Tuesday, August 31, 2010

Calories Count so Post 'Em

I cannot believe that this one almost past me by unawares! The FDA is expanding the requirements on posting calorie counts and other nutritional information regarding the foods that we are sold. The industries that are also coming under the policy include but probably are not limited to, airlines, convenient stores and movie theatres.

Of course I am 100% in favor of full disclosure anywhere we can get it.

There is some preliminary reporting on the effects of these measures and the change in consumption seems minimal. I continue to believe in this tool, however, the missing piece is education. A person isn't going to pay attention to the information or use it to make a choice if they do not know why it matters to them.

Not to worry - I am doing every thing I can to become the expert that will make the education piece part of the big picture.

Monday, August 30, 2010

Vectors and such

The best I can do for tonight is explain what the epidemiology class I assist with will be talking about tomorrow. This way I refresh my memory while educating my readers, perhaps, and continue in my general multi tasking glory!

Tomorrow the class will be asked to give examples of disease agents and vectors as they are depicted in the epidemiologic triad. The triad, a triangle, actually has four variables, one in the middle. The triangle points are host, agent and environment. All have some interaction in regard to disease. The middle contains the vector - or disease carrier - transmitter- which occasionally is not necessary for disease to occur.

So my examples of the agent - are viruses, bacteria, exposure to some toxin and my example of a vector is a mosquito (West Nile Virus) and a tick (lyme disease). The host could be the deer or bird originally and then the person if bitten by the vector. The host and the environment have something to do with who gets sick and who doesn't. This is information that we talk about often in the blog.

Okay - off to study.

Sunday, August 29, 2010

Odds and Ends

New category - Problem of the Day - my printer won't work anymore and it won't even uninstall - sigh sigh

I kept a little list this week of things to say in the O&E however, I wrote down one word and no notes, so ha ha - I don't know what I was thinking....

Zestra- I remember seeing the commercial on TV for this product that is supposed to increase sexual arousal in women. It is some type of gel that I think is applied to the female genitalia that makes a woman all atingle. I wrote it down because it just amazes me to see these ads, male or female, for such an intimate part of a person's life.

CDC/HIV - This has to do with a project for which one of my professors has received funding. It is to reduce HIV in high risk individuals and I was intrigued by the definition of high risk. If I remember correctly it was someone who had unprotected sex two or three times in the last thirty days, who was not an IV drug user, and who never had sex with men. The professor made a good point about the thirty day issue. It could be that the person does regularly engage in unprotected sex but hadn't gotten "lucky" lately.

Old Friends - Not only am I able to tap into my old workout and dance buddy network, but since I have Time Warner Cable I am back on with FitTV and can do my abdominal work with Gilad again, which makes me smile.

Falls and the Elderly - I read a headline about falls in the elderly that stated an increase in actual falls based on the persons fear of falling. Even though this was a study in the over 65 population I imagine it would apply to all ages. I can say for certain that it applies to me. And thus, the reverse must be true. I am testing that out now. I made it through this week without falling off my bike and I did come close one time. However, I am telling myself, I am NOT going to fall. :)

COPD - Oh me oh my, Dog the Bounty Hunter, haven't you been reading my blog? Last night a man - one of the fugitives - told Beth and Dog that he had COPD. Dog asked what that was, cancer or something? and the man said, not it is - okay, I think the guy said, "Cardio obstructive pulmonary disease" but maybe he said chronic. So Dog asked, "What's that from, the alcohol?" The man said, "no - smoking." Now all three of them were smoking during this conversation and Beth said, "Let me tell you something. My dad was an alcoholic and that is what he died from." Now how many ways can a person DENY that smoking is bad for them - shame.

Condoms - Ah - as I was running this morning at Salem Lake, where two buses from High Point University were parked, I meant a group of young men coming around a corner and one was talking. I only caught a fragment, but something like, "condoms, better be glad he was wearing one." Well, I am glad! Yay safe sex :)

Saturday, August 28, 2010

My Topic Highlighted

As you know, I expect my life's work to be related to the prevention of obesity as it causes chronic disease and that chronic disease is affecting ever younger populations. Recently I alerted you to a new program or service that the CDC was implementing called Vital Signs. Each month they choose a topic and highlight the amount of that disease in the population and what can be done to prevent and or treat it. This month it is adult obesity and though I plan to read every word, I don't have the leisure to summarize and pontificate for you. Instead, I offer you the link, trust you will visit it and in your head hear my voice on certain pertinent points!



Friday, August 27, 2010

Greenway Observations

I ventured out on my own this morning to explore the trails and greenways in my new home town. I know that I can find new places that I love and driving to my old NC town is not really the best use of my time, though I will continue to do it on Sundays.

Anyways, there are many trails in the area, mostly paved but off road as well. If you enter at the right spot you can run or walk or bicycle for well over ten miles.

Today I started in a place called Country Park but ran through to the Guilford County Military National Park and even onto what is called the Atlantic Yadkin Greenway. But I did not trust myself to run off the pavement and I back tracked a little because I wasn't sure what looped and what didn't. I found out at the end, when I went into a park office, that the area where I parked also was a big loop, 1.6 miles that went around a lake and into the woods. Tomorrow a friend is coming over and we will explore more. I would like to try the Bicentennial Gardens.

After my run, it was reading reading reading.

I wanted to point out a few things from my morning adventure. The park office reeked so badly of cigarette smoke I almost gagged. On the trail a dog on a leash came close to tackling me, but that really isn't any one's fault. I saw a person walking with weights in their hands and I still want to do some kind of "point of purchase" communication to alert them of the danger. Oh, and I saw a lady walking wearing those shoes that are advertised (falsely according to a ACSM report) to tone you up or burn more calories etc. Though it is a silly waste of money on the surface, if it means that person is going to walk, which WILL help them, then let 'em wear the shoes, right!

Okay, back to my studies....

Thursday, August 26, 2010

Temporary Plans Give Temporary Results

That sounds rather intuitive doesn't it and yet day after day in many a country people adopt a strategy for some goal and when they achieve that goal they drop the strategy. Usually a method only works while it is being employed. (heck that even applies to government incentives right! - or cash for clunkers, etc)

If you reframe it however, it does not have to be a negative and if you choose a strategy that is NOT painful, but one that you enjoy, then you will not mind incorporating it into your very essence.

