Gym Seen

AH - that reminds me of my post of things seen at the beach - I miss the gulf coast of Florida. Anyways, if you read that one, you know I really am referring to observations not scenes...

So I was in the Student Rec Center today - reading journal articles while moving - OH - BTW - one of the professors here at UNCG has the treadmill desk - so awesome. He can walk slowly while working on his computer. It isn't exercise really, but a way to prevent the deleterious effects of sitting too long.

Anyways, this rec center is NOTHING compared to Lifestyles Family Fitness - where I was a member in Florida, but it is paid for with my dues, so hey - it is sort of , almost, but not really, free.

The treadmills are very different than you see at most gyms or even for sale to take home. The are a little shorter and much narrower. The console is small enough for you to hug, though you cannot reach all the way around. Today, a young lady next to me had her speed up relatively high and had both hands gripping the top of the console. It is hard to explain in words but I must try. She was a tall, thin girl, nice long legs - her elbows were at her ribs and with her hands above, there was about a 45* angle or a Vee from her shoulder to elbow to hands. Her stomach was very close to the lower part of the console, where you push start, stop, enter etc. So her feet are flying, but barely touching the belt - she was indeed anchored with her hands. It was ALL I could do to not say anything.

Here is what I would have said, "Girl - your arms are working way harder than your legs!"

Take home message - don't hang on to the treadmill.

Price Disparities

In the work that I do now, which is research or research review with regard to obesity and chronic disease, the term health disparity is often used. In fact, many government and philanthropist organizations offer grants to research entities who will work to end these disparities. The term basically means a significant difference in quality of health and quality of health care between certain groups.

When looking at those who are OW(overweight) or obese, there is some difference in numbers based on race and income, but I do want to be very clear when I also say - there is NO group; eduction, income, gender, or race that has a majority of normal weight persons within its ranks. As a country the USA is over 66% OW/Obese - we are second to none.

There is one reason and one reason only that a person or a population is OW - they eat too much. There are dozens of reasons however, that they eat too much and some are based on disparities. (others are culture, emotional, environmental, education, etc )

I have seen this before I have said this before but because I am studying it more these days, it pushes my buttons significantly. I was at a local grocery store and the items I wanted to buy were just too much money. I was not at Wal-mart. I didn't buy the mushrooms, I didn't buy the 100 calorie snacks. The 100 calorie snacks which I can find for 2.50 if I am lucky, were being sold for over 3 dollars at this store, but what put me over the edge were two separate snack packs near the registers. The packages had 4-6 servings of honey buns or danish - each pack was 99 cents. One had 250 cals and the other 310, one had 8 grams of saturated fat, the other 10. What is a low income person going to do in those situations? I wanted to call Michelle Obama and tell her to get herself down to NC right now and DO SOMETHING!!

Ah - okay, that's all for today's rant...

Un Naturally

You have been forewarned by yours truly that in the USA there is not a well thought out definition of all natural in regards to food labels. I have encouraged you to use common sense when reading a label to determine how truthful the "all natural" declaration may be. Legally the words only have to mean minimally processed. That is quite broad. Most foods found in boxes are far from unprocessed.

Today Ben and Jerry's decided to stop calling its ice cream all natural after one of my favorite groups, The Center for Science in the Public Interest, called on them to do so. They have actually been harassing them for a little while.

I see it as a good thing - I hope others will engage in truthful labeling. We shouldn't have to make it a very specific LAW for companies to follow - they should just do right.

Check out CSPI's website for more and to read about the ten worst foods!

Cariology

That is a real word! It is the study of cavities. Today I heard about a new approach in dentistry which involves treating tooth decay in the earliest stages, before the enamel is in need of drilling and filling. This must be the type of problem we have when the dentist tells the hygienist "keep an eye on number 7."

Some dentists think that better brushing and fluoride is all that is needed in this case (oh and not consuming a lot of sugar), but others are using a technique in which mild acid is used to clear out the early decay and a resin is used to fill the holes left behind.

