Monday, August 31, 2009


I enjoyed a conversation with a health care professional today who is in her mid twenties, my guess. I was telling her about my recent revision of a stuffed cabbage recipe, soon to be on You tube, and she began to tell me about her parents and then herself.

She recalled that her father had been diagnosed with a severe artery blockage after failing a stress test. In fact, the stress test was so bad that he had surgery the next day. He was not yet 50 years old. His daughter remembers the day she came home from school to find her mother going through all the cabinets and removing foods that they couldn't eat any more. It was a little funny in the telling, as her mom didn't wean anyone off of anything. They went from whole milk to skim milk in a matter of minutes. Her mom also learned to cook differently and not badly. Her dad has been doing well, but on medicine for high cholesterol.

My friend learned a lesson from her parents and I am happy to see that her parents took the situation seriously. I have known too many who deny that food has any role in disease and continue the same habits as before their diagnosis or heart attack. Her mother acted seriously, quickly and permanently.

The second part of the story does not fit into my perfect world - magical thinking however. My friend was diagnosed with high cholesterol herself, familial high cholesterol, and started on medication at the age of 16. She was already active, but even being young and active and eating well, her cholesterol was over 300. On medication it is 180. At 16 her HDL was 20. When she told me how low it was, I gasped. BTW, she is also thin. I am concerned because statins do have side effects and I can't imagine that they were ever intended to be used in the teen age population.

The main concerns with statins, such as Lipitor, are muscle pain and sometimes a deadly condition of muscle wasting, kidney and liver failure are also listed as adverse event risks as is pain in the extremities,but believe it or not, these conditions are very rare. I did some research before posting this blog, and did not find what I expected. Of course, I went to academic journals and Medscape to do my reading, other websites, such as those that sell alternative meds to treat high cholesterol did talk a lot about kidney failure from the muscle wasting condition, which is called rhabdomyolysis. I found a study that followed children (214) aged 8 to 18 who were given statins for two years and no real problems were discovered.

My friend wants to try a different course of treatment but when she came off her meds before the cholesterol went right back up. You always have to weigh the risk, in this case, usually muscle pain, but more seriously rhabdomyolysis, to the benefit of not having a heart attack and dying.

After the statin Baycol was pulled from the market because of some kidney failure deaths, a safety task force did review pre and post market drug studies and concluded that the remaining statin meds were not high risk at all. The National Lipid Association was responsible for the task force and the final recommendations.

My last thought is this. The first statin to come on the market with FDA approval did so in 1987. That is only 22 years ago. We have no where near the long term data to say that the body can safely metabolize those drugs for 40 to 60 years, which is what you are looking at if you prescribe them to children! But what do we do for people whose condition does not respond to lifestyle changes if we don't use the medicine?

Sunday, August 30, 2009

Odds and Ends

Another week has ended..for me time flies, for others it drags... I understand this.

I have a few scraps of paper here with jotted down notes. The first few regard calories, specifically our discretionary ones.

One of my dear friends sent me part of the package from some disposable plastic containers she recently purchased. Why? Because the label says that they are perfect for 100 calorie snacks. My friend wondered if people might think that the container could be filled with anything and have 100 calories.. Good call. And wow, that would be very cool!

My mom mentioned that her yogurt had 11g of sugar and asked me if that was a lot because it sure seemed like a lot but it only had 80 calories. First, YEAH Mom for reading your labels! Second, well, I told her that I try to have no more than 8g of sugar per serving in any product when I can, but that it didn't seem awfully bad. I looked at my yogurt just now and I have two. One is a Dannon brand and the other, Walmart, both are the low calorie kind. And well, I know at least one of my friends will think I make this stuff up, but seriously, the Walmart value brand only has 8g of sugar per serving and the national Dannon one has 11g. The one my Mom was talking about was the Publix Supermarket brand. Oh and I would add that we are allowed about 24gs a day for the 6 teaspoon of sugar recomendation, so Mom has three left after her yogurt!

Another friend, they all send me bits of info so I have something to do in the evenings, told me about this new cream she bought for her face. It has shiitake mushrooms in it. I thought you were supposed to eat them, but of course, there is soap with yogurt in it so what do I know. My friend bought the facial cream because it was recommended by two older women who looked phenomenal and swore by it. Just a quick search and I can see that there are properties in the mushrooms that may be beneficial but I did not uncover any good research studies to prove the hypothesis.

Now, here is a real humdinger.
Be fit or be a frog.. a real issue to ponder. Let me tell you what happened...It involved two completely different events.

Earlier in the week, during one of my tobacco education classes, a student challenged the notion that quitting tobacco and possibly warding off deadly diseases was a smart thing to do. At best, he implied it was unneccesary and at worst, futile... because you cannot change your destiny. The student noted God in the conversation so I refrained from much of a challenge. I thought about it though, for days. I meant to say back to him, but did not, sure, but what if we are destined for some great physical challenge.. shouldn't we live our life so that we could meet it, just in case.

I firmly believe that we should take care of ourselves in case we don't get hit by that car or shot by the jealous lover at age 40 or 50 but instead live until we are 90, because living that long without physical and mental faculties intact is just NOT pretty.

Then the second thing happened.
Last night I caught my cat apparently in the act of getting a frog into the house. The time before I just found the dead frog. So in through the cat "window" came the cat and frog. The frog hopped across my bed and my cat chased after with intent to kill. I scolded the cat and wondered how in the world to catch a frog. Ah plastic ware.. I got a container and returned to the bedroom. Cat and frog were in the closet at this point, I trapped the frog, yelled at the cat again and then went back to the kitchen. How to pick it up??? I returned with a plate. Cat still guarding trapped frog. It was actually easy. I scooted the plate under and lifted all taking the frog out my front door. And away he hopped, headed towards the stairs and a nice tropical courtyard.

This morning I walked to my car, and there on the pavement was a sprawled flat dead frog. Surely it was NOT the same frog. But if it was, well, you can't change destiny and that just stinks.

Saturday, August 29, 2009

Samples that Shouldn't Be

My post for this Saturday evening or Sunday morning will be brief. I am disillusioned once again, though I should not be because I KNOW, that is why I write the blog, so that I can let YOU know…

I am signed up for regular prescription, medical device and other such warnings from the FDA. Most of the medicines or equipment that I receive alerts on do not effect a significant part of the population and rarely do they directly effect me (not since Vioxx!).

I receive notices in my email when an existing medicine receives a black box warning or a label change and when a medicine is contaminated. Recently I have received some alerts about IV tubes and diabetic strips that were irregular. And most recently I received a notice about several products that were being marketed and sold illegally. I read the alert and therefore my brain stored it somewhere, but I did not expect it to matter to me and I did not say anything to you guys.

The alert was regarding various companies that are selling topical ointments, sprays or creams that have ibuprofen in them. They may also have other ingredients, like herbal or supplement products. The companies are getting letters from the FDA because ibuprofen is a medicine. One cannot just add it to things and sell it and not have FDA approval for safety and efficacy.

I read it and moved on. Then on Wednesday of this week, my physical therapist suggested that I take some of this sample medicine home, Ibunex was the name. She gave me two samples and a brochure. I read the brochure and I said to her, this is ringing some kind of bell in my head. I thought at first that it was undeclared ingredients or something. I came home and re read the alert and this was exactly one of the products that was being recalled. The physical therapy office had a sign up offering two free samples if you bought a bottle of the spray.

So just like drug companies, these lesser companies sway health care professionals including mine, and my health care professionals were likely selling the medicine/supplement to make a profit. I emailed the alert to them the next day. If the product is still on the counter Monday, we will have an issue.

BTW, the PT office also had a sassy chair or whatever you call those godforsaken motorized scooters in the lobby with a big sign on it regarding how they could help you buy one.. just so disillusioned am I.