I say this today because I was walking with my dear friend who has had the weight loss surgery (WLS) and as I will continue to say, though I think negatively of the procedure, I do NOT think negatively of my friend.

It has been more than a year now and she has lost about 80 pounds I believe. She thinks another 75 would be good. I asked what her plan was to make that happen and she shared that though she has to eat small meals now, she still is drawn to foods that are high in calories and that she feels compelled to eat sweets.

I told her about something I had heard on the radio recently that sounded a lot like me. It wasn't the ideal, but it was a step in the right direction. This is the person who decides to only eat at certain times and even knows what he or she will eat at those times. It puts the person in control so much so, that when a person enters the room with donuts or cakes or cheeseburgers for that matter, the controlled person isn't even going to be tempted.

My friend said that she had been very good about eating every few hours and packing her meals BEFORE the surgery and she just thought that afterwards she wouldn't have to do that anymore. Even this incredibly invasive surgery was, in her mind, going to be a quick fix.

It doesn't work that way, but if you find foods you enjoy, cook them in ways that doesn't increase their calorie or fat content and you exercise in ways that make you smile, you can make it a lifestyle. The benefits will continue.

Wednesday, August 25, 2010

Hips and Knees

Okay - I am sitting on the couch with my newest laptop. I have been using it with my docking station but this is the first real time I have typed out on its keyboard. The space bar does not seem to be sticking anyways, but I am skipping over letters in my haste and unfamiliarity. No worries, let's move on. The bicycle is back and ready for riding tomorrow.

My classes themselves are mostly boring me to tears, but I am trying to be patient and not to come on like gangbusters as my last employer (supervisor) told me once that I could put people off by coming on so strong. So I wait.

Now about these hips and knees, not mine, but the ones that Johnson and Johnson is really hoping that you will replace with one of their devices. The FDA has sent them a warning letter about marketing for unapproved uses and also for promoting and selling a test or exam kit that has not been sanctioned for market. I have told you in the past why a company would do this. IN case you have forgotten, it is to make as much money as possible from each product that they create. I am especially interested in this TruMatch Personalized Solution System that is suggested to show physician's a 3 dimensional diagram of a knee so that the surgeon can place the new knee with precision. The system involves a high tech CT and we all know what that means yes?? Radiation. I am glad that the FDA has called them on these issues.

And to those of you wondering how I found the time to read that article I must admit, I didn't - find the time I mean, I robbed it from somewhere and now I need to go pay it back!

Tuesday, August 24, 2010

Ethics

Wow - It is hard not to be frustrated with the day (month) that I have had. I know though that others have had much more trying days than I and I know too that this will pass and someday seem funny. I remember also that when I was a practicing social worker, people would tell me that they felt bad describing their issues because others were far worse off, I would tell them that this wasn't about other people it was about them and they COULD vent about their world. (there were some people however, that drove me to quit social work because they would ONLY complain and never change)
So - let me just say - my bicycle broke on the way to class. I had to drive my car instead and the parking deck was full so I had to find street parking and move my car during class so it would not be towed. I brought my bike to be fixed and am getting a basked attached. It should be ready tomorrow - but first I will have to drive to school again.

I went by the IT lab to get three things quickly fixed on this old laptop and they did not solve any of them. I went to Best Buy to get my replacement laptop for the new one and paid 180 dollars extra and they still would not transfer my data for me. I am trying to do it myself now and UGH - I just need to be studying not doing these mundane - "oh life happens" things.

Class was okay today - a little slow. But a topic which comes up in health education often is whether or not we should try to force change or coerce or manipulate change so that people do what is better for them. I am of the school - and it seems I am NOT among the majority in academia- that YES!! YES we should use strategies such as policy, to enact change and sometimes I think it is unethical NOT to.

But that is all I have time for today, the other lap top needs my attention..

Monday, August 23, 2010

Committment

I believe that I have finally found something that will keep me busy (i.e. grad school)! There is so much to say but I have so much to read, and that means I doubt I will be able to finish the novel I was reading until Thanksgiving. But I digress.

Today I want to make a point about exercise, or more importantly, the exercise routine. I have not had access to a swimming pool since the beginning of August when I had been swimming twice a week. I had worked up to 26 or more minutes continuous swimming. In that particular pool it was 34 laps. I had stopped bicycling for about a month, so when I was originally unable to swim but able to bike, I thought it an okay temporary situation. The pool is now open and as intimidating as it seemed, I knew I had to get over there as soon as possible and not let the fear or any other side tracking talk me out of it.

The pool schedule is very limited. Just a few hours on different days and not the same hours on any given day. I saw my window this evening at 5pm. First "obstacle" - I prefer to work out in the morning. Second "obstacle" - figuring out this bicycle and back pack issue, how much can I carry, etc. It takes less than 15 minutes to ride to school but there are a few challenging hills. I left my swim wear at home this morning because I just didn't think I could handle it all. Third "obstacle" -well I rode to school and walked around a lot, so that really is physical activity (which it is - be remember physical activity is important and exercise is as well - they serve different purposes) - and I ran 12 miles yesterday. Fourth "obstacle" - ok, I have to ride home and get my things, maybe I should DRIVE back - oh no no no. Fifth - now that is going to be almost 8 bicycle miles and I need to do all of this reading and I need to go back to Best Buy because they told me this morning that they had to replace my brand new laptop with a completely new one that I still have to pick out.

But I did not let any of that stop me. And though the pool is in this very remote part of the building and I was nervous about finding it and walking around in my swimsuit with those youngsters, and swimming my non swimmer laps, I DID it.

I did it because running and biking and walking don't keep me in swimming shape. I did it because if I didn't do it today, I would just as likely not do it next time. I did it because whatever obstacles I overcome, the more I will be able to handle.

And as busy as I am and will be for the next several years, I will not become sedentary and soft as most of my professors appear to be!

Now - don't tell me you are too busy for daily exercise - YOU ARE A PRIORITY!

Sunday, August 22, 2010

Odds and Ends

Sexual Health- I have been holding on to this thought, wondering if I should make it a full blog post or just and O&E. You see where it ended up, but that should not lessen its importance. Sexual activity and maturity is individualized but it is also very much a matter of the culture into which one is born and raised. I am most familiar with Western culture and our youth are generally not ready for the intricacies of sex until they are over age 16. Really I want to say over the age of 21, but maybe it can be thought of in degrees. I bring this up to express my angst at a display found at a retailer whose name is The Children's Place. Children are not ready for sex. If children are not ready for sex, they are not ready for appearing sexy. So this retailer should be shamed for selling jeans referred to as Sexy Boot and described as low rise, slim in the hip and thigh, etc. I saw this in a WSJ article.

