am just hitting myself for making my friend that spaghetti squash parmesan.. ugh. Also, for people with GERD it is best not to eat within three hours of bed time. The best link I have found is this:

I realize that some of the foods that are to be avoided are well liked by many of us.. However, if avoiding them and eating smaller meals in general reduces the acid backflow it is a small price to pay, in my opinion because that back flow is extremely damaging.

That will bring us to today’s cooking video. The point of these videos is to assist you in eating food, lots of food really, without adding non nutritive and even disease promoting extras.. like saturated FAT and sugar.

Today’s video is on snacks….

Friday, March 20, 2009

Weekly w/ Video

The News:

The American Heart Association: I hope that this volunteer health agency which is comprised of both medical and non medical volunteers is one that you trust. It has been in existence since 1924 and facilitates research into the prevention and treatment of heart disease. Their mission includes reducing deaths from heart attack and stroke by 25%. Research is published in peer reviewed journals and is used to create evidence based guidelines for health care professionals. The AHA recently spoke to Congress and shared concerns that the gains that have been made in reducing the above mentioned deaths will soon be lost due to increasing numbers of heart disease. A major concern is obesity and the Association is urging the government to increase funding for prevention in the schools and community. They are also very clear regarding the consequences of tobacco use and support FDA regulation of tobacco products which would limit if not prohibit some of the marketing and advertising by tobacco companies. The main risk factors for heart disease include: unhealthy weight, poor diet, smoking, and diabetes (type 2). These are modifiable risk factors, in other words, you can control them.
Carcinogens in Products: I am going to start sounding like a broken record but I cannot help but point out this type of discrepancy when I see it. An American consumer interest group had made claims that some Johnson and Johnson baby shampoo and lotions have two chemicals that are known to cause cancer at some level. They are formaldehyde and 1,4 dioxane. I have not researched this myself I only point out that the organization has gotten the attention of the Chinese government where these products are sold. They are also sold here but the FDA is not yet investigating. There is no report of death or illness at this time. This is of note because cigarette smoke contains at least those two chemicals and over 40 more carcinogens. These “cigarettes” are responsible for millions of deaths a year worldwide… so uh, where is the outrage? [post note: this issue has been cleared by China's state food and drug agency]
Pretending to Smoke: What an odd little “game” the children have created. From A WSJ article I learned that kids can crush up certain candies, sort of inhale the dust and then blow out smoke. They even practice blowing smoke rings. All I am saying, kids really need to get out and play more
PSA Testing: I recall talking about this test for prostate cancer when my newsletter was first being published. In the early 2000s then, the concern was whether to test and then whether to treat because this cancer, though the second cancer killer for men, was a slow killer and often the men could live the rest of their lives without much decline in quality of life and likely die of something else before the cancer killed them. [probably they will die from heart disease, no?]. The testing or screening can lead to biopsies and treatment that is rife with side effects. The treatment can be debilitating and or embarrassing. Two very large research studies, studies lasting 15 years, do not offer a disposition. Over 240,000 men were studied. The results were a very slight benefit in one study, but with significant side effect costs and the other found no benefit at all. This is exactly the kind of reporting I want to see on medical devices, tests and treatments. Not that they do not work, but whether or not they work and what the risk to benefit is.
Number One Cancer Killer?: Good question. Though men suffer from prostate cancer and women from breast, the number one killer of both men and women is lung cancer. There may be a higher prevalence of the other cancers, including colorectal, but those with lung cancer generally die from it, while the other cancers have better survival rates.
HDL: The Good Guy: A reader and friend recently asked me to tell him a way to raise his good cholesterol that he didn’t already know. Certainly he knows what most of you know, you raise it through exercise (though not exponentially) but more often those with high HDL have a gene that promotes it. I did take his challenge however and read what I could about the issue from sources that I consider valid or research based. I.e. you are NOT going to hear me recommend a supplement to increase your HDL. What you will get from me is a practical application of what I have vetted. Here it is then. The mayo clinic among others, notes that oils with mono unsaturated fats, like olive and peanut, enhance the anti-inflammatory properties of the HDL. So though you may not be able to change your number you may be able to increase the impact of that number, in my opinion. I strongly suggest that you follow my example from the cooking demos and do not cook in the oils but add limited amounts to your already cooked veggies or to a salad. A teaspoon for example, or even a tablespoon spread throughout the day. It is also true that HDL works in keeping you healthy by carrying out excess bad cholesterol. It is known that certain fibers can also aid in ridding the body of bad cholesterol so again I recommend something like my cereal bars. Lastly, do not smoke. Smoking lowers HDL. Some research supports that red wine may have an HDL promoting effect but not enough to make a standard recommendation for anyone to add wine if they do not currently drink it.