Friday, August 28, 2009

the Benefits of Blood Flow

This week my research took place in doctor's and physical therapist's offices. I spoke with an orthopedic specialist and separately with a physical therapist. Though they practice in different offices and do not know each other and indeed have different specialties, they said the same thing. (that never happens :))

Their opinions or medical advice were supportive of what I have been told by others in sports medicine over the years, but as with research, anecdotal evidence that repeats itself gains more sway.

The issue addressed was cardiovascular exercise when injured. Indeed, this applies to acute and chronic injury, but also to chronic disease conditions such as arthritis and back pain. Gone is the recommendation for bed rest or even relative rest and in is the need for doing some form of physical activity. This increases mobility, decreases atrophy and in regards to injury, can speed healing by carrying oxygenated blood to the injury site and carrying inflammation or free radical damage away. The heart pumps this blood through our system and exercise can enhance that pumping.

To be fair, the doctors and I had a deeper conversation in regards to athletes and people who engage in routine vigorous physical activity. This class of person is getting a lot more from their “exercise” than a strong heart and increased blood flow. Usually, the exercise is used as a coping skill, mood stabilizer, competency booster and to challenge ones limits. People in this category tend to push through pain when they are injured, and according to Jason Koczman, PA at the Advanced Sports Medicine Center in Sarasota Florida, it doesn’t always lead to worse injury. Jason said that sometimes pushing through can work and the problem ceases. That is not usually what happens, but since many of us know that it could happen, it is our first response and desperate hope. Other times, an injury, a pain, is a message to stop doing whatever it was that caused the injury or exacerbates it. Both Jason and PT Judith Chmiel agree that maintaining conditioning and blood flow will improve healing. The point is to do something that does not hurt but to do something. Both were clear that complete rest was not recommended. Active recovery appears to be the newest mantra in sports medicine and I for one am glad of it. Oh and pain meds are pretty much old school as well. Most docs will now recommend ice and limited use of ibuprofen.

Thursday, August 27, 2009

Unnecessary Radiation

Just quickly browsing the paper this morning, I noted three persons of some notoriety that had died of cancer. The World Health Organization or WHO recently stated that over 7 million people died of cancer in 2005 and that by 2015 84 million people would die from the disease (of which there are many types).

The leading causes of cancer are not genetic, but environmentally related. Cancer, the uncontrolled growth of abnormal cells, is often triggered by an exposure (external, internal, involuntary and voluntary). The biggest risk is, of course, tobacco use or second hand smoke inhalation (1.5 million of the above total was attributed to tobacco use). Probably the second biggest is inactivity and diet. Other exposures can include chemicals in the air or in our homes, the sun and tanning beds. But one that we may not think about and should is our exposure to radiation in routine X-rays and CT scans.

Not all illnesses or injuries present symptoms at the time of onset. You may feel the effects of food poisoning within hours of eating the bad food, or a burn from the stove within seconds, but not realize that the time you just spent in the sun has caused DNA damage to your skin. This delayed response is a big concern for smoking related cancers and today’s topic – cancer related to radiation through medical tests.

People are exposed to more radiation from CTs then from X-Rays. Either way, these are not meant to be used as every day diagnostic tools. In some instances, for example heart disease risk and lung cancer screens, the CTs may be more risky than they are effective in ruling out a problem. I tell you this because these scans may be marketed as preventative but could actually put you at risk for the condition you are trying to avoid. It is far better to avoid tobacco, inactivity, unprotected sun exposure, radon, asbestos, and saturated fats, to name a few, then to rely on a test to tell you that you ALREADY have the disease.
And because the damage from any of the above is cumulative, beginning exposure in childhood significantly increases the chance of cancer. Because CTs are now common place, this could especially increase cancer cases from radiation in our children, when they are older.

Wednesday, August 26, 2009

Diet Drugs

How well do you know your blog writer? Here is a test question. Does Deirdre believe in diet drugs? Answer. NO

It has been a little while since our grocery stores held prominent displays of the latest OTC weight loss drug, Alli. Long too, since Wynona Judd did her print and TV ads endorsing the product. I of course, had my say in these pages

This drug was intended to enhance weight loss by blocking some fat absorption, probably because eating less fat would be too inconvenient for some people. I railed against it, I still rail against it and now the FDA has made a cautionary statement in its regard.

FDA notified healthcare professionals and patients that it is reviewing new safety information regarding reports of liver-related adverse events in patients taking orlistat. Orlistat is marketed in the United States as a prescription product, Xenical, and as an over-the-counter (OTC) product, Alli. Between 1999 and October 2008, 32 reports of serious liver injury, including 6 cases of liver failure, in patients using orlistat were submitted to FDA’s Adverse Event Reporting System. The most commonly reported adverse events described in the 32 reports of serious liver injury were jaundice, weakness, and abdominal pain. FDA is reviewing other data on suspected cases of liver injury submitted by the manufacturers of orlistat, analysis of these data is ongoing and no definite association between liver injury and orlistat has been established at this time. FDA is not advising healthcare professionals to change their prescribing practices with orlistat. Consumers currently taking Xenical should continue to take it as prescribed and those using over-the-counter Alli should continue to use the product as directed.

Scientifically speaking the safest and most effective way to lose weight is to take in less calories that you burn.

Tuesday, August 25, 2009


First, thanks for the comments on yesterday's post! I love to know you're out there...

Today 's story first showed up on my yahoo home page last night from several news sources then again this morning in my print news copy ( wall st journal). So do let us talk about SUGAR, added sugar that is, white granulated or sticky syrup SUGAR.

The American Heart Association has made a formal recommendation on the amount of added sugar or non nutritive sugar we should consume, if any, on a daily basis. The goal is to reduce overweight and obesity and the diseases so associated.

Whether or not added sugar directly causes obesity is not yet proven. What can be said is this: You have a certain amount of calories that you need per day. This amount will keep your weight steady. Which type of foods you use to fulfil that requirement determines what your body will then do for you. So weight aside, nutrients can heal you, fuel activity, accentuate brain power, help you perform physically and keep you free of chronic disease.

You can spend all your calories on junk or pleasure-only foods, but you will get a compromised system in return. Your vehicle will be a lemon. The more calories you spend on sugar, the less you spend on lean proteins, good mono and poly unsaturated fats, and the complex carbs that are our fruits, vegetables and whole grains.

The American Heart Association recommends that women consume a limited 100 added sugar calories a day, or 6 tsp which should be about 25 grams and men, (of course it is unfair) men get 150 added sugar calories, or 9 tsp at ~ 37 grams. Most of the time the food packages list sugar in grams not teaspoons. This is an approximate conversion as sugar has 4 cals per gram and Rachel Johnson from the University of Vermont who authored the recommendation gave the calorie requirements. I just did the math. Recall that I have suggested that you do not buy any processed food that lists the sugar as more than 8g per serving. Also, determine what exactly that serving size is and act accordingly.

Added sugar refers to table sugar and syrup, sugar in processed foods and some dairy foods like ice cream and sweetened yogurt. The biggest source for us is soda and juice. Most women would use all their discretionary sugar and then some in one regular soda. And as you have heard me say, "Lose the Juice." Sugar in juice is discretionary sugar in fruit it is not!

Now the American Beverage Association and the Sugar Association are not happy about this AHA statement and want to remind you that there is not a direct link from sugar to obesity, but as you can see, that is not the only reason to avoid sugar.

Oh and a last note on a comparison made in the WSJ article that got my dander up.. I KNOW that rarely happens, any ways..
A moderately active middle aged woman might consume 1800 cals
while a
Sedentary middle aged man would consume 2200
Okay, first HE does nothing and gets to eat more, second, why don't we change just the one variable, ie sex......... and compare the same activity level...

Monday, August 24, 2009


I want to write about water today. Water in the sense of environmental health more so than physical health, but do let me start there.

We all need fluids to maintain well, our life. We get the fluids we need both in the things that we drink and the foods that we eat. There was a time when many health care professionals from docs to exercise physiologists were telling us that we need 8x8 glasses of water a day, or 64 ounces. That was never a scientific finding or official recommendation, and most people know that now.