Domestic Violence- DV is another issue that you may not expect to see in this health blog but it IS a public health issue. I am concerned by the USAs number one pop single which has been the number one from just about the time it was released. The song is recorded by rapster Eminen and pop vocalist Rhianna. The song and the video depict domestic violence. I am not sure what disturbs me the most, the fact that so many people love the song, (even I like it - at least Rhianna's voice is so beautiful), or what the song seems to be saying. I have listened intently and it seems like the couple both act aggressively towards each other and the male is saying that he wants to stop but he cannot. Unfortunately, Rhianna's refrain is "I love the way it hurts." The song is important because our youth must be experiencing these things in their relationships and it means we have some health promotion and education to conduct.

Insane Workout - I believe that was the title of the program being advertised and sold on some channel over the weekend. It was a series of DVDs that guide a person through some hard core cardiovascular workouts. There were a couple of people at my last gym who took the calisthenics to whole new levels. I can't imagine what a persons goal is in that regard.

Odors - When I went to Yoga last week I brought my own mat that had been in my closet at this new apartment. I told my friend that I got in the car to come over and wondered why the air condition blowing smelled like stale smoke or some other foul odor. When I got to the Y I realized that it was the mat that smelled. It reeked like my house. I was devastated as that meant that my clothes and my body also did. My friend advised that I put cups of vinegar around the house. I did. I also bemoaned my fate on Face Book and received additional ideas. Some that I have tried include baking soda (in a spray bottle with water), coffee grounds, fabric softener sheets. Of course, my windows have been open since I moved in.

Game On - Classes begin for me tomorrow. I have had some readings already and my assistantship work has begun, but it is official tomorrow. I will be helping with an epidemiology class and will be taking a class about understanding and evaluating research - YAY! and also about applying for grants. I want you to know that my point for going to graduate school is not to get a degree. It is to make a difference. The classes that I will take and the process I engage in, will allow me to create an intervention that I hope will move us in the right direction towards saving our children.

Football - Yes it is time for my favorite sport - :)

Saturday, August 21, 2010

Healthy Feels Good

Busy day today - drove about 35 minutes to the old par course I used to run on weekly. The park is very nice and has many memory trees and benches. One of the trees, a dogwood, is a memory tree for my dad. It was nice to see it. I had a nice time there. I also wasted a lot of time today while going from store to store trying to find my Waldon Farms products. I get irritated when I waste time. It seems that several stores have the products, but they don't all have the same things and I have yet to find my pancake syrup and chocolate dip. I may have to ask my mom for a care package. I also rode my bike to campus and worked out with weights. In the free weight room is was me and boys - no girls in there, but I kept my chin up. I also went to the library and read some. That was cool - oh and I spent maybe 20 minutes in the arboretum eating my snack and reading a NOVEL. While I was at the library my friend Beth texted me to ask about a recipe. She asked because I would often bring food to work, we worked together, and of course, I have the You Tube channel that has many of my recipes or cooking ideas. Anyways, it was good to hear from her. We were colleagues for almost three years and she left just before I did. She is going to pursue a Master's degree and has returned home to Montana.

Anyway, Beth has become more healthy over the years and is now working on role modeling a health promoting lifestyle with her friends. YAY! Today she told me that everyone loves the saying, "nothing tastes as good as healthy feels." Well, she reworded my saying actually and I feel kind of bad taking credit for that one, though to be sure, I inspired it, Beth said it better. What my saying had always been is , "nothing tastes as good as being fat feels bad."

But Beth's phrase made me think to tell you about my dinner, which I just had and found to be delicious. It was an impromptu meal. I roasted some Brussels sprouts, enough for several side dishes. I roasted them with red pepper flakes and onion powder. I heated a Quorn naked cutlet in the toaster oven. I seasoned it with curry powder. I had some spaghetti squash left over but not enough for a side dish by itself, SO - I simmerfried a carrot and mushrooms with garlic powder (remember simmer fry is adding bits of water to sizzle up the food) and when those veggies were done I added the bit of spaghetti squash I had and a teaspoon of Parmesan cheese, turning off the heat at that point. I served this with a small strawberry fruit cup. It was delicious and had less than 200 calories. SO I get good food, filling food, AND my desired weight. I highly recommend this type of cooking/eating.

Now back to that novel before my novel days take a hiatus.

Friday, August 20, 2010

Convenience Can Be Deadly

But first - I am so excited. Time Warner returned today and the technician, a real employee of TWC not an independent installer, found that the signal coming in to the home was almost at a zero it was so low. He changed cables and things himself but also called the office and a truck came out and changed some things at the big power pole. I knew I wasn't crazy and that the upload speed was BEYOND slow. As I write this my other lap top is uploading a video to You Tube in what looks like a pretty quick pace. YEAH! (click on the link to the left - on the website- and you can see the video)

So just briefly then -
I have to say that technology, besides the Internet :), is not always the best thing to come around. The most recent advance appears to be a self propelled lawnmower. No, not the self propelled mower that makes PUSH mowing a little easier, but a truly self run lawnmower. I gotta tell you, I well, I don't know what I gotta tell you. I am too flabbergasted.

The calorie is certainly the king when it comes to weight maintenance but physical activity has another role to play in keeping us well and in allowing us to eat a certain amount of those calories. The less we do, the less we can eat and If I have learned anything about people in Western countries it is this, they (we) love to eat.

Now I have to add on to that old story of mine, relating to how sedentary a society we have become. Let me see: We ride to work in our car, park as close to work as possible, take the elevator if flights are involved, sit at a desk for most if not all of the day, drive home, maybe stopping at the drive through window of some restaurant for dinner, stop our car at the mailbox, hit the garage remote, walk in, sit on the couch, remotely control the TV , the vacuum cleaner AND the lawnmower. Even if the person in this story is of normal weight, the adverse consequence of inactivity can include heart disease and cancer. What does Michelle Obama call her health initiative, oh I remember, "Let's Move."

Thursday, August 19, 2010

Movement is an Analgesic

If you do not know what analgesic means or what an analgesic is - look it up. That is what my Dad would always say to me if I didn't know a word. He didn't tell me to Google it - but you may do so!