You can read about it here.

I heard about it on the radio this morning and as I was listening I sort of giggled thinking that 100 years from now, the new civilized world is going to gasp at the thought of the barbaric drilling we poor fools endured!

Odds and Ends

I think that the best I can do for the odds and ends this week (because I am too stubborn to admit that I just can't do them), is to share a few websites or links that I came across this week during my research review. All I have time for it seems, is research reviews - and hey, that is why I am here! :) [ okay - I did go to a dance workshop on Sat and Sun - but I studied during the lunch breaks!]

First an article by my favorite expert - i.e. legitimate source of health information - I haven't even read this yet, but it is on my list. It is titled, What Should We Eat?

Here is an article about government's role in the obesity issue.

Ok, this is the website for the Small Step program which is to assist you in doing little things to improve your health. What is great and may not be there when you visit the site is a memo pad for the tip of the day which says, "Don't Skip Meals!" So please - do yourself a favor - eat often, but eat small.

This links to a very startling report from the OECD which predicts that in the year 2020, the USA will have an overweight obese rate at 75%. This report compares countries. Mexico is second only to the USA. This information is the most up to date I have seen.

This last webpage is for the Society for Prevention Research which would appear to be one in which yours truly would find a nice fit. There is a good chance that one of my professors will be allowing me to attend the conference in May of 2011 with his entourage and I am stoked!

Beware Your Popular Friends

Okay - I only know this and have time to say it because I told the instructor for the class I am helping with, epidemiology, that this article I read might lead to a good activity for the students. And guess what he said? Basically, "make it happen."

Sigh.

Researchers tracked flu cases last year. The study involved college students at Harvard. Students named their friends, and whoever they named were expected to have even more friends because they would be the popular people. Well, if the BMOC gets sick, a lot of people would be exposed to him. The researchers must have identified the popular folks and when they tested positive or went to the health clinic with flu symptoms, the scientists predicted that a little outbreak would occur a week later. They were right!

Take Back Campaign

Tomorrow or Today - by which I mean Saturday 9/25/10 - over 4000 sites in the USA will be offering prescription drug take back services.

This is a way to get unused, expired or unneeded prescription drugs out of your cabinets and away from anyone who might abuse them - such as your children.

Prescription drug abuse is a problem for both adults and children and the Partnership for a Drug Free America claims that the number one source of these drugs (for kids) is the medicine cabinets of ones own parents or the parents of their friends.

The take back program is possible due to several recent legislations and it is being coordinated by the DEA. The DEA claims that prescription drugs are the first high for 2500 hundred kids a day. They are as popular as marijuana and it appears, easier to access.

Another point about these drops offs, which was noted in an article by Pete Yost of the AP, is that the drugs will be properly disposed of, incinerated, and not get into our treatment facilities or ground water.

I strongly encourage you to clean out your cabinets and just as strongly urge you not to put those pills in the trash, sink or toilet.

To learn more about take backs and drop offs, visit this link.

Bug Free Milk?

A national campaign exists to encourage breast feeding to at least six months of life, if not longer.

The American Congress of Obstetricians and Gynecologists lists these reasons to breast feed on its website:

-The colostrum—a yellow, watery pre-milk—that breasts make for the first few days after birth help newborn's digestive system grow and function.
-Breast milk has antibodies that help a baby's immune system fight off sickness. Babies who are breastfed also have a lower risk of asthma, obesity, allergies, and colic.
-The protein and fat in breast milk are better used by the baby's body than the protein and fat in formula.
-Babies who are breastfed have less gas, fewer feeding problems, and often less constipation than those given formulas.
-Breastfed babies have a lower risk of sudden infant death syndrome (SIDS).

Let me add one more - your own breast milk is highly unlikely to be recalled because of a bug infestation as was Abbott's Similac Formula - this past week. One news reporter stated that the contaminated products were not life threatening and that babies would JUST get an upset stomach maybe and then not want to eat. Are you kidding me? Who would give their baby milk with insect parts in it.