That will bring us to today’s cooking video. The point of these videos is to assist you in eating food, lots of food really, without adding non nutritive and even disease promoting extras.. like saturated FAT and sugar. Today’s show is peanut butter cookies which in fact, are HIGH in fiber… and the peanut butter is a source of monounsaturated fats. These are not your mother’s PB cookies, nor my mom’s which are fantastic.. but this blog is about health not decadence.

Ingredients include:

Smucker’s All Natural Peanut Butter
(do not use jiff, peter pan, etc- for numerous reasons)
Splenda or Altern
Kellog’s All Bran Original
Loose Oat Bran
Non fat cook spray (butter)
Cookie Sheets
Large microwaveable bowl… glass is best
Heat oven to 375*
I forgot to say this in the video but cook the cookies for 20 minutes and then check them, move pans around, check every five or ten minutes, you will get the idea in time.

This is the original recipe from a cook book I made a long time ago, but it is hard to explain what I mean, thus the video!

4 Tbls smucker’s all natural peanut butter
2 c All Bran original
¼ cup loose oat bran
¼ to ½ c loose Splenda

In microwave if available, heat the peanut butter with about 1 ½ c or more water for about 2 minutes, then use beaters to mix this until it is peanut butter colored water mixture, also mix in the sweetener. Then add the cereals, set aside until moist. Mix this again adding some water until it is moister than other cookie dough. I use a scoop to make two trays with 20 cookies on each. Bake at 375, twenty or so minutes until done. More water and less cooking makes them seem moister. It is good to experiment until you like them!! Made my way, each has about 20 calories.

Serving size: 3 cookies
Amount per serving: calories: 60; fiber: 3g; protein: 2g; fat: 2g.

Saturday, March 14, 2009

Wellness Weekly with Video

The News:

Outrageous: These three issues were particularly unnerving to me this week. Two are commercials and the other was a news ad. The first commercial encourages moms to buy their kids a drink in a box called Fruitables. The USDA food guide recommends very little in the way of juice or any drink other than skim milk (recommending instead water and non caloric beverages). The reason juices are not recommended is because they do not contain the natural fiber that fruits and vegetables do. Fiber helps to regulate the sugar in fruit so it is not something that will spike blood sugar and cause an immediate and abrupt insulin response. Children, all of us, need to eat our fruits and vegetables not drink them. The second ad is for a supplement or herbal remedy that is supposed to naturally lower one’s “bad or LDL” cholesterol. That I doubt its effectiveness almost goes without saying, but what peeved me was the statement that it was a natural way of lowering the cholesterol. It is a synthesized processed something in a pill. That is not natural. The natural way to lower ones bad cholesterol is through diet and exercise. Think, walking and eating those cereal bars. The last outrage, or so I thought, was an article regarding tobacco companies’ move to increase the cost of cigarettes before the federal tax increase would force them to. In fact, the maker of Marlboro decided to raise the price 10 cents more than is required. It appears there is no worry that the tobacco user will stop buying the product. Could that be because they know how addicting the product is and have no worry that sales will tank? This is why tobacco taxes reduce NEW use, not current use and why states have NO valid argument for not also raises the taxes… what are they afraid of, that the youth will not start using tobacco and that will be a bad thing? So I was done with the outrage section, but I forgot about last week’s grocery shopping. In the sugar/sweetener isle I saw a bag of Splenda that said “ -- grams of fiber per serving”. WHAT? They added fiber to the sugar. Good grief.. Eat some oatmeal. The only reason they did that, in my opinion, is to compete with Stevia which has naturally occurring fiber. Well, I buy neither so there.
Wynona: Ah, this should be in the above section to be sure. I cannot believe the younger singing Judd has become a spokesperson for a diet PILL. Worse is that she refers to Alli as safe because it is FDA approved. By doing this commercial and through that statement she implies that the pill is effective and without side effects. I doubt it is effective and know it is not without real risk. Furthermore, the pill box states that the results are related to the amount of exercise one does and the calories they consume. So, why exactly do you need the pill? Oh yes, it helps to keep some bad fat from being absorbed, so much so that the makers advise users to start the product over the weekend or take a few days off of work. Oh yeah, that sounds safe and fun too!
Comparative Effectiveness: update- This still looks possible while being strongly opposed by drug and medical device makers. The current stimulus package has set aside funding for this research, mentioned in previous news. The Institute of Medicine will be overseeing the studies and I for one look forward to the day that I can decide on a treatment or a medication based on these variables.
ByeBye Trans Fats: Another city takes action against these unnecessary fats which increase levels of LDL cholesterol. Boston’s ban includes bakeries and prohibits use of oils, shortening and margarine with partially hydrogenated vegetable oils.
Pills are NOT a Panacea: A report regarding heart patients in several European countries that could be generalized to American heart patients, supplies some disturbing though not surprising news. Persons taking medicines to reduce their blood pressure and lower their LDL levels are NOT changing the parts of their lifestyle that led to these problems in the first place. Well over half of them continued to have problems with these issues and were put on even more meds to treat them. The researchers are concerned that eating, physical activity and smoking factors are not addressed in this group. I have long believed that people in our country get a false sense of security from pills and are also looking for a fix that doesn’t take effort, such as eating well and exercising do. The same study found a higher incidence of obesity and diabetes in an age group comparison to 12 years ago.