Without tracking down the journal article on this study (who has time!), let me tell you the initial finding and why I at least support the idea of the research. The study may not be a gold standard clinical dream - i.e. it may not be generalizable, but the researchers are most definitely on to something.

The Tufts University School of Medicine worked with 66 persons who had been diagnosed with a disease that is sometimes considered controversial, Fibromyalgia. I am one of the doubters, or at least I associate the illness with something somatic, like depression or another mental illness. At times I even wonder if it isn't just something that a pharmaceutical company has "created" because if you can name it you can treat it - or throw drugs at it.

The recent study was suggestive of a reduction in symptoms and an improvement of mood for persons who engaged in regular sessions of tai chi.

Exercise IS Medicine.

The worst treatment for fibromyalgia and nearly every disease, including back pain, is bed rest.
(usually)

Personally, I had a busy day in orientation and feel good and excited about my classes and the program as it begins on Monday. Rode my bicycle in the rain though and that was less than fun. However, I did not FALL off the bike at anytime today :)

Wednesday, August 18, 2010

Flu Shots! Flu Shots! get 'em here, get 'em, hot, get 'em now

Knowing I would be out and about for my Yoga class this evening, I jotted my notes for this post while waiting for assistance at Time Warner Cable - yeah, that is still unresolved. The point I make is that I am a consummate multitasker. (yoga was nice - haven't taken a class in years)

Today I have an example of two issues intercepting nicely, except the interception is more disconcerting than nice.

Without meaning to discourage anyone from getting a flu shot, I have to point out that there is a market incentive to your getting one. Last year I remarked about the promotion (urgent need for protection) and restriction (but we are backlogged so only these certain people can have one) of flu and H1N1 vaccines. This was followed by the "we have shots and will come to your office" promos because they could not get rid of them once the full orders came through. The vaccines have short shelf lives and have to be discarded.

This year, recently, I noted that pharmacies and / or drug stores were bemoaning their customers apparent good health as they noted losses of revenue. The sales of flu and cold medicine were down!


Today I share that the big D's are ordering up flu shots and delivering them early. They are hiring and training more pharmacists to administer the shots and are even selling gift cards that promote flu shots. They are doing this to increase sales, and they hope that when you go in for the shot you will buy some of their new products, like fresh food. CRAZY :)

Tuesday, August 17, 2010

Lifestyle Vision Exams

I wrote my notes for this post while at the social security office. I had downloaded and completed the form for a replacement card because I need my SS card to get my driver's license. I need the DL to get the registration and tag, and I need those to establish my NC residency. (of COURSE, I went to the registration place first and the DL place second so I drove all over town for nothing. The registration lady was kind enough to let me know I was looking at more than 200 dollars in fees when I did have my ducks in a row and next year, I would be required to have the car inspected and to pay property tax!) I have to have NC auto insurance before I can get the rest rolling. I did switch the insurance anyways. The SS lady said it would be two weeks for the card. My Mom found my original card at her house and is mailing it to me. Did I mention that yesterday one of the professors said I needed to establish residency weeks ago? Yeah, it was that kind of day. Tomorrow night I am planning to take a Yoga class with my best buddy and I need her and it more than ever.... because that voice in my head keeps wanting to whisper..."mistake" and that won't be productive at all so I am refusing to give it permission to speak to me! :)

Health Note:
Reporter Melinda Beck described a phenomena that she said could affect the 80 % of us who are spending three or more hours a day looking at a computer screen. It isn't just desk tops or laptops but our smart phones and hand held video games as well. Because we ask our eyes to adjust to these varying distances and fonts or resolutions, some optometrists suggest that people ask to have a vision exam at various distance levels as well.
There are ways to address poor vision with different lenses - bifocals, trifocals, progressives, computer glasses - contacts and even surgery. My favorite part of the article was the statement that some people who see better near than far or near sighted people, like me, do not have a worsening as quickly and thus should do NOTHING just yet. The other point which caught my attention was that we might also let our doctor know what different activities we engage in as they can tax our eyes differently - for example, hunting, fishing, running, needlepoint, golf - etc.

Monday, August 16, 2010

A Billion Dollar Problem

I agree with a South Carolina politician who spoke about that state's obesity problem and the pilot program legislated to deal with it. First though, let me give my little personal update.

The day did not start out to be as hectic and tiring as it ended. I had expected that I'd blog this afternoon with leisure, and now it is much later and I feel spent. I went to my first meeting on campus for the Graduate Program Committee. My role there is as an assistant to the department director. When I rode up to the bike racks outside the Health and Human Performance building I came to a stop, tripped and fell over sideways tangled in my bike! Strong work (really really it should be a gut buster - I am sure it looked VERY funny). After the meeting, I met with the director and was given several pieces of work to do. Then I met with the other professor with whom I am to work who is also my program advisor. He is going to have me work with him for the Epidemiology class. I will have papers to grade!He wants me to review the syllabus for the class and familiarize myself with the text book. HAHAHA, what about my OWN classes - oh wait, it is too soon for me to complain. Also I learned today that I need to get all of my information changed to NC yesterday, meaning tomorrow I will be at the DMV.

So, the legislature in SC where 30 percent of adults are obese and another 33 percent are overweight, agreed to fund a program to offer state employees, through their insurance, one of two types of gastric bypass surgery. The state plan will allow 100 persons who meet the criteria to have the procedure. I hate weight loss surgery, WLS, but I do like that this is a pilot program that will be evaluated after 18 months and if the surgery results in an untoward number of serious or adverse health consequences OR the people don't have improved weights and health, the program will not be continued. The politician I referenced does not agree with the WLS incentive and instead thinks that people over a certain weight should pay higher health insurance premiums. That did not get much support in their congress so next year he will propose that normal weight people pay less. Good Job!

I will provide you with this link to a support page regarding WLS that my friend a WLS recipient Paula, alerted me too. I like that it has educational areas and explains the procedures and helps the obese person to evaluate their own appropriateness for the operation.

Sunday, August 15, 2010

Smoothie Sunday

Ok - too preoccupied this week to really catch much for an odds and ends post and after last night I thought to keep this one a little more simple.

So, NO - I am not encouraging everyone to go out and get a smoothie - instead I want to point out that they really are not a "health" drink.