Sigh - all processed foods have the potential for contamination on top of how poor their nutrient content usually is -

Salmon

I expect that those who have been reading me for the last five or so years are wondering why I am not weighing in on the great genetically modified/altered salmon debate.


The reason is that I do not like to write about things I haven't explored thoroughly. I am not as free to explore myriad topics these days with all the other readings on my agenda. It is possible my head could explode.


I did hear a little bit on the Diane Rehm Show today and I have a link for an NPR story. What I hope is that you will do a little reading on your own for this one.


I can say that the FDA is tasked with determining if the labeling has to indicate that it is a GM (genetically modified) food. A company does not have to make that distinction UNLESS the GM food is substantially different from the non GM food and or could cause health problems because of this new production practice. So the question regards how this fish compares to wild or farm raised salmon.


The debate I heard this morning was pretty interesting. The problem the two scientists argued over was whether or not the data was good. The concerns are about allergens, growth hormones and insulin-like growth factor number one. IGF-1 is studied in regard to cancer. There is also concern for the environment on several levels.


I was able to follow some of this because of the epidemiology and environmental health classes I have taken in the past. Diane Rehm spoke up and asked how in the world the consumer was supposed to understand the "data" validity, and such.


I actually did find a link to the transcript to the show. I think you should take a look and if you like you can listen to the pod cast instead. It was great to hear Diane speak up for us!


Oh, the fish is supposed to have all the good things we want in our salmon, i.e. those Omega 3s. I myself will wait on this one.

Pump Often

I forced some time into my evening and went to a short bicycle seminar. The class covered changing or repairing a flat, lubricating chains and cables and keeping the bike clean. All of these things can prolong the life of the bike and its parts which will reduce the risk of accident and injury.

As I have already had maintenance and crash issues, I thought it wise to go to the class. I think the most important thing to tell you, as I can't show you anything, is that a common cause of a flat is low tire pressure. When the pressure is too low and you hit a curb, for example, the rim can pierce the tube.

Thus it is recommended that you put air in your tires every time you ride, even daily. Or at least check them every time. Air can leak out just from time, but also when the temperature cools, like it does in automobile tires.

You should also have a decent pump which will cost around 30 dollars and last longer than a cheaper one.

I took my free class at REI.

Punting

Friends - today has been too much - aaack - going to punt this one to Harvard School of Public Health - home of my favorite health promoter, Dr. Walter Willett. This short article gives you hints on how to navigate the headlines and get the truth out of the hype - regarding nutrition.

Hope to have more time tomorrow - or three years from now :)

Odds and Ends

Weights on the Greenway: I cannot let go of this pet peeve and think that I will eventually have to coordinate some type of public service health promotion announcement at trail heads. Weight lifting is meant to be done when you are still. That does NOT mean that you cannot interweave it with cardio bursts, or that you cannot do multi joint exercises. It means if you are walking, running or taking a step aerobics class while carrying weights you are making a mistake that can cost you valuable cartilage while providing negligible results. The worst thing this week was that I saw a very attractive, seemingly fit guy doing overhead presses with weights while walking a 2 mile green way course.

KFC: This is actually something I heard a few weeks ago on the radio. Someone was talking about the fact that few people today realize that there was a real person associated with Kentucky Fried Chicken and that they don't even call it Kentucky Fried Chicken anymore. The person on the radio blamed it on people not caring about Kentucky. I don't know where he got that. The reason it is referred to as KFC is because they are trying not to say FRIED. In fact, the next time you see a KFC, look at the sign, it says Kentucky Grilled Chicken. Really.

Produce Bags: How cool this is. On the thin bags that we put our fresh produce in at the grocery store, at least in a Walmart in NC, the USDA slogan, Fruits and Veggies - More Matters was written on the bags!

Money: It is a sad sad thing that whole wheat breads cost at least one dollar more than white breads. Now tell me that people who make less money have easy access to healthy foods.