We still need water however and where we get it has also been a matter of controversy. I.E “everyone and their water bottles”… plastic and waste, chemicals and landfills, cost and fraud, tap water vs spring..(in bottled water) etc.

I live in an apartment and have for the last two years. The water from my tap has an awful taste. I have struggled with this dilemma, as I do drink 60 or so ounces of water a day. Buying packages of bottled water every week is too costly for my wallet and our environment. I tried filling bottles with water and leaving them uncapped in the fridge for say 24 hours, as my niece suggested, but it only took the edge off. I filled my bottles at work from the portable water cooler as often as possible, but it wasn’t enough.

I went away for about a week and when I came home, I was unaccustomed to the taste of my tap water again. It was gross. I kept thinking it could not be good for me.

Now I have gone back and forth with what to do for almost the whole two years. I looked at filters you add to your faucet and filtered pitchers. I evaluated a home water delivery system, or buying a cooler and refilling it at the supermarket weekly. For a while I bought two gallons of water on the weekend to drink during the week, but even recycling those two jugs was an issue for me. Plastic recycling is not necessarily a safe, economic or even actual thing. I worry about that.

So I finally bought a water pitcher which came with one filter and an additional box of three filters, on sale at Walmart I think. Fifteen dollars each. The filters last 2-3 months. It was the best thing I ever did. The water tastes fine. I do not have to carry any cases of water or gallon jugs and I do not have to discard any waste. Also, if it is true that plastic bottles can leak chemicals into our water, I am mostly avoiding that as well.

So if you also struggle with this, I recommend the pitchers!

My schedule is getting the best of me and I am not sure that I will be able to blog tomorrow. If not, please accept my advance apologies… Deirdre

Sunday, August 23, 2009

Odds and Ends

My final thoughts for the week:

Fiber: Interestingly, I learned one thing new about the positive effects of fiber in the diet. I have long suggested my cereal bars as a great source of tasty fiber with the message that fiber can remove bad cholesterol, keep blood sugar level, help you to feel full and keep your elimination system working well. It can also help to keep the good bacteria working in your gut. The last one is what I learned today. I read an article about food companies adding fiber to everything, which you know I abhor and in that article it was said that the companies are adding fiber because consumers do not like it when things such as sugar and salt are taken OUT of their foods. It was also said that the price will be steep and the outcome will be poor. Many of the new products will have more sugar and fat than is healthy, to go with the fiber. For goodness sakes. Natural sources are best and lowest in calories, remember that. And here again is the cereal bar recipe.

Diet: Just a note. My friend and I were talking about my passion on wellness and diet earlier this week. In that conversation we talked about the misconception that some people have on the word diet. You see “diet” is a noun not a verb. It is NOT something that you do and if it is, you are bound to be disappointed, but the overall picture of what you consume. For example, my diet consists of lean non meat proteins, many vegetables, fiber and fruit with some monounsaturated fats. That is what I eat on a regular basis. Your diet is the food that you eat not that you don’t eat!

Exercise: On my mind this week because I seem to be in a bad place in that regard. My preferred form of exercise is mostly inaccessible and my second and third choices are themselves causing me some difficulty or pain. Even so I have to remember what I have said in one of my side bars, which is, “I will not wallow, I will not whine and I will not succumb.” So each day I find a way to exercise and I keep my chin up and I know that I will find a good place again.

Tobacco: Early this week I mentioned that I was seeking the source of the nicotine found in medications that people use to quit smoking, or nicotine replacement therapy. I received an answer from GSK, but now I realize that I didn’t ask the necessary follow up question. Does the nicotine comes from tobacco that cured or uncured? Curing is what creates tobacco specific nitrosamines which are linked to cancer. It is an important question. The same question about nicotine sourcing needs to be asked of the electronic cigarette makers.

Sunscreen: This time at the beach I heard a parent say the right thing so that is worth noting as well. A dad came to the beach with his two children, an umbrella, a chair or two, some sand tools and buckets and began to unload. He said to his children, approximately aged 5 and 2, “Ok, the very first thing we have to do is put on your sunscreen.” And he proceeded to slather them up!

Me and Julia: And lastly, I saw the movie Julie & Julia this weekend and really enjoyed it. I will say this about me and Julia Child. We both love food, love to eat and love to cook. We both love a place. She loved Paris and I love Sarasota. So she thinks butter is divine and I eschew it in all recipes. She was tall and big boned while I am short and a bit dainty. Otherwise, really, we could be twins!

Saturday, August 22, 2009

DO Be Defensive

Our bodies were meant to be lean mean fighting machines. I thought of that today as I read an article regarding some research into the microbes that inhabit our gastrointestinal or GI tract. This system includes our mouth, esophagus and stomach. The National Institutes of Health is awarding grants to various researches to study every microbe that is in or on the human body according to Barbara Martinez of the Wall St Journal.

Scientists at the University of Michigan have been studying mice to see what effect antibiotic use might be having on microbes in the GI tract. They found some instances where the good or worker bacteria was killed along with the invading germs or parasites and that the good bacteria did not always return to its normal levels even six weeks after the antibiotic course had ended. This of course will make a person suscpetable to even more illnesses. Of great concern is a disease called C dif. I recall this disease when I worked in the hospital and now I realize the persons who were diagnosed with it were often being treated with antibiotics for urinary tract infections. C Dif can become serious, even deadly, especially in compromised or elderly persons.

This only drives home the point that we must be mindful of what we are exposing our bodies to, whether elemental or internal. It is very disconcerting to me that we allow exposures even purposely cause them (i.e. tobacco) and then take drugs to treat the consequences which themselves have consequences.

Eating right and preventing illness is best, tolerating some acute illness or pain is also called for at times. Too many times we want a pill for every single thing that ails us. As I said yesterday, even people with the flu should not necessarily take medicine for it.

And with that heavy on my mind, I went grocery shopping today. In front of me at the check out was a family of four. I could see a few new outfits and supplies for school. I thought the parents were doing their duty to prepare their children for now and the future. But also on the conveyor belt was a case of instant noodle lunches and a 12 pack of some juicy drink in a bag. I do not think that the parents realize that they are making a mistake. I do not think that the people who need the message about healthy eating the most are getting it. What our children are consuming in their early years is going to cause them disease as very young adults and will prevent them from achieving all that their parents dream.

I want to get the message out. I want to simplify all this health info and make it practical and possible. I also am aware that it isn’t just the under educated who are misinformed but the college educated as well. Maybe it is information overload.

I say so because in another WSJ feature, “What’s Your Workout” , a perfume company president, Terry Darland, said that her breakfast often includes low calorie orange juice and 2% milk. Her workout sounded perfect, but if I had the chance to talk with her, I would advise that she lose the juice and choose skim milk over 2%.

Friday, August 21, 2009

H1N1 and you

I spent the better part of the day pondering what my post should be about today. At the last minute I decided to briefly discuss the H1N1 flu strain. This was formerly called the swine flu, but after innocent pigs were slaughtered, the name went technical. This flu is not what we expect to have instead of our seasonal flu strain, but in addition to it.

Scientists have created a vaccine for the seasonal flu, based on some assumption of the 2009/2010 strain. Scientists and pharmaceutical companies are currently TESTING a vaccine for H1N1.

I chose this subject today because I was part of a conversation between my boss and a health department information officer today, and there were local news stories about the school system and H1N1 yesterday and because I read about it in the Wall St Journal while eating dinner. Interestingly, my boss taught me something that the newspaper did not explain. I think that is pretty cool.

So, the biggest difference between the two flu viruses is who they target and who is on the priority list for vaccines. The seasonal flu has always been said to be a threat to the elderly. The H1N1 is a threat to people under 65 and most threatening to pregnant women. My boss taught me that pregnant women, especially in the second trimester, have reduced immune responses. The body turns off or lessons the immune response in order to protect the baby from rejection. Pretty neat, but not when it comes to illness.