That will bring us to today’s cooking video. The point of these videos is to assist you in eating food, lots of food really, without adding non nutritive and even disease promoting extras.. like saturated FAT and sugar. Today it is a dinner, next week another baking recipe.

The Video Ingredients:

Quorn is a meat substitute and is found in the freezer section at Lowes Foods, Harris Teeter, Publix and Whole Foods: Not all Quorn products are low calorie or low fat. Choose Quorn naked cutlets or tenders

Quorn tenders ½ to 1 cup
Salad (nice leaf lettuces)
Mushroom, red onion, tomato
Mrs. Dash or McCormick spices
Spaghetti Squash
Parmesan cheese
Garlic and Parsley
Salad Dressing (I choose Waldon’s Farms or recommend Balsamic Vinegar – not vinegarette)
Fruit of choice (but not a high sugar one, like kiwi, banana, pineapple etc)

Okay like I said most of my dinners have 200 cals or less and then I have dessert…

Saturday, March 7, 2009

Wellness Weekly with video recipe

Most of the articles that caught my eye this week, or my ire, as it were, appeared in the Wall St Journal or on My Yahoo homepage. Interestingly, I emailed the reporter for one of the stories so I could have more information for my readers. I will hit a few highlights, but I also want to provide a little history about this blog site and newsletter.
I began writing a weekly email newsletter in 2000 and it was first for the Social Work / Case Management Dept at WFUBMC. I was the department’s appointed wellness ambassador for our Action Health (employee wellness) program. Things rather cascaded from there. I received some fitness and nutrition certifications (nothing gold standard) and the newsletter went out to a lot more people and was also at one time posted at two Fitness Centers, in NC. Originally it ended with a recipe. I put many recipes together into a small cook book as well. At the time I was a social worker doing some personal training and catering on the side. In 2004 I went back to college, to grad school and received the Public Health master’s and the credential of Certified Health Education Specialist. This blog came about because many people wanted to keep getting their “News” even as I moved to FL and my web page attempt was tedious.. My goal has been the same for four or five years now, and is the premise of the blog. I want only to prevent disease or progression of disease in myself and the people I know and the people with whom I share this world. My next goal is to have this influence as an “expert” but for now, I do it as I can and as a layperson. Many times I share my ideas about food with my friends, coworkers and family. I have a gift.. I am sure that I do. I can revise any recipe and make it healthier. I have learned tricks on the preparation and the selection of foods. I believe 100% in the Volumetrics concept of Dr. B. Rolls and not at all in any dieting. My cooking tricks, techniques and ideas are hard to put in writing and for some time I have considered video taping my cooking. If you checked in lately, you can see that I have taken a stab or two at doing just that. As I work to make this better I do have to wonder about the balance between the news and the cooking.. or I might find a way to compartmentalize. Bear with me as once again the Weekly News, now nine years old, gets a makeover. Today’s column will end with my most famous and historic recipe, Cereal Bars, with a demo video.