Capri Sun: Don't be fooled by the ad. The fact that it is 100% juice does not mean you should give it to your kids. Better for them that you give them a glass of water and a 70 calorie orange than 15 grams of sugar and NO fiber to slow it down.

Bisphosphinates: I am surprised that this week another study pointed to unexpected and unusual femur fractures in persons on drugs like fosomax more than five years, when a few months ago, we were told NOT to worry about those outcomes.

Preferences: Just something I know about myself that I wanted to share. When it comes to an injury my first preference is always ice and massage as opposed to medicine and rest.

October Fest

I spent most of this evening trying to remember what I heard today that I wanted to share in the blog - and finally, it came to me.

Oktober Fest is nearing and in Germany it will be the 200th Anniversary of the event - which includes drinking a lot of beer in tents that are set up outside. This is the LAST year that smoking will be allowed in these tents, in Bavaria, a southern state in Germany.

Germany has a smoking rate about ten percent higher than that of the USA in both men and women. It is a significant 30+ percent.

It is surprising then that the law passed, but pass it did (that is what happens when the smokers don't come out to vote!). This German state joined many others by banning smoking in cafes, bars and restaurants. Next year, add tents to that list.

YEAH!!!! I can go to the Oktoberfest and breathe easy.

the Whole Patient

Oh so briefly, on Science Friday today a scientist from The University of Chicago School of Medicine discussed research they were conducting with medical students and residents (doctors not yet on their own).

The outcome of interest is whether or not physicians will ask patients about life events during their clinical exams AND incorporate the answers into the plan of care. For example, if a patient indicates that things have been hard lately because of X, does the doctor say, 'sorry to hear that', or 'tell me more.'

The intervention was adding a class to the med student curriculum for one group while another group just had the stand classes. The experimental group did spend more time with patients and ask more about their LIFE.

I was interested in the idea of changing behavior by educating or teaching a skill to those not yet in practice vs trying to teach doctor's who are already treating patients. The scientist thought that they would have better success teaching the students and I think he is right.

It is the same premise that I am engaging when I say we need to teach CHILDREN very early about nutrition and calories, etc. I think that the parents will be somewhat affected by the children, but not enough to solve the problem. I am okay with doing my work now and waiting a generation to see the full positive outcomes.

Here is a link to SciFri. It was an interesting show. Especially since the second part included a guest from Union College in Schenectady NY. I was born in that city and my brilliant, beautiful, athletic niece is a Union student :). (oh, one of my nieces, as I have dozens!)

Fat Suckers

I took a minute away from grading papers to open a newspaper. I had four unpoened ones on my couch.

The WSJ had a story about fat cells. Apparently, the FDA has lost all sense of reason and has approved two devices that are meant to remove subcutaneous fat cells from the body (the kind just under the skin that we don't like to see on our body). Visceral fat, the kind that settles around the organs as we age and if we become obese, is the fat that does us harm. Subcutaneous fat just looks bad and if one continues to eat more than they burn (need), it will just come back.

There is concern about procedures that remove fat as fat cells actually have special roles to play in the body and this type of manipulation can really mess up that delicate balance. It also always amazes me what expensive, uncomfortable, often futile and invasive things a person will do to avoid changing the way they eat.

The real point I wanted to make today is that in the article about the new procedures it was said that the fat will come back unless the person eats less OR exercises more. The wrong message again - because when you compare eating fewer calories only to exercise only - the weight loss occurs in the eat fewer calories, but if you do BOTH, the person loses MORE calories or loses them quicker. Exercise alone is not a strong weight loss strategy but it does significantly improve mood.

Back to work now....

Calories Vs Nutrients

Just thought I better make this clarifying point because I do not want to misrepresent my own knowledge and beliefs.

I am trying to make a clear distinction between factors that impact weight and those that impact health - of course there can be overlap.