Pregnant women and children are the priority group for H1N1 vaccine along with the usual; child care givers and health care professionals, as well as, people between ages 25 and 65 who have chronic diseases (diabetes, heart disease, COPD).

There is some speculation that those over age 65 have some built in immunity from viruses that occurred in the past.

There may be concern about vaccine safety and the CDC and others are watching closely for signs of problems. The CDC does not expect any problems, but is aware that people are concerned because of the Guillian-Barre Syndrome of 1976 and because of mercury found in a preservative. There are vaccines available that do not contain any mercury. A protocol is in effect for a quick response if any problems surface.

So to avoid getting either flu, take care of yourself. Wash your hands with soap and water if you can, or hand sanitizer. Keep your hands off your face; nose, mouth, eyes. If you have symptoms which are often mild, stay home. You do not need to call the doctor unless you have chest pain, trouble breathing, dizziness and confusion and prolonged vomiting. Try to treat your fever (OTC medicine and water)and avoid antivirals unless you have a severe case of either flu.

It is said that you should remain away from others for 24 hours AFTER your fever breaks. It is also said that you can spread the virus before YOU have symptoms.

So eat right and exercise now to get that immune system primed for flu season and be well!

Thursday, August 20, 2009

But is it a BETTER longer life

We have gained two tenths of a point in our life expectancy rate. That is supposed to be very significant. Our main causes of death are heart disease and cancer. They account for almost 50% of the two million plus deaths per year. And while the incidence of some causes of death have come down emphysema death rates have actually risen.

I want you to take pause when you read the head lines. Remember, we are living longer not because we are healthier, but because our diseases are not killing us as quickly. This is where the concept of compressed morbidity comes in, again. We don’t have compressed morbidity. We should strive to increase healthy life years and squeeze all this disease and disability into the very last years of that long life. For now, for many, it is a longer life but not a disease free longer life.

[my mom reads my blog so let me point out that she is 81 and is very active and healthy.. a role model to my 30 year old friends!]

Obesity has become such a serious threat to our health and our economy that the Cleveland Clinic CEO was on CNN last night discussing how to reward employees for not being obese. They already do not hire smokers and most laudably use the Go Slow Whoa eating concept in their cafeteria. There was discussion about not hiring the obese if that person would be too impaired to do the required work.

It is of great concern that today’s children will have the onset of chronic disease before the age of forty. For that generation, living 37 years with diabetes, heart disease and other disabling conditions does not shout PROGRESS to me.

Something must be done.

Wednesday, August 19, 2009

the Tobacco Plant as Hero

Before the market collapsed and the economy sank state and local budgets, I was in support of increasing tobacco taxes and imposing public smoking bans. At least three years ago, I wrote a handful of letters to the editor regarding tobacco. Some were published in the Winston Salem Journal. I was aware then as I am now, that beyond tobacco companies, for whom I have no sympathy, there are tobacco farmers and cigarette factory workers whose income and skill is intricately tied to this deadly industry.

I once proposed that the tobacco companies find a way to make tobacco an alternative fuel. I see now that it would be harmful to have many of the same chemicals in cigarettes emitted through exhaust. I had also proposed that the tobacco farmers’ change crops altogether and use those as an alternative fuel. That idea remains a valid one in my opinion.

Today we have yet another use for tobacco, one that can save lives and prevent illness instead of taking lives and causing morbidity. The tobacco plant can be a creator of vaccines.

The most recent and perhaps only successful example of this process thus far, is a vaccine created for the norovirus. It is very cool in that the tobacco plant is stimulated to create a protein that it forms into a little ball. When this protein ball is placed in an animal the immune system recognizes it as a virus and attacks it, which creates the antibodies, but the ball has NO virus in it, it’s a dummy virus! How cool.

Norovirus does not generally kill people, but it does quarantine whole cruise ships of people. A vaccine would likely be voluntary, and not make a company too much money. I understand that plant based vaccine development is a new and growing field. Creating vaccines in plants is faster than the way most are done now, in eggs.

While reviewing and writing about this, I came up with a question that I am surprised I never had before, which is, where does the nicotine used in nicotine replacement therapy come from? If it is taken from the plant itself, then the tobacco farmers would still have a use for their crop if cigarettes and other tobacco products were banned. I have emailed a tobacco expert to find out, and will let you know as I know.

Post script: Well, my tobacco expert, and I mean national expert, did not know the answer and suggested that I contact GlaxoSmtihKline which produces many of the products. It actually took four people at the pharmaceutical company before I got my answer. They do sell a patch, gum and lozenge all of which are created by using nicotine from the tobacco plant itself. I think that this is great. I am not anti plant or anti tobacco farmer, just anti tobacco products that kill.

Tuesday, August 18, 2009

Stroke Risks and Signs

Today I read the synopsis of a study that was conducted in Ireland. Interestingly, the headline and the first line of the story generalize the results to all older persons. I imagine the same could be true of older persons in other countries which is why I am writing about it in the blog, but clearly I am making an assumption.

In the study from the Royal College of Surgeons, over 2000 persons, with average age of 74, were questioned about the risk factors for having a stroke and the signs of a stroke. The best number from the study was in regards to the knowledge that high blood pressure is a risk factor for having a stroke, (uncontrolled hypertension) either way, 75% of the persons they questioned knew that to be true.

Less common knowledge and a teaching point perhaps are other lifestyle factors that can increase the risk of having a stroke, they are:
High cholesterol
Alcohol in excess of one glass a day women and two glasses/drinks a day men
(with regard to alcohol the drink is the equivalent of one 12 ounce beer, one 4 ounce glass of wine (read that again) or one and a half ounces of liquor.)

Of course, the more risk factors that apply to a person the greater their risk of stroke. All of the above risk factors can be prevented or controlled by diet, exercise and in some cases medicine.

It is very important that a stroke be recognized and 9-1-1 called within minutes of its signs. A popular mnemonic for knowing what to look for is FAST

Face - ask person to smile, is one side drooping?
Arms - ask person to lift arms over head, does one arm drop, drag or drift down?
Speech - ask person to repeat a simple sentence, is the speech slurred?
Time - if the answer to any of these is YES, call 911 immediately

Monday, August 17, 2009

TV Chefs Gain Weight

Over the weekend, my cousin and mother were talking about Julia Childs and then TV chef’s in general. My older cousin said that the chef’s that she had been watching over the years had gotten “so fat.” My mom and cousin then talked about all the butter the TV cooks used and that sort of thing.

My recent entry into Internet cooking shows, via my You Tube channel, offers a change of pace. I am not getting fatter nor will you if you adopt some basic principles with regard to food. They are;

Choose low calorie high nutrient foods at the store
Cook them without adding non nutritive high calorie oils, fats, butters and sauces
Order foods at restaurants which are cooked without the above

I trend this way as my baseline, bottom line and over the line, in other words, I do not stray from this method. That works best for me, on occasion however, higher calorie sauces may be your choice and if you look at your WHOLE day, you can do that without harm by adjusting another meal – NOT skipping the meal, adjusting it.

Unfortunately, many people who would benefit from the video cooking lessons and this blog, do not have access. Until such time that I can package this up and bring it to a local level; schools, employers, community centers and churches, I hope that you will spread the word for me.

Food does not have to be cooked in fat and butter or fried at all. Check out the many examples on my YouTube channel for simmer frying and Volumetrics.

Sunday, August 16, 2009

A Pill is All I Need

Today I am posting a paper that I wrote in grad school not too long ago. I came across it as I was trying to clean out some of my word documents. It is not my best writing and though it appears to be a response to a reading we were required to do, I seem to be addressing two separate issues. They are pharmaceutical companies and providing aid to other countries. This was written during the Bush Administration era when many strings were tied to our giving. Any way, there are a few cogent points in the rhetoric and so I will share it.

“Not to worry, we’ve got a pill for that.”