The News:

Treating Stroke: Tom Burton of the Wall St Journal described an interesting debate regarding what is the best treatment for preventing a stroke. This is timely as we hear talk about effective treatment and comparative research. Tom noted a study that compared surgery to stenting but which does not answer the question about drug therapy as the third option. In the article, Tom explains the stenting. This is to insert a small metal tube in the neck to open the blocked artery. We have spoken of stents a lot so you know the risks with them. This is also known as something that is noninvasive, but to me, a tube in my arteries IS invasive. The surgery has been around a long time and is considered effective for clearing clogged arteries. [just writing this scares hell out of me and is exactly why I eat the way I do] The surgery is referred to as a carotid endarterectomy and Tom says that this cutting open the artery and then cutting away the fatty plaque is “pretty routine”. A third option is the use of medication. There is some evidence that drugs like statins can keep the plaque from building up more and in some cases may even reduce it. The next step would be in evaluating if the drugs, the endarterectomy or the stents prevent the most strokes and of course, which have the highest adverse outcomes. Now if this doesn’t make you want to avoid high fat foods I don’t know what will. And that would be the fourth option, preventing plaque buildup in the first place.

Knees and Knee Parts: I am sure that there are people who receive knee replacements and have an improved quality of life, I haven’t met them. Research comparing physical therapy to arthroscopic knee surgery, for instance, did not show a better outcome for surgery. I have said this before but here again… some people choose surgery over physical therapy HOWEVER<>

Speak Up: This week also brought an article that encourages the recipients of health care, you and me, to speak up about the quality even to a white coat. Yes, it is okay to say, gee Doc could you wash your hands please? In reading this article I recalled one time that I did not speak up and wished I had and others where I do speak up but have a hard time being heard. The first was ten or more years ago when my Dad was in the hospital and had to have his blood taken. The phlebotomist (I think that is the term) did not wear gloves. I remember thinking that he must think my dad is a safe stick, because he is 70ish etc, but that doesn’t mean the person drawing the blood was “safe”. More personally, because I am a health educator and study this stuff, I know that to get a good blood pressure read, the patient should be seated for several minutes and their arm should be at a 90 degree angle. How many times do you walk in and right away the cuff is placed for the BP?

Colds: I like oh so much to be right, so let me share some info from Melinda Beck’s Health Journal from Tuesday. Basically, it is ok, even beneficial, to work out when you have a cold, she said swim or run. It is not helpful to take those supplements and herbals that claim to protect you from getting colds or shorten their duration. Research supports that getting plenty of exercise, sleep and vitamin D (some from sunlight for sure) is protective for preventing colds or minimizing symptoms and duration. To ease symptoms these three things were suggested, decongestant sprays, hot beverages and acetaminophen. The researcher stated that there was no evidence to support use of antihistamines or cough medicines. True that.

Ok that is enough news.

Here is the recipe. These cereal bars are, in my opinion, wonder bars. They keep you feeling full, they level your blood sugar, they assist in the removal of LDL cholesterol and they keep you regular, which would intuitively also protect against colon cancer and a cranky mood. [omg, I crack myself up]. Let me add a disclosure, what I mean to say is that the ingredients in these bars will do the above, the bars themselves have not been used in a research study… yet.

Cereal Bars

1 ¾ c Kashi Good Friends Cereal (in red box) or Kashi Go Lean
3 c All Bran original
½ c loose oat bran (buy at a whole foods store)
1/4 c skim milk plus 1+ cup water
¼ c Waldon Farms sugar and calorie free syrup
1/4 c apple sauce(no sugar added)
1 tsp cinnamon
1/8 c egg substitute

mix all together in a bowl and pour into 8 ½ by 11 inch pan that has been thoroughly sprayed with butter flavored non-fat cooking spray. Bake at 375 about 40 / 45 min, if spring to touch they are done. When completely cooled, place on cutting board, cut in half and then each half into 12 bars, will have Approx. 40 calories each and about 4 g of fiber. (I use a brown glass dish and I cool over night in the fridge for easier cutting. These are small, cut into twelve pieces for 80 cals each).

Very important note, before you add the milk/water mixture (last) have the oven heated and the pan sprayed so that as soon as you stir it you fold it into the pan and place in oven, otherwise, the water is quickly absorbed by the cereals and it’ll dry out. The mixture should be wet, but not too loose. It’ll be trial and error. I use almost 2 cups of milk/water mix.

Wednesday, March 4, 2009

Meal Ideas

I am beginning to create videos for the blog. My initials ones are pretty rudimentary, but they will get better. I am going to get a better camera and software and I may actually manage to get all of me in the video at some point. Note, I have nothing fancy in my kitchen and buy most of the ingredients at Walmart. This is every day stuff.. and you CAN do it.