But as I have said before a calorie is a calorie. Too many of them lead to weight gain, just the right amount will maintain a weight and less than is needed should lead to weight loss. Weight alone is NOT an adequate indicator of HEALTH. If one eats a pretty safe 1700 calories a day - their weight should be stable (many things considered) but if they are 1700 calories of steak - high cholesterol and subsequent problems could follow. IF they are all sugar calories, then insulin resistance and eventually diabetes may follow.

If a person eats 1700 calories of plant based foods and good fats, but never exercises, they could still be at risk for certain cancers.

With my research, I intend to point out that weight control is related to calories more than anything else and that point needs to be clear in the messages we (public health experts) send.

Epiphany

I struggled with my obesity issue last night. I was reviewing my old papers and other people's papers and the same old data bases and the government's websites and feeling that something was OFF.

For starters, I didn't understand WHY I was doing this again - I already know what is going on, the extent of the problem, the diseases its causes, the economic impact, what the government thinks, what non profit agencies think, what local agencies and their coalitions think and STILL the numbers of obese people and amount of preventable disease in our country just keeps rising.

I went to sleep overwhelmed and frustrated. I awoke thinking maybe this afternoon I could sit down and really get into this again. Then I went for a run and had my epiphany.

Everything we read about obesity frames it around three behaviors. This is true in statements from the President and First Lady, the Health and Human Services Secretary, and the Surgeon General. If they say it, then the federal agencies (DHHS, CDC, NIH, etc) say it and the nonprofits say it and the research dollars and grants go to these three areas - You know what they are: consumption, physical activity and sedentary behavior. Those are the triumvirate of the prevention model for this country.

Remember that Harris Interactive Poll I mentioned Sunday? People believe that IF they are overweight it is because __________ Seriously - what is the answer we have all come to accept and desperately want to believe? (no not genetics :)) People think that they are overweight because they do not get enough exercise. They think IT because someone is perpetuating the myth that the best way to maintain a healthy weight is through exercise and that is NOT confirmed in the science. It seems that even public health experts don't want to EAT LESS.

Physical activity and exercise are absolutely key to preventing disease states and disease progression but they are NOT the gold standard for weight maintenance. And that my friends, is the theme for my class paper :)

You should have seen me explaining this to my professor - talk about passion :) I realized that none of my strategies, as good as I like to think they are, will work if people think calories don't count!

Back to Task

For those of you who were unable to open the links from yesterday's post - this time, it was NOT your computer - it was me. I believe they are fixed now.

When I got to campus today my blackberry was missing. I rode my bicycle. The good news is I found it about 1/4 of a mile from where I was. The bad news? It was in the middle of the road with the screen badly damaged. Upshot - have to buy a new smart phone.

I am establishing a planning committee for my doctoral program and dissertation. The professor I met with today wants me to start with a problem analysis. Of course my problem is obesity ( ha ha - not my personal problem). I have to update my data from three years ago and from FL to NC. I did notice just now that the latest information for state childhood obesity rates has NC and FL just tenths of a point a part at 18.6 and 18.3. Mississippi is the worst state in the union at over 21%. Curious about your state? Click here for the Trust of America's Health report.

BTW, I have been so entrenched in tobacco these last few years that I am having trouble not feeling completely overwhelmed. Oh and then, I have to go find a phone in my spare time -

Its gonna be funny one day -

Odds and Ends

Without preamble or follow through - a few notes



3 Ms - Received an email newsletter sometime this week. I wasn't able to spend much time with it, but it suggested that we consider these three Ms with regard to our eating. We should maximize variety, flavor and plant based foods, Moderate calories and meats and Minimize fats and sugar.



Survey - I am not sure how much validity this survey would have nor why I should trust the Harris Interactive Poll, however, intuitively, the results make sense, do not surprise me and validate my professional objectives. An online poll (excluding millions of people right there) of a couple thousand adults showed two important things. People do not accurately perceive their own weight status and when they do see themselves as overweight or obese, they blame inactivity not overconsumption. Remember, physical activity is a strong mediator for health whereas calories are related to weight.