I feel that the price of drugs is related to our dependence on them and has a lot to do with insurance companies brokering deals with big pharm companies. I think there is a lot of wheeling and dealing going on. The problem, as I see it, is what I refer to as “the pilling of America.” I have much doubt that big Pharma will ever reduce the price of prescriptions but I do feel some efforts by politicians to allow importation and to list retail prices in pharmacies (NY) can be helpful to discerning and Internet savvy persons. (I find it ironic that it is okay for our pills to be manufactured out of the country, but not purchased from out of the country. I find laughable the argument that only WE can make safe drugs. Were this the case, wouldn’t Europeans, et al be falling dead every day from their pill popping?”)

I do not believe that prescription drug prices will be reduced enough to make them affordable and I see no incentive to the pharmaceutical companies. I appreciate that they do provide some free meds, but I abhor their tactics and I SEE their tactics every day at the hospital. In fact a current ad running in the paper regards a cardiologist, “ I have studied the heart for most of my life, I trust mine to Lipitor.” Wrong message.
I feel the issue is working with (other) corporations to help fund prevention programs. They can boost their reputation and sales with health promoting products, i.e without excess sugar, fat and calories. Some already advocate exercise and should continue to do so, as that cardiologist above would be wise to consider.

We as a nation are not taking seriously the notion that chronic disease can be prevented because too often that message is absolutely eclipsed by the one that says it can be treated.

In regards to other countries, it came to me as I read that I don’t think our government should be involved at all. I think we should get meds, supplies and basic needs to countries like Haiti, through philanthropy. The USA is not rich, but individuals and corporations are and they don't make policy. They can help, they should, and some, such as Bill Gates and lord help me, Angelina Jolie, do.

We, the USA, need to pay off our own debt and give proper care to our own people.

Saturday, August 15, 2009

Preventing a Devastating Disease

Research continues to build in support of the positive effects of a diet that is very low in red meat and high in plant based foods including grains and monounsaturated fats as well as lean proteins such as some types of fish and legumes.
There are many types of disease that this type of intake along with exercise (daily) will impact. It also will impact ones longevity.
Recently I read a brief synopsis of two additional studies. One was a long term study of almost 2000 persons in NYC. The study followed the persons over time as they aged. The results are not causal.. meaning we cannot say that for certain that the lifestyle prevented the illness or caused the illness but that a strong association was found. I feel that as studies such as these continue to provide the same results, the association becomes very strong. That being said, people who adhered to the diet noted above reduced their risk of Alzheimer’s by about 40% while people who had the highest levels of physical activity reduced their risk by 33%. These numbers are comparisons to the people in the study who did neither, and according to Nikolaos Scarmeas, the author and lead researcher from Columbia University, doing both will reduce the risk by 60%.

Separately, there has been some movement in the genetic field with a possible susceptibility noted for the ApoE gene.

The take home message would be that, independently, eating a less processed, less meaty diet will improve health and can reduce the chances of being afflicted with several devastating diseases. Independently, moderate physical activity on a near daily basis will reduce the chances of getting several diseases and dieing from them.

Doing both will get YOU the most protection and if you have a gene or predisposition to a disease, then you need to do these two things more than anyone!

Alzheimer’s is a devastating merciless disease. If you are told that you can decrease your chances of getting it by all means, it isn’t so hard, please do it. Alzheimer’s has secondary victims..It isn’t just about you.

And as another physician was quoted as saying in this same WSJ piece, “Healthy diet and exercise is part of a package of lifelong healthy living.” Dr. Knopman also noted that this can’t start at age 70.. you have to eat right and exercise NOW. Of course, if you are 70 and reading this, it isn’t too late for you…

Friday, August 14, 2009

FDA in doubt?

There appears to be some controversy at the FDA these days and it is disheartening to hear allegations of misconduct in the agency that is supposed to protect us from medical treatment fraud. This week a regulator of medical devices resigned in the midst of concerns that he was too friendly with the persons or companies that were trying to have their devices approved for use. In reading the story I became concerned because there was mention of an approval for a nerve stimulation device, [I believe this would be the vagus nerve stimulator and not the transmagnetic stimulation device], to be used in treatment resistant depression. Concerning because apparently there was doubt about the safety and efficacy of said device and an FDA panel strongly discouraged its approval. It was approved and it has been used and I know of people who had the procedure because I have worked in the psychiatry field.

I will tell you that I personally do not believe in either device and am pretty certain that there is skepticism on both. What concerns me is that I do not recall anyone telling the patients that there was a controversy on approval. I imagine that the law for informed consent does not demand disclosure of pre market concerns. Stories like this just add to the national distrust of the FDA and I don’t like that. I need to trust the FDA.

The VNS is implanted by surgery, the TMS is a magnet applied to the head to stimulate the brain during an out patient appointment. The VNS can be turned on and off after placement and was thought to be a adjunct or alternative to ECT or electroconvulsive therapy.

Thursday, August 13, 2009

Misguided Empathy or Empathy Gone Wild

A friend and reader of this blog sent me a video link to a news story that she thought would get a reaction out of me. As she has known me awhile, she guessed correctly. I was appalled at the video and because I found it so asinine as to be disturbing, I will not share the link nor the name of the person in the video with you. I am afraid that the true motive of the personal trainer was fame not empathy, as he claimed. And yes, I would label him notorious. By this point, you should be pretty curious about what has set me off. I will describe it now.

A very fit and attractive male personal trainer and model decided that to truly understand the struggles of his overweight clients, he should too be overweight. So in an exaggerated version of Supersize Me, he gorged himself and put on 90 pounds. His face is now swollen and his stomach protrudes. He has low back pain, and his cholesterol is significantly elevated. I believe he said that his blood sugar was also borderline for diabetes. He is now working out again, limiting his food intake and taking what he considers to be the same journey that his clients face.

I am pretty certain, though I did not conduct a survey, that the majority of people who are overweight and obese did NOT set out to make themselves that way. People truly struggle with self image and issues around eating - such as; food as reward, food as love, food as a coping skill. Learning new ways to eat and to nurture oneself require a lot more than the “empathy” of a personal trainer who spent the last six months or so force feeding himself.

I would add another note about empathy and how this very useful skill can be misconstrued. There are people on both side of an issue, most often addiction, who think that to legitimately help a person or to be helped by a person, both have had to have had the same experience. I.e. alcoholics run AA, former smokers are the “only” ones that can help current smokers quit, and to help a person control their eating one must have also struggled with eating in the past. This shared experience is the concept that drives empathy.

So true that, fine. Where do we draw the line? Can I help you parent your children if I have had none? Must I have beat my children in order to teach you not to? Do people who work in domestic violence have to have been a victim or perpetrator? Can I treat your diabetes if I have never had diabetes? How about that blockage in your artery? Must all cardiac surgeons have a history of heart attack? Must all psychiatrists have a diagnosis of schizophrenia or bipolar in order to medicate others? Do you have to have had a mastectomy to perform one? Perhaps our personal trainer would like to smoke for 20 years to see if he can get lung cancer and a little empathy there too.

Ok, true, I would like a runner to treat my running injuries, but that does not mean a non runner doesn’t know about muscles. Indeed, professionals must at times profess a lack of personal experience and acknowledge instead their education, awareness and experience treating others with similar problems. So if empathy escapes you, try honesty. People respect and respond to honesty and a genuine desire to help.

Wednesday, August 12, 2009

A message from the ACSM

As a member of the ACSM I have been asked to share this information with you and to encourage you to pass it on to others.

Message Points:
Exercise and Energy Balance

Exercise and Weight Management
 There is strong evidence from the majority of the scientific literature that physical activity is an important component of an effective weight loss program.
 Physical activity is one of the most important behavioral factors in weight maintenance
and improving long-term weight loss outcomes. In fact, participation in an exercise
program has proven to be the very best predictor of maintaining weight that was lost.
 Effective weight loss and maintenance depend on a simple equation called energy
balance: Calories expended through physical activity and normal lifestyle functions must
exceed calories consumed.
 It is a myth that exercise can actually prevent weight loss by leading exercisers to
overeat. Research and common sense disprove this notion. Look around the gym or the
jogging trail. If this were the case, wouldn’t those who regularly exercise be the fattest?

