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:

http://www.gerdcare.org/Default.htm

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….






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