CDC - another report - we are not eating enough fruits and vegetables. Let me encourage you to eat more plant based foods and to serve more as well. Fruits and vegetables contain nutrients and chemicals, sometimes called phytochemicals that can reduce the risk of some cancers. They are also - usually - lower in calories than many other foods. The CDC conducts a telephone survey where they ask Americans about their fruit and vegetable intake. The latest data is from 2009 where over 75% of us report eating less than five servings of F&V a day.



Vital Signs - Wow it is already another month. The report this month is on tobacco. You can see it here.

Now - make your exercise plans for the week and fill your lunch box - YES, bring your lunch - with low calorie but nutritious foods.

Electronic Cigarettes Revisited

I had the chance to open a newspaper this week. Actually, I keep putting a hold on the paper and then letting it start again only to realize that I still do not have time to read it.

I am glad that I opened it yesterday, it being the Wall St Journal, because there was an update on a topic I have often educated on. The electronic cigarette. The e cigarette is a devise that is sold on line and at mall kiosks. A battery heats up the a liquid cartridge of nicotineand then releases a vapor.

When I last spoke about it, I noted that if the e - cigarette is either a new tobacco product or a nicotine delivery device. It clearly is the second of the two and in that case it is a drug. The FDA has long been the agency to regulate the sale of drugs (1938) and in so doing, they mandate that clinical trials be completed and approval granted before a drug can be sold.

There are five known electronic cigarette peddlers and they have all received letters from the FDA warning them that they are in violation of the law and MUST present the safety data on these devices.

I personally know several people who own these. They know my feelings against them - namely , there are no clinical trials for me to review which would attest to safety and efficacy. I recall telling these same people a few months ago, that the devices WOULD be pulled from the shelves so they better get all the supplies they could.

Informed Eating

I have decided that my doctoral work will involve several things. I will tell you the statement I have begun to employ.

I am interested in reducing the incidence (new cases) of obesity and tobacco related chronic disease states in the 20-40 year old population. My research and intervention interests include obesity prevention in children, Hookah Bar policies and creating a tobacco cessation data base. I will continue to work with web media to further my main objective. My main objective, with adults and children, is to assist in the creation of an environment that allows informed eating. By this I mean, children learn why a calorie matters at all, the best foods for getting them, and such, at the same time that restaurants, schools and other food providers give them the information they need, we need, to make informed decisions about what we choose to eat at any given time.

Which brings me to today. The week ended on a much better note. I was one of the main facilitators for a prospective student information session. Since it was going to be a small gathering, the program director thought it fine that I take care of the refreshments personally. I mentioned the menu a few days ago.

The trays went over VERY well. The guests and the faculty were very complimentary and appreciative. Now this happens wherever Deirdre goes! I provide healthy foods that look and tastes good. It is my passion. Unfortunately, I was on the tour when my trays were set out. I should have taken pictures for you guys, but I thought of it too late. Any ways, in the center of one tray were the light round baby bell cheeses, wrapped. On another tray was the light laughing cow cheese wedges, wrapped. When I came in, two doctoral students were waiting and I noticed that the cheeses were UNWRAPPED - how weird. They were in little individual packages. I said, "hmmmm - I would not have unwrapped those." My peers said, "she made us." She is the secretary. AH SO. One issue - the uneaten cheese is no longer in the fresh wrap, but more importantly, you cannot have informed eating if someone removes the labels! I'll clarify next time. I expect I will get a next time :)

Genetics Extra

From past posts you would know that though I believe in genetic predisposition to disease, I do NOT believe that is what people in general should be focusing on. Instead, I think that a genetic predispositions for some diseases is a big flashing neon sign urging that individual to make as many healthy choices in their day to day life as possible. To be fair, there are diseases that are 100% genetic, but they are rare.

It is more likely that a disease has both a genetic and environmental cause - an interaction often takes place between the two. I am currently refreshing my basic genetic knowledge for the epidemiology class for which I am an assistant. We are having a genetics student as a speaker in a few weeks. One of our suggested themes for the class is HER response to direct to consumer advertising of the genetic tests and the GAOs response to them. This was the topic of a past blog post.