Other Benefits of Exercise
 Exercise and physical activity have been proven to help prevent chronic conditions such
as heart disease, osteoporosis, anxiety, depression, obesity and diabetes.
 Studies show that when students are more active (through physical education,
classroom activity, play, etc.) they improve test scores and attendance and experience
fewer discipline problems and sick days.

Policy and economic implications
 Physical activity and exercise are key components of workplace wellness programs,
which have been shown to return $2.90 to $5.96 in cost savings for every dollar invested
by the employer. Participants in workplace wellness programs have reduced absenteeism, error rates and health care costs; they feel more alert, have better rapport with co-workers, and enjoy their work more.
 Physical activity and exercise must play a vital role in health system reform. Cost savings
from healthy lifestyles can help fund broader coverage for the underserved.
 Stimulus funds designated for electronic medical records should include fields to record
each patient’s physical activity level. Exercise IS medicine and should be measured as a
vital sign like blood pressure or cholesterol levels.

Tuesday, August 11, 2009

Cancer Mortality - reduction

Today I reviewed a study that in some ways can be considered a gold standard. The positives of the study include that the sample size was large, over 3000 persons; the study was long, 16 years; and it followed people over time forward before disease occurred. A less respected way to study disease cause is to look back at people's exposures after the illness is identified, or retrospectively. This study is far from perfect. It only involves one geographical area and one gender, which some may say prevents generalizing the results to other people. I feel that the results will likely be repeated in other populations. The study also relies on self report from the participants though there were trained assistants conducting interviews. These are not, however, clinical measures. The study is thus a cross between an experimental control study and an epidemiological study. The results should however, turn your head.

In regards to cancer mortality, (not getting cancer, but dieing from it) the intensity as well as the duration of physical activity is protective. Other variables related to cancer outcomes were isolated, or taken out of the equation so that the data ONLY looked at the effect of this variable - exercise. The other factors, so you know that they are an issue, are weight, alcohol consumption and smoking status. The intensity of the exercise was measured in MET. This was mentioned in a recent blog and stands for the metabolic equivalent of oxygen consumption. The researchers identified several forms of exercise and then determined what level of MET to apply to them. This is a good follow up to the previous blog because the exercises that they found protective had METs over four and included, jogging at a 10, swimming and rowing at about 5.5 and cycling at 5.1. I am surprised that swimming was that high, but we do it for less time usually. Skiing and playing ball games was at about 9. Walking came in at a 4.2 but that may have been leisure or work related walking.

Bottom line was a significant reduction in deaths from cancer in those men who had consistently exercised 30 minutes a day at a moderate intensity. The activities listed above. In fact, the lead researcher was quoted,
"We found a 50% reduction in the risk of dying prematurely from cancer," Dr. Kurl pointed out. Exercise also improves well being and confidence, and leads to better sleep and weight control, he added. He also told the interviewer that he jogged three times a week and did weight training at the gym twice a week.

so now you know. Exercise: the more you do the more you get...

Monday, August 10, 2009

Health and Taxes

I continue to have work crunch issues and will keep the post brief today/tonight.

In regards to health reform, someone wrote in to the Wall St Journal recently suggesting that instead of punishing people by increasing taxes on junk foods, soda, cigarettes and such, it would be better and less “paternalistic” to reward good behavior. The writer suggested a health credit.

This is not a new or bad idea. In fact, it is the type of incentive that employee wellness programs are encouraged to provide. And on a micro level it makes sense. If people test negative for tobacco, they can pay a lower premium or get a better insurance plan. If people either maintain a health promoting weight or take steps to get one, it can be rewarded. Having normal blood pressure or keeping it normal with diet, exercise and even medicine compliance, can be a means to lower a premium. Even tracking gym attendance can work on this small scale. Also, we would hope that the employee insurance system is a not for profit one and will not miss the lost revenue.

However, to monitor this nationally and give a tax credit is difficult on both ends. Do the fitness facilities become big brother? Do we have national gym card scanner data bases? And can we afford to take in less tax revenue? I do not really think so.

I want to be rewarded for my good behavior. At the same time, I understand that alcohol, tobacco, sweets, and more are things that I do not NEED to survive and if I have say six dollars to spend on any one of them, then I have seven dollars to spend. Taxing these items will give the local, state and federal governments some desperately needed funds. Additionally, if one cannot afford to buy these items it is likely to IMPROVE their health. Why in the world are people complaining about measures that could help people to live longer better?

On a different note, but in the same debate, some are suggesting a renewed push for gambling. Well, I have never been against gambling and am not now, but if I gamble my money away I have no money.. that is harmful. If I spend my money on junk food I lose more than my money and that could be more harmful. But if the taxes keep me from buying junk food I could keep both my money AND my health.

Sunday, August 9, 2009

Odds and Ends

Ah, another week has passed and a few items should be noted, saving the best for last, let me begin:

Compressed Morbidity: I thought of this again this week, having first heard the term at the Cooper Institute in May. The idea is to compress disease into the last years of a long life instead of spreading it out over many years. In other words, as Dr. Cooper had said, right now we are dying longer not living longer and that needs to change. I think of this with lifestyle related illnesses.. illnesses associated with obesity and tobacco. Yes, for many illnesses there are medications, but rarely a cure and some illnesses will significantly impair the quality of life a person experiences. It is time to leave disease for old age.

Weighing: This past week someone asked how often I weighed myself, following that question with another before I could answer, "Every day?" In fact, I do not weigh everyday and told my new friend that I tend to weigh two or three times a YEAR. I thought afterwords that the reason I have no need to weigh more than that is because I am consistent. I eat and exercise according to recommendations, well, okay, I do perhaps exercise more and eat a little less, but I have been this same weight plus or minus two or four pounds for almost nine years. I am NOT on a diet.

Heart Rates and Cool Downs: I was pleasantly surprised when the instructor of a spin class reminded everyone to slow down and not stop right away as the heart would be better conditioned if one eased off the intensity. I have always hypothesized that the reason for heart attacks at racing finish lines could be strongly associated with someone going full throttle and then coming to a complete stop. Many times I see runners bend over or sit down. I think that is crazy! I imagine blood backing up into the heart.. no medical training tells me that is so, but just think, PUMP PUMP PUMP run run run.. okay screeching halt.......STOP.. scary to me.

Calorie Awareness: I thought this would be a good thing to share with you. I have in my head a baseline calorie amount that I like to stay around and plan around. If I do no exercise that is what I eat, if I do moderate exercise I add a little more, if I am running my very long runs I add even more. So the message to myself is I eat LESS when I do not exercise. This is an exercise motivator. I do not eat EXTRA when I exercise.. that can be a fools game.. I eat LESS when I do not and I do not want to eat less, so I exercise!

KUDOS KUDOS KUDOS: This week I happened to stumble upon two incredibly inspiring people. Both are women and both were once obese and unhappy. I am inspired by them and I want YOU to be inspired by them because they lost their weight and have maintained their new weights with lifestyle change concentrating on energy in and energy out. They have both cut their calories and increased their exercise. I cannot do their stories the justice they deserve but you can read them on line. I will post links for you to find them. I read about Miss Rosie Coates in Runner's World and her story had me saying YES YES YES a few times. And Miss Raquel Barragan who goes by Rocky, is a partner in the cooking video world and has also lost a significant amount of weight and has done so with the new Weight Watchers program (not diet, program). Both ladies have my utmost respect and admiration.

Rosie's story:

Rocky's YouTube Channel:

Oh, yes, I think it was Rosie who said this.. but you know how I say eat less move more.. she said eat less, sweat more :)

Saturday, August 8, 2009

Label Tricks

I become increasingly frustrated with producers of supplements and meal replacements as well as producers or manufacturers in general as they tout their wares as health promoting and essential when they can be anything but…

There are dozens of reasons why vitamins and minerals added to products, liquid or otherwise, can be a waste of money. Here are a few:

1) Research often doesn’t support the health claim in THAT form
2) Products don’t have enough of the said ingredient to make a difference
3) The product may have fillers that counteract the positive health effect
4) The label is misleading
5) The product is contaminated or has unclaimed ingredients that cause harm

In many ways, all we get for our dollar is expensive pee.