Recently an ingredient used in many smoothies was associated with several cases of typhoid fever - so that should give you pause - as should this:

Whether you choose to get your 16 ounce smoothie from McDonalds, Jamba Juice or Starbucks you will receive similar amounts of calories and sugar. Starbucks did have the least grams of sugar at 41 - whoa - but the most calories at 280. McDonalds was 260 calories and 50 grams of sugar, Jamba Juice was 250 and 52. If you remember from a past post, we are encouraged by the AHA to limit our sugar grams according to certain factors. Men should get no more that 36g a day, women 20g a day and children - who may just LOVE smoothies, 12g a day. As far as calories go, well that's a meals worth for those who eat frequently and as you can see - far too much sugar for anyone.

Sorry :(

Saturday, August 14, 2010

I Act on Truths

My classes do not officially begin until August 23 but my first assignment has been made available to me and I have begun. In reviewing the professor's plan for our semester, aka the syllabus, I thought I must be in heaven. He expects us to read articles, take notes, look up unfamiliar words, ponder the ideas and then talk and write about our perceptions and opinions. Hello! I do that every day :)

So the first reading has to do with how we as health educators should go about the business of encouraging people to adopt the behaviors that science tells us are necessary to avoid disease and disability. The author, David Buchanan, a DrPH , describes the medical model and the health education model and in so doing, seems to encourage us to choose neither.

I have my thoughts and expect that I am going to become "famous" for choosing NOT to engage in the dialogue that he suggests, but I will get to that later. First I wanted to summarize a few of Dr. Buchanan's references. He mentioned praxis, theoria, Aristotle and Plato. Theoria is basically an explanation of our beliefs. For example, I believe "this" to be true because in my universe I see it every day, science routinely recreates it, and nothing disrupts it. These are facts. Praxis is the reasoning behind our actions. We act according to and in spite of ever changing things in our world. We want to force an outcome or maybe stop one. For example, I know that too many calories consumed leads to weight gain (I believe it because I see it repeated over and over again). This is a scientific fact. Now I will make choices and take action, on any given day, about how much of what I will eat based on a multitude of changing situations and perceptions.

In his writing, Buchanan moves towards the concept that health educators should not persuade people to do something because of the facts but that health educators should share a dialogue with people so that they choose a course of action that will allow them to live the life they consider fulfilling. He notes, without apology, that the person may not wish to address obesity (or any health issues) because they have deemed other things important - taking precedent.



The irony is that I agree with Buchanan. Many times the people that we are trying to reach are too consumed with other "life" issues to exercise five times a week thirty minutes a day or to even THINK about doing such a thing. I use his argument, however, to support the persuasion and policy perspective not to discount it. I believe in making the environment as conducive to healthful living as possible and doing so withOUT engaging the community in dialogue. The people most at risk for adverse health outcomes need immediate help.

Where I do see hope for this "illuminating" and autonomy that he discusses is in reaching our youth in the school system. He is right. When people understand that certain behaviors will promote their individual life goals they are more likely to commit to that type of lifestyle. He doesn't say anything new however. Our alcohol, tobacco and other drug programs have often used that same approach to keep kids off harmful substances and sometimes they even work!

The part about Plato had to do with his belief that a person learns what makes a good and bad life and can become discerning or critical in that regard. The ultimate goal being to choose the path to make the good life, both physically and spiritually. This was described as the purpose of higher education. I do not disagree. I read that passage thinking oh YES, I have spent so many years cultivating MYSELF and learning what it is that makes me happy and brings me peace and at the same time can better some parts of the lives of others - or at least not harm them! But for Buchanan to expect that public health educators can take on the role of informing self actualization and encouraging social justice does not make sense to me. There are other disciplines for that. We (PHE) are REALLY in the business of promoting health - not through a dialogue but through well, I am going to say it, manipulation!

Friday, August 13, 2010

Endorphins are Involuntary

Dateline - UNCG, Bryan School of Business - No, I didn't change my major! I am in the auditorium with a couple hundred other "students" waiting for the teaching assistant training to start. The guy next to me was talking on the phone and told whomever that we were going to be told not to sleep with our students, ha ha. So I will be in this seminar all the day, with an hour lunch break. I received notice from the Public Health Education Department to come by and get a key to my "office". I wonder how little it will be. Anyways, this morning while I was out running, I thought about the health note for today. I might as well write it now as the class still has not begun.

Health note of the day:

A friend of mine was bemoaning her lack of interest in exercising. She does that often. She tells me so that I will remind her that she likes it afterwards and that the benefit is really worth the trouble. So we had that conversation yesterday and then she ran on the treadmill and reported to me that she felt awesome and to please remind her of that next time. So here is the thing about exercise and endorphins. You cannot prevent them from being released from your receptors once you trigger them. In other words you feel better whether you want to or not. Think about other neurological processes. If you touch a hot stove and do not want to scream or be burnt, you still are and you still will. You cannot control the physiological, neurological response. So when I tell you to fake it until you make it I MEAN it. You go through the motions like my friend forces herself to, and you still get the positive benefit. Now if you are really a crab apple and keep telling yourself that you hate exercise, that will dampen the effect for sure - mind over matter I suppose, so STOP it.


Look at me. I am 45 years old and for the first time ever, I rode my bicycle to school! I told myself that I could ride this new (used)bike and that I would not fall off and that I would be happy to be doing it - it all became true.

Okay, teacher is at the podium - take good care.



AND my video might actually have uploaded! (or not - my tech guy said I may have to do my uploads from somewhere besides home!)



video

Thursday, August 12, 2010

Not a Knee Solution

OK - got some things accomplished today - like a haircut and a bicycle purchase, oh and finished getting my apartment in order. I may attach the video, but apparently Timewarner Roadrunner is the SLOWEST ever in uploading stuff. I apologize for ever complaining about Verizon. So, my bike is awesome! I have a real bike now with hand breaks and GEARS! I rode it to campus, without falling off, and it took less than 15 minutes. I have a daylong seminar tomorrow and the plan is to ride to school. I still have to pack my lunch and get up super early to run so let us get to that knee thing.