I wanted to share a few things from the reading, beyond what I have just said. First is that twin studies are pretty close to the best scientists can hope for to study genetic links. However, the twins have to be identical or monozygotic because those pairs are from the same ovum and share 100% genes. Fraternal or dizygotic twins are the same as non twin siblings in the gene sense. So look for that if you are reviewing a twin study. Further, know that the twins of either type are very likely to also share the same environment and thus be influenced by it.

Adoption studies are better but not perfect as any time we are out in the community there will be factors that we cannot control or even know sometimes that may have an influence.

The other thing I wanted to explain with regard to twin studies are the terms concordant and discordant. Consider this sentence, "The twins were concordant for breast cancer." My immediately deduction is that the twins BOTH had cancer. Only part of that is right as the other is unknown from the sentence. Whatever the outcome, the result is concordant - the same. Both twins either have it or don't. If I said instead, "The twins were discordant for breast cancer." I would mean that one had it and one did not. This would lead us to think that genes were NOT involved. It is not whether they have the disease or not, but if both identical twins have the same disease status then they are concordant.

Last thing - what geneticists find in many instances is that the younger the age of onset of disease in one monozygotic twin the more likely it is to be concordant. In other words, both twins will get the disease and it is thus more often linked to genetics. If in identical twin girls, one gets a cancer at 13 say, the other twin is also likely to have it or get it soon. IF the twin gets the cancer in her 50s, there is much less of a chance that her sibling will get it - from her genes - it is more likely to be some environmental cause.

Ok lesson over :)

Check out the widget I added to the blog home page - under the text of the posts. It is from my favorite Go Slow Whoa initative from the NHLBI -

FOOD

So I do not want to get into a kid theme, but I will pass on this link from a friend. It shows some very creative lunch box ideas that do look quite healthy. The food is a keeper, but I guess adults don't need it to be so cute!

I brought my lunch to class today. It was a salad with lettuce, boca crumbles, tomato, onion and mushrooms with Walden Farm dressing. I had a few orange wedges and a couple of my favorite Mexican brand sugar cookies. It was less than 150 calories total.

On Friday, we are having a few visitors to my graduate program and guess what the director did? He put ME in charge of the refreshments. Ah SO. Going to the store in the morning. Here is my shopping list:
Fruit - probably grapes and oranges
Bell Peppers
Laughing cow light spreadable cheese
Kraft 2% cheese cubes
Hummus
Crackers
Water

Okay back to studying....

All Children

I continue to be a fan of WebMD and today one of their newsletters found my inbox. In this edition, certain nutrients that are important to children were noted, and concern was raised that some children may be deficient in these. At the very least, the writer who penned the letter suggests being mindful of these four nutrients. (also note that webmd materials are physician reviewed)

I want to say this first however , and you may have heard this from me before - "if it's good for or bad for pregnant women and children I want to get it or avoid it too!" Today I add - "though we may not all be parents, we ARE all children."

The ingredients to note are:

Vitamin D - yes it continues in its exalted state (supplements may be needed)
to quote the newsletter

The AAP specifies that children who don't drink a quart of milk fortified with vitamin D take vitamin D supplements to make up for what they miss from their diet

Calcium - fat free milk is a great source, fat free or lowest fat cheese and yogurt are awesome and for those who cannot or will not consume dairy, there is fortified OJ. Of issue is that children drink sugary beverages that are problematic in and of themselves, but also because they take the place of milk.

Potassium - I did NOT know that the more processed a food, the less potassium and the more sodium, but so says WebMD. I did know that fruits and veggies are good sources of potassium. Remember, you can use this USDA resource to find foods rich in any nutrient. I.E there are foods beyond bananas that are high in potassium :)

Fiber - sigh - you know this one right. If you like, these cereal bars are a great way to get fiber into you, your kids and those you love...