More so, I want to educate consumers. Labels on our foods can be misleading. Recently I discussed why buying foods with omega three fatty acids was misguided, but many other health claims or label facts can trip you up as well.

Fat free, trans fat free, sugar free, calorie free – most of the time means that there is a trace amount of the item per serving size.. depending on how the nutrient is measured it could be .49 grams of 4 calories.

Serving size is another issue. Recall my ice cream dessert video on you tube… ½ c is the serving size on the box and not only do most of us have a cup.. the weights are different on almost every box.. it is calorie per gram that the consumer would be best to consider.

Recently I wrote that the FDA/USDA did not define the term “natural” and I was mistaken. They do, only in the sense of a policy, not a regulation. Both FDA regulated products and USDA regulated meats and poultry labled "natural" are encouraged to be minimally processed and not contain artificial flavorings, colorings or preservatives.

Many times a product will claim itself to be hormone free when the law prohibits hormones in the first place, i.e. poultry and hog products.

My favorite was when all sorts of things that never ever had carbs began to have labels claiming they were carbohydrate free… like WATER.

Added fiber? Try getting it the old fashioned way.. the way research says is helpful.. in a food that contains it from the beginning.

It will nearly always behoove the consumer to read the ingredient list of baked goods, like bread, to be sure, no matter what the label implies, or screams at you, “multi grain”… that the word before the grain is WHOLE. Did you know that there was something called the Whole Grain Council and that they have a label for whole grain products.. indeed… if the package has their black and yellow stamp you CAN be assured that the serving size has at least 8 grams of whole grains.

Another label to be trusted is the USDAs certified organic. Unfortunately, a recent research study found no health benefit to eating organic foods. I myself do not eat them. BTW, the organic label does NOT apply to any USA raised or caught seafood and according to an article in Runner’s World this month, that label on food sold here would be from another country and may lack any clear and consistent definition or practice. In fact, one would be better off eating wild Alaskan salmon which is apparently regulated here and farmed arctic char which is also supposed to be healthy and safe.

Another trick noted from the same Runner’s World article was putting 100% juice on a label under the drinks name, like pomegranate, but only 20% of the juice is of that type. Anyways, fruit juice is not the best beverage to spend your money on whether it is 100% or not.

Lastly I want to say that you do not have to shop at Whole Foods to eat whole foods and eating whole foods; fruit, vegetables and grains is health promoting.

Friday, August 7, 2009

Role Models

During my travels this week, I was able to use a fitness facility associated with my hotel , but also with the community.

One morning I was in the change room while a conversation between two members was taking place. Based on their vocabulary, mannerisms and a bit of “work” they had done on their faces, I imagined the women to have a bit of a privileged life. ( and oh were I to have the same!)

The women were over 70, how much so I am not sure, as I said, they’d had some work done. They were dressing for aerobic classes. One was taking Zumba dance that morning and tap class that evening. As she was getting ready I noticed her agility, balance and flexibility. Also, the women were engaged, happy and healthy. Role models for certain.

My take home message is that exercise is the best investment plan for your retirement.

PS this fitness center deserves Kudos also for having hand pumps with little “serving” cups for body lotion, mouth wash AND spf 15 sun screen.. as they had tennis courts as well. Very health promoting!

Thursday, August 6, 2009

Fructose Continued

Continuing with information on fructose from a lecture presented by Richard Johnson, MD

Dr. Johnson suggests that fructose is more of a problem for the general public than glucose, though glucose is of significant importance for people who have diabetes.

The glycemic index which rates foods based on the way they affect a person’s blood glucose level, would, according to Dr. Johnson, be of less importance than a Fructose Index.

Checking the USDA nutrient data base the fructose in grams IS listed. For example, a medium sized apple with skin has about 4gs of fructose.
Remember from yesterday that we should keep our intake at about 25gs.

Dr. Johnson also discussed a soda tax which has been promoted enough recently to trigger anti tax commercials from the beverage industry. You would be enlightened to know that as years have passed the price of most foods and specifically fruits and vegetables have increased, but the price of soda’s have stayed the same. Professor Kelly Brownell from Yale has spoken publicly about the benefits of a soda tax. In his writings one can make a comparison to what has been done with cigarettes. Actually from the start:

Cigarettes were very popular but bad for us
Tobacco companies said they were not bad and no one should tell us what to do
We wanted to raise prices and were aggressively challenged by Smoker’s Rights orgs
We taxed cigarettes.. years later…
Less people smoke and more people quit
Tobacco related expense and illness decreases

Dr. Brownell suspects that a one cent per ounce tax on sugary drinks, soda and juice, could bring the state of NY over a billion dollars a year.
We could then compare a state that taxes to a state that does not, over time and see if people drink less and if the drinking less equals better health outcomes. I can see nothing but win win win win win.. in this argument.

One note that Dr. Johnson made yesterday also offers an AHA moment. He said that banning soft drinks in schools and worksites for example may not have the effect that a tax could have because people might choose to drink more soda and drink it faster when at home and that is a problem with the body reaction of uric acid creation.. [I still think they should be banned. I do offer a shout out to my last employer however, WFUBMC, where food service charged LESS for water and diet soda than for the sugary beverages]

On a completely unrelated note: I saw today that Jay Leno the comedian had lost about ten pounds and reports that he has joined my favorite physical activity group - RUNNING. He runs about 4 miles a day.

Wednesday, August 5, 2009

the Perils of Fructose

My goal today is to list some of the main points from two lectures I attended today. The speaker was an MD researcher who has linked, through his research, fructose with cardiovascular disease in that he believes it causes metabolic syndrome which is a precursor for heart disease and diabetes. I want to share any points that might be relevant in our real lives, so here they are:

Fructose itself appears to increase uric acid and uric acid increase can lead to a nitric oxide decrease. Fructose also seems to effect the hormone leptin which is supposed to suppress appetite when we have had enough to eat. Scientifically over my head, but I believe these are the actions that lead to a syndrome which has the following adverse health components:
Increased weight, abdominal fat
Insulin resistance
High levels of triglycerides
Oxidative stress
Endothelial dysfunction

Limiting fructose is advised. Table sugar is a molecule of fructose bound to a molecule of glucose. High Fructose Corn Syrup contains the same two molecules in an unbound or free form. Both fructose sources cause the increase in uric acid, but the free form is more potent.

Fructose is also found in fruits, however, there is some neutralizing of the effects because of the fiber, antioxidants and polyphenols found in many fruits. Watch out though, not all fruit has the protective chemicals. For instance and sadly, watermelon is one of the most high fructose fruits with little antioxidant balancing. Also watch dried fruit because of the high sugar and calorie content involved. People eat it too freely.

Dr. Johnson advises that we eat 2-3 fruits a day, because there is 4-8 g of fructose in each. He strongly encourages limited fruit juices and avoiding soft drinks.

I learned some odds and ends as well.

In white persons under 40 who have high blood pressure, salt restriction doesn’t seem to help.

Olive oil is best purchased in the can, to preserve its health promoting properties.

Heart disease or vascular disease has two distinct pathways. I understood Dr. Johnson to differentiate between atherosclerosis and arteriosclerosis. Whether I have the terms right or not, he was explaining that one type of artery disease was related more to saturated fats and cholesterol while the other was more likely due to the inflammation and cell damage from the hypertension related to fructose consumption. He was responding to my question regarding whether or not he was trying to minimize the effects of a high fat diet on heart disease and he said NO , not at all.. but that the high fat diet caused one type of problem and the high fructose diet caused another.

He estimates that we consume upwards of 50gs of fructose a day and would be better off at 25gs a day.

a little more tomorrow in regards to a fructose index, fructose sources, and a soda tax...