I have several running friend who use a band under their knee (usually just one, though I do know a woman who uses two) while they run. It is called a patella band and is something that squeezes the area to prevent movement. My friends know that I do not like the bands, but understand why they where them. I learned a little more about them just recently as a WSJ article referenced them. The band was created by a doctor who no longer holds the patent on the device. Thus, there are several brands a person can buy. The point made in the article and that I wish to iterate is that the bands do NOT correct the problem and if you have pain, you have a problem. The underlying condition should be addressed by an orthopedist. I get that runners - run- I just hope that runners can be smart too.

sorry the video didn't upload - darn internet

Wednesday, August 11, 2010

Watch that Stomach

An eventful day, full to be sure, but alas I continue to feel like I accomplished little. Feelings are not facts however, so let us move on. I did walk to campus today and it took about 45 minutes. Then I worked out in the student gym even though they told me that I was not supposed to until fall semester starts. I do not get to do my swim tomorrow because of this, and I am bummed. I should use the time to find a bicycle however as I have not yet done so. I went to the Public Health Education Department and said hello to the secretary and the department head. Most people were not there, but I did get a hug, and that was nice. Now I am thinking that it is good that I cannot swim tomorrow, as there is just too much still to do – like try to find cheap or rentable textbooks (One of my professors already sent out the syllabus with the first weeks reading assignments) and go to Time Warner Cable and lodge a formal complaint. (My TV doesn’t work and they cannot come back until Saturday. The technician did not leave any paperwork and he didn’t even put the screws back in the wall.)


So your health note is related to the measurement of weight status that I have mentioned time and again in this blog and which are explained in depth at my website. A study looked at both the BMI of persons in a study AND their waist measurement. Remember that women need to have a waist less than 35 inches in diameter and men, 40. The researchers found that people who had normal BMIs, between 19 and 25 but had larger waists, were more likely to die in the next ten years than those who did not. In other words, the people were not considered over weight but their stomachs were too big. I love too that a scientist involved with the study noted that doing crunches is NOT going to shrink your stomach. No sir – ma’am, it is the same old same old, watch your calories and exercise. This reminds me, I took this picture in the stairwell of the PHE department building. Now of course, they are exaggerating the number of calories, because it is also based on weight and intensity, but you get the idea. BTW, my department shares the building with the exercise and sports science folks! Oh yes, and I brought my umbrella along on my walk today, in case the sun got too hot. I also had on my hat. I saw ONE other person use an umbrella for shade. I had not been using mine but after a while, I did, as she gave me motivation to be different. Do note however, that the umbrella and the hat do not stop the sun from coming off the street and reflecting on your skin.
Okay really – I must go.


Tuesday, August 10, 2010

Just Bad

Well, it will be dateline Greensboro for some time now so there is no need to keep that up. It is not easy going yet, and my routine is hard to etch out with all the cable and Internet calls to Timewarner - JUST when I think I have one thing off the to do list - up pops another. I was going to say more about the day, but I have lost too much time - my apologies. I think that blogging while taking classes is going to be easier than blogging while moving in!

Your Health Note: I think I have the upshot in regards to chemicals, whether they be bisphenol A from some plastics, the chemicals in our ink, emissions from industry or phthalates - they are ALL harmful. Research on the effects of some of these is underway now and results have made it to various journals and popular news sources. Of interest is the affect that the chemicals appear to have on hormones especially those of a reproductive nature. The irony is that a few years ago one of my professors had us read a newspaper article on phthalates and at that time it showed changes in frogs. Today I read a similar story about frogs. However, scientists are now concerned that girls are in puberty sooner, possibly due to obesity but also from the changes in estrogen production, possibly linked to chemical exposure. Similarly there have been changes in male babies, such as having testicles that do not descend as they should. The research continues and will include regular blood work of some thousands of volunteers. Those volunteers may have health outcomes and if a pattern emerges with similar blood work, we may have more conclusive evidence.

Still, whether it is chemicals in food wrappers or cans, mercury and cadmium in the soil, air and water, or BPA from bottles, the less exposure the better. Of course, industry representatives will minimize the science and that is a matter of financial survival for them. However, they CAN change and it might be better if they do so before our fifteen year old girls have breast cancer and our twenty something boys are impotent.

Monday, August 9, 2010

A Matter of Attitude

Dateline: Greensboro NC. Okay the truth must be told. I am only human. That is it. I am human and exhausted and worried and in a tizzy but should acclimate soon. I will be sleeping in my own bed, in my new apartment tonight. But first I have to make the bed and I also need to take a shower, after I hang the curtain. OH MY - but I really, really, really, just want to go for a run. NO exercise today however - just a five hour ride and a day long move in.

I DID have something to say - my goal remember was to have a health note every night.

I heard a program while traveling through South and North Carolina. The topic was the recession and people losing work, staying unemployed, facing financial hardship. A few things really hit me. One was a man who said that he was some type of white collar professional who lost his job and is now doing landscaping work. He said that he was over 50 years old and that type of work was too hard on his body. HELLO? Another was a woman who said that many in her family were struggling during this recession and were now on medications. She meant psychotropic ones. Lastly,another caller talked about when he lost his job and stopped his exercise program among other things and soon became very depressed.
I say, when change happens, and it will, keep whatever part of your routine that you can, as it will ground you.

As you can see, I practice what I suggest.

Sunday, August 8, 2010

Odds and Ends

Dateline: Savannah, GA. Boo - I am tired. The day started at Mom's when I overflowed her toilet. Then SHE was cleaning the water up with towels while I was standing there saying, "MOM. Stop. I will do it." To which she said, "I am just helping." "Mom - stop. You are 80 years old." actually she is 82 but who is counting. And she said, "So, I am 80, I am not dead." Ah, Mom's say the darndest things. Then I ran nine miles in muggy muggy mugginess that turned into rain. Still, I set off to begin the doctorate journey at about 12:22. It went fairly well until a traffic jam on I95 in Georgia, then a detour off the interstate and finally the hotel at 7:15. Drinking a beer now. But have three health notes for the week's end.

Cholesterol and Youth - The results of a twenty year study indicate that having higher than normal cholesterol as a child or young adult significantly increases the risk for heart disease as a middle aged adult. The take home message was that the condition needs to be addressed. I was heartened to see that the lead investigator recommended diet and exercise as the ONLY option for our children due to the absence of evidence that using statin therapy for this age group for what would turn into decades is a safe thing to do. My goal of course, is to prevent the condition to begin with by addressing the causes of childhood obesity.

Bob Evans - My sister reports that they have healthy options! She said that she has eaten there twice in the past year and was very pleasantly pleased and surprised. Her last meal was grilled chicken with steamed brocolli. SHe remarked that her food was not greasy or slick and that her brocolli did NOT come buttered. YEAH>

Vending Machine Warning - My awesome friend, I choose to only have AWESOME friends- called me today and left a message about a vending machine she came across at an automotive shop. The machine was of course the usual container of soda and sweet/salty snacks. The shop owner had put a few notes on the machine. One of these absolved the establishment of any monetary obligations. IN other words, if you lost your dollar it wasn't their problem. Under that note was another. It said, "Use at your own risk." Or something similar. At your own risk INDEED.

Saturday, August 7, 2010

medical marijuana

Dateline Bradenton, Fl: At the car wash where I can get on the Internet with my laptop. I am getting the car ready for the trip tomorrow. Slept much better last night. Ran and lifted weights today; my last of each with my two Saturday buddies. Mom and I are going to the movies later and I am hoping that my sister will come to tell me good-bye. Now for the news!

I was going to write about cholesterol levels in young people, but adjacent to the article I was reading was another, on medical marijuana. The story was really about the dilemma that some employers are facing with staff who use this drug in compliance with certain state laws that allow it. I did not know that people used marijuana for pain. I had only heard of it for amelioration of nausea associated with cancer treatment.

It was harder for me to find evidence for the health promoting effects of marijuana in the science journals that I trust. However, it has been associated with the two conditions above and also with boosting ones mood especially when that person is suffering chronic illnesses. That does make it a broad spectrum drug. Marijuana is primarily a psychoactive drug which basically means it alters the mood.

I do not have a political opinion in regards to legalizing marijuana, but a public health one. With the current estimate of 4% of the population using marijuana once a year (WedMD) we do not know the true nature of health consequences. It was only when 42% of the country smoked cigarettes on a daily basis that the deleterious effects of tobacco came to light.

That being said, I am concerned about the use of marijuana for additional indications. When the amount of users and the frequency of use increases so will the risk of lung and heart problems from the smoke and the chemicals in it, like tar and carbon monoxide. This is just another example of where we have got to think things through a little bit. To legalize it is to make it more accessible and that will increase the numbers of persons at risk for unintended consequences. Think about it. If you took a drug to reduce your nausea and the side effect was emphysema or lung cancer, the risk would outweigh the benefit. An adverse consequence such as that would get a pharmaceutical drug off the market.

Friday, August 6, 2010

It Ain't What You Shake

Dateline Sarasota: Last day of work....

Had a restive night, not used to the bed, the house, the whatnot - but Mom is very hospitable. Started the day with my usual Friday morning treadmill run and the routine of it, the normalcy, was calming. Received really nice gifts and sentiments from my coworkers this last day. Oh, I think I will add the picture of us...




Now the Health Mention:

I had mentioned not long ago that there was again a push to address the salt content in our foods as the majority of Americans are consuming far more than the recommended 2400 mg a day. Not only are we consuming more than is recommended, but a growing number of health experts are saying that the recommendation itself is too high. What's more, the amount that we really need is less than a teaspoon - the mg amounts to about 3/4 of a teaspoon. (BTW too much salt effects blood volume and flow which then effects the arteries and thus can lead to heart disease)

According to people quoted in a recent Wall St Journal article, the problem isn't what we add, it is what is already there. The best way to get control of this intake is to limit processed and restaurant foods.

Salt is basically sodium and chloride and it is sodium that we are trying to limit. At least with processed foods you can read the labels. And DO read them, all of them, because sodium sneaks into foods. Bread, cheese and vegetarian meals can pack a wallop as can cereal.

Also, did you know that salt has its own advocacy industry. Yup, the Salt Institute. It IS true that we need a certain amount of sodium to maintain our system. At the same time, it is highly unlikely that a person would have a sodium deficiency. Those most at risk might be athletes, but then they are aware that they need electrolytes and I expect they would hydrate accordingly.

So the simple message for today is really this: Read your labels and avoid foods that have more than 300 mg per serving and follow these other tips offered by the public health folks at Harvard - home of my favorite PhD/MD - Walter Willett.

Thursday, August 5, 2010

Extending Retirement Age

Dateline: Sarasota Florida 9:10 a.m. The movers have arrived. By the time you read this post, I will be at my temporary shelter (Mom’s). I will keep you posted on my daily progress, and my hope is to also get a word or two in regarding a public health topic.

For today, I choose the issue of extending the retirement age. This idea is gaining momentum around the world as countries find that they cannot support their citizens with these entitlement programs for as many years as the current retirement ages would involve. I fully intend to work well beyond the age of 65; in fact, I hope to be engaged in some type of work well into my 80s. I am, so far, a healthy individual and my expectations of myself are realistic. The expectation of states in my country is, however, laughable.

We have a serious obesity problem in the USA and because of it, we have a population rife with chronic diseases. This includes heart disease, diabetes, arthritis, and even cancer (yes chronic). According to the CDC, a few years ago, one out of two, or HALF the country had at least one of these diseases. The numbers for multiple diseases are also staggering. So I ask you, HOW are you going to keep these persons on the work force past the age of 60?
We must get a handle on this, and I mean prevention too – because there will be no healthy and ready workforce to take their place according to the health status of the nation’s children. What I expect is that if workers are forced into longer service, they will end up on disability instead of retirement, but they will STILL cost companies and taxpayers money.

We have to think our solutions through a little bit more. Very often, our thought process stops without considering what the long-term effects of one step will be. Simply raising the age of retirement will shift the costs to another area, it will not lessen them.


Wednesday, August 4, 2010

Words Are Hardly Necessary

We continue to be in the midst of an obesity epidemic in many a Western country. Though pharmaceutical companies and their scientists strive to convince us that it's our genes or our metabolism (and thus modifiable with drugs) - the public health folks - my ilk, KNOW that regardless of ones genes or ability to burn calories, too much food equals too much weight. It is especially easy to over consume if your diet is high in processed foods.

Cheap junk food is a significant factor in the world obesity rate. I believe it should be taxed and gone after much the same way tobacco was. At the very least, we might pull back on the advertising, or I KNOW, add warning labels to ads, such as the one below. The warning might read:

You can fuel your road trip as pictured, and when you do - don't blame your genes for your heart disease





Tuesday, August 3, 2010

Do You Need a Supplement

This should be brief as you have either already noted my concerns about the use of supplements and acted accordingly, or you are choosing to ignore the evidence because you just like to spend money. You probably feel like you are doing the proactive thing to improve your health and I am not going to be able to convince you otherwise.