Tuesday, August 4, 2009

vigorous physical activity

Hello, the travel today was not fun and I am cranky... drove over to the market and bought myself a healthy salad and vegetarian lunch meat... was good. NOW I think I can focus a bit.

I was mentioning to my brother n law the other day the importance of including not just physical activity, but vigorous physical activity, into his routine. It is the higher intensity that improves our overall fitness but also more stronger effects our cholesterol levels, in fact, exercise intensity directly impacts HDL levels.

It is recommended that adults participate in 20 minutes of vigorous physical activity several days a week. [or moderate intensity two and a half hours a week.]
So just what IS vigorous?
It gets a little complicated if you consider it in METs or metabolic equivalents.. but being still is equal to one and vigorous activity is six or more. If you think of perceived exertion is it about a seven on a scale of ten.. for the 20 minutes.

Now what is moderate for a 20 year old may be vigorous for a 70 year old, so some subjectivity is involved.

Here are just a few examples that the CDC and the ACSM consider high intensity or vigorous.

walking very fast... five miles per hour..
(it usually takes me 17 minutes to walk a mile which is low to moderate activity!)

running - no MPH given but 12 or less minutes per mile is usually considered "running"

bicycling at least ten miles per hour...
(I can do 12 in around 63 minutes on my no gear bike! and believe me, cyclists fly by me on the road so that I am almost embarrassed. I actually want to yell out, "I am just an injured runner, not a cyclist!")

mountain climbing and hiking

roller blading

aerobics, step, dance, floor - high intensity

jumping jacks

jumping rope

and YES TOM... rowing machine (at vigorous effort)


ballroom dancing

competitive sports (tennis, soccer, football, basketball, etc)

steady paced lap swimming

canoeing etc, at more than 4 mph

well, that ought to get you started...

Tomorrow I will be in conference so I should learn something new to share!

Monday, August 3, 2009

Referring Out

I had to work this evening and did not have any down time to write earlier.. so I am referring you to someone else's blog note.. also I am traveling across the state tomorrow but do hope to get a note in before bed. Wednesday and Thursday I should have some new info as I am attending the Florida Public Health Assoc. conference. Also there are 30 or more past posts from July that you may have missed.. and you can use the "search this blog" box to look up a topic .. like volumetrics etc.

Until next time.. please enjoy one of my favorite health news sites and a post that contains information not unlike that you have seen here..

Sunday, August 2, 2009

Odds and Ends

Birds of Prey? I was eating lunch at the beach Saturday and though I have seen this before, I was still stunned when the sea birds began swooping in for my food. Seriously, one of them actually hit my head with its wings! Now I don’t eat much and I only take out enough for one serving so by gosh.. that bird was NOT getting my lunch. I had to hold my sunscreen can and swing at them.. I was agog. How did these fowl learn that people on the beach had food that they 1) wanted and 2) could steal? Well from us I am sure. For goodness sakes... how does a sandwich attract a beast meant to eat fish?

Parents and Choices: Years ago, I was going to be a daycare teacher. I began college studying child development before switching to social work and later worked in child abuse and neglect for about seven years. I took courses on parenting skills and also taught them. One thing I remember very clearly which helped others and myself, is that one should never give a child or an incompetent adult a choice that doesn’t exist. Still a choice should always be given so the person is empowered. I.e., not “what do you want for lunch?”, but “which of these two things do you want?” Or, “what shoes would you like to wear to the store?”, not “do you want to go to the store?” And lastly, “which Assisted Living Facility do you think would be better for you?”, NOT “do you want to go and live in the ALF?” I thought of this over the weekend as an adult and elementary school aged child arrived at the beach. The adult said, “Do you want to put on your sun block?” and the child said…. “NO,” and bounded off for the surf. The better question? “Would you like to put on the sun block yourself or shall I?” Remember that the biggest risk factor for skin cancer is having significant sun burns as a child. [after this, I saw my nieces who had spent over seven hours at another beach the day before.. and there was not one spot of pink on them. They applied and re applied.. good girls!]

Medicaid: My mother told me about a radio show she had recently heard. From her description, it appeared to be related to long term care planning. Some of the information appears to have been sound but when she started talking about Medicaid in regards to long term care, I became upset.
Basically one should figure it this way. IF you have been unable to support yourself most of your life and the government has assisted you with health insurance and housing, it is likely to continue to do so when you are older. If you are independent and have had the good fortune to work, save and prosper... paying for a home perhaps or for housing and cars and the like, it is NOT expected that the government will suddenly pick up the tab for your housing in an assisted living or nursing home. Nor should they... unless the whole system changes.
I think that lawyers who can make your home and money “invisible” are cheating our system and are one of the causes for the health care crisis… similarly I am upset when lawyers make non disabled persons suddenly disabled enough for social security disability income. Really, I think it is bullshit. Needs based programs are just that – needs based.

Physical Therapy: Interesting statement made by a physical therapist this past week. We don’t usually see people who are active; we more often are treating problems due to inactivity.

700 calorie burn: I enjoyed an awesome spin class over the weekend. The teacher was great, energetic, skilled, etc... music good.…participants lively and helpful. There was just this one thing... At the end of our 45 to 60 minute class, the teacher said that we had just burned 700 calories…..doh!... As a former instructor, I take issue with any of us claiming a particular calorie burn for a class. One can not offer legitimate general data like that. Now to say that this burned more than walking or the elliptical or as much as running for 20 minutes, something like that, OK.. but numbers are based on well... numbers... YOURS .. I may have burned 200 in that class, and my neighbor maybe 400. I doubt that anyone burned the 700 but could be. I just worry that people hear that and then base their calorie INTAKE on it.

A Twist of Phrase: I recall three separate things that I heard this week that led me to think myself clever-
1) Some one was talking about French fries and said “But you can’t eat just one.” And I thought, “Oh, but I can eat just none and be the better for it.”
2) My auntie said, “You can’t live forever,” in a conversation where I was lamenting over her becoming a seeming recluse and I responded, “No, but you can live while you’re living!”
3) And lastly, I saw a magazine with the caption, “Eat better for less.” And thought, “Eat less for better.”

Oh that last one reminds me of my grocery shopping. Alert! Pay attention to your foods. There can be a drastic difference in price and calorie content for the same foods by different companies. Look at UPC labels on the shelf and calorie by gram on your foods.

Saturday, August 1, 2009

Graze Ways

This post should be relatively short and simple with no scientific study or google searching required. I want to make a statement about "grazing" in order to encourage a healthful eating pattern not an unhealthful one... Or is it healthy and unhealthy... either way...

I don't like the word grazing but I think it was meant to take the place of snacking.. as snacking is generally thought of as eating "fattening" foods between meals. Grazing however makes me think of near constant eating, and that isn't good either.

The way that our body best responds to and uses energy is in small doses over time. Thus, eating frequent small meals is the healthful option. As I was having a conversation the other day, I realized that "small" is not the right word either because small doesn't mean low in calories, it just means small.

Imagine eating a donut or candy bar or even a peanut butter and jelly sandwich.. Small meals in the context of "frequent small meals" is meant to mean low in calories not necessarily small visually. A salad can fill a plate and have 50 calories where as a piece of cheese may not fill your hand and have 200.

I cannot tell any of you how many calories you should consume in a day but I can tell you that if it is 1800 then spread them out! It doesn't have to be even, but it can be.

Mine usually go like this;
50 cals to wake up
150-200 for breakfast

75-100 snack

150-200 lunch

100 snack

75-100 snack

300 dinner and dessert

200 snack

200 popcorn..

and another couple 100 spread around in there :)

Those are consumed from 7am to 10pm.. every two to three hours...

It is not wise to eat two 900 calorie meals or even three 600 calorie meals.. meals that high in calories are often that way because of high fat or sugar content. Heavy meals increase the heart's work load, effect metabolism negatively and often make the eater feel sluggish.

So - eat low calorie meals OFTEN.. and move more too!