The truth is that the majority of persons do NOT need to take any vitamin or mineral supplements as a well balanced diet will provide the correct amounts of both. A few people may be deficient in something, but it isn't usually the something you think it is.

This month the consumer group Public Citizen released a user's guide for vitamins and minerals. The persons that are most likely to need supplementation are older and do not consume enough calories, OR the calories that they consume are empty or junk calories. Other persons who may need supplementation include those recuperating from injury, surgery or illness. The organization strongly encourages any one who wants to supplement to talk to their physician. There is a risk of taking too much of something and NO evidence to suggest that taking more of that which is recommended is of any help. Public Citizen recommends that you buy the least expensive product and the no name brand. They also say that there is no benefit to buying one that claims to be all natural and that the companies who sell these products sometimes charge 1000 times their cost.



The vitamin I hear the most about is Vitamin D and I suggest that all of you talk to a health care professional regarding your need for this in a supplement. Other wise, it is more likely that a person will need a mineral, like zinc, iron or magnesium than a vitamin, like C.



Which brings me to my last point. Eating a diet rich in fruits and vegetables while also taking care of your body with regular physical activity is the best way to avoid colds and such. The products sold to enhance your immune system are just ridiculous wastes of money in my humble opinion! HA since when am I humble...

Monday, August 2, 2010

It Ends With The Grave

I am going to share another man's story tonight. It won't take that long. I met this man in a class that I teach, I believe I have mentioned this class in the past. The purpose of the class is to educate tobacco users on the health consequences of said use, the benefits of quitting, some evidenced based methods for quitting and to to inform them of community and company resources that might assist them in this process. It is NOT a quit smoking or tobacco cessation class. Everyone in the class either uses tobacco or is exposed to enough second hand smoke to test positive for the nicotine metabolite, cotinine. (yes those people exist)

The gentleman that I am referring to is over fifty, possibly sixty, years old. In tonight's class we talked about reasons that people may be motivated to quit tobacco. The usual reasons are always to save money, improve health, set a better example and to be free of the addiction (the compulsion to use). I will call my gentleman, Bob. Bob said much of those same things and I asked him, "Can you stop before you get one of those diseases or do you have to have the diagnosis first?" He smiled and said, "I think I might need to have a touch of something first." Ah, that is too bad. Then Bob told us about his brother. His brother died at the age of 63. He was a smoker and he suffered from and died from COPD - most likely emphysema. Bob took care of his brother. "I watched him as he gasped for breath, folded over his walker." Bob helped him with his oxygen that he had to use all the time. He helped him with his rescue treatments when he could barely breathe at all. "My brother kept smoking, he couldn't even breathe but he would smoke." Bob smoked too. Bob smoked then and Bob smokes now. Bob said that his brother couldn't smoke. He couldn't. He also did not have cigarettes. "He would go out on the porch and take my old cigarette butts out of the ash tray and smoke them."

Our class tonight had been about addiction and I think there is no clearer example of the powerful nature of nicotine. Bob's brother died about a year ago. Bob told the class that he would stop smoking before he got that way. He said that he would never do what his brother did. I asked Bob, "Did your brother not say the same things?" There are some people, as Bob brother shows, who will quit only when they are in the grave. I said that to Bob, I said that I hoped he would not be one of those people.

I will close with my newest assertion about cigarettes. You may have heard me say this recently, but only in the last few months. I do NOT fault tobacco companies for marketing, even aggressively, a product that they are legally allowed to sell. Instead, I fault the government for allowing them to do so at all.

Bob's brother was simply too young to die. Remember death in old age is the only death we are powerless over.

Sunday, August 1, 2010

Odds and Ends

This time, one week from today, I expect to be in a hotel room just north of Savannah GA on my way to a different life in NC. Just so you know!

CDC Vital Signs: This is something new that the CDC has started but it is pretty awesome. Each month they they will target a health issue or disease and give a few succinct statistics on it while suggesting some next steps. The July Vital Signs discusses cancer screening for both colon or colorectal and breast cancers. Though we have certainly made progress in this area, there is much to be done. You can find this Vital Sign here.

Antioxidants: These are wonderful substances that are thought to aid in ridding the body of waste material that can be harmful. Our body is able to make some of them, but we also benefit from consuming foods that are rich in them, like fruits and vegetables. In the grocery line today, I heard the cashier exclaim "Wow, cherry diet seven up!" I looked over at the conveyor belt, as it was not my order. I wasn't sure if I had heard her correctly as that flavor was not new. What WAS new, I noticed, was that the label claimed "antioxidants." Really guys, whether you drink soda or not, it isn't the place to get your free radical consuming antioxidants.

Beach Reports: We have heard a lot about the state of our beaches and ocean water due to oil spills lately, but the NRDC or Natural Resources Defence Council has also released its 2010 report on the safety of US beaches. The report does address the new threats, but for years the NRDC has tracked the amount of bacteria in our waters and sadly, it is rising. You can review popular beaches or all beaches by state if you like. It is a little confusing at first, but when you see the % of times that a state or a beach exceeds standards, the higher the number the worse the beach is. The standards are really limits of pollution and exceeding them is a bad thing. You can learn more here. You may recall that I go to a certain beach in Florida at least once a week and I was very happy to see that it did well.

Eco Salon: Hmm - I wrote my little notes some time ago, but if I remember correctly, there was a bit of investigative journalism in the WSJ where they tested salon services in places that claimed to be eco friendly. None of the places did very well - getting rid of the chemicals was not so easy and when they did the result was not so good. Personally, I only go to the nail/waxing salons on occasion for a BROW wax. Yes there I said it. I do go in and out as fast as I can. If I have to wait I go somewhere else. Those places are absolutely toxic. I know the employees wear masks but so should the customers.

Teen Business: It appears that hotels are trying to cater to the not yet adult but not still a child demographic. Of course, keeping a family happy will increase business and tips so it makes perfect sense. What was dismaying in the article I read was some of the tactics. Video game tournaments (not Wii fit) with prizes. So after being sedentary while playing video games the kids received ice cream sundaes. Now that's the way to fight this obesity epidemic in our youth, eh?

Speaking of: And lastly, I saw a display at the Publix Supermarket today. It was a cardboard school bus and in it were all types of sugary snacks for kids to take to school.