To Unbreak a Habit

As a colleague (we're grad assistants) and I were leaving a meeting today, I mentioned that I was going to hang out until the pool opened. She said something supportive and admiring about my dedication, as people often do. I explained that my goal is to swim on Tues and Thurs and I fear if I miss one, then I'll miss two - etc.

She laughed and shared something that HAD to go on the blog -

She said she had missed her Yoga class one night and that had been a year ago. Exactly.

Which made me wonder, hence the title, how long does it take us to undo the habits that take three to six months to instill? The answer appears to be - uh, one day!

So I did swim and believe it or not I had the WHOLE pool to myself with two life guards standing watch :)

Odds and Ends

Has it indeed been another week! I have to say that I feel more grounded in my studies and caught up with my readings and such. It is a good feeling, except I keep thinking I must have forgotten something. That being said, I found time to read a little here and there and keep a sheet of notes for today, so let us have at it.

A Positive Consequence: One of the older diabetes drugs, i.e. not the one that the FDA has received calls to pull from the market, but metformin, may have another indication. This is popular drug is being studied by scientists at the National Cancer Institute. A preliminary finding in mice shows that those exposed to one of the tobacco specific nitrosamines, nicotine-derived nitrosamine ketone or NNK, associated with lung cancer, do not develop tumors when on this medication. However, I have to call out Reuters for saying in their headline that the diabetes drug may prevent smokers from getting lung cancer because the loudest headline should always be - Stopping Smoking Can Prevent Lung Cancer.

Allergan: Allergan is the company that makes botox and they just got in trouble for one of the things that I am often all in a tizzy over - misleading advertising and physician manipulation. They have agreed to settle and pay hundreds of millions of dollars in fines and or restitution for not only telling us that botox can help with migraines, pain, muscle spasms and cerebral palsy, but health care professionals too. Botox may be approved for additional uses now, but in the past it encouraged (maybe with money) doctors to use the medicine in ways it had not been approved. Off label use is legal but it cannot be marketed. I believe the fees are over 600 million bucks.

RD Club: My campus has a nutrition club and of course I signed up. This weekend I received an email about the first meeting and event. I cannot go to the meeting because of my classes, but the email included a notice that they would be having an ice cream social. Seriously? And you wonder where the freshman 15 come from!

With Regret: Yes, it is with regret that I add these few sentences because what I witnessed was at Walmart and that is where I prefer to shop because I have limited funds and because a lot of people work there and I want them to keep their jobs. This weekend though - darn it - I saw this and just sort of stood there stunned, staring, disappointed and fruitless - meaning - I didn't buy any fruit. I had been at the green beans and didn't get any because mixed into the big batch of them were moldy ones. I then went to the strawberries and grapes and a produce clerk was rearranging the strawberries. Now, it is ALWAYS a challenge to buy these berries, no matter the store. There is almost always containers with darkening or moldy fruit and they never seem to last long once you get them home. So the clerk was pulling the containers forward and making the display neat. I had already been looking for a clean batch and had come across several in very bad shape. To my dismay, they were NOT pulled from the shelf. It was like the person was there to arrange the shelf not to think. As I watched him, sort of dumbfounded, I noticed that he had places on his forearms that were scratched and bloodied. I just sort of stared as I said, and then walked away. Sadly, the next day I went to an upscale grocer and their strawberries and green beans were also turning bad.

Fitness: I think I wrote this word down on my list just to toot my own horn. I have my routine now. Running five days a week, 7-6-8-6-8 if possible, swimming two days, 30 laps but I think tomorrow I am ready to go back to 34, weight training two days and for transportation I am bicycling about 20 - 24 miles a week with a little walking too. I must say that in the last couple days I have started standing up and pedaling on the hills instead of lowering the gear and I am getting stronger. BTW, those spin classes that have you add resistance and stand up - they pay off!

Now it Matters, but Not So Much

First do let me update on the Timewarner Cable saga that has become my life. A tech was here last Sunday for an hour or so, same problem as the last time a tech was here for an hour or so and this guy scheduled ANOTHER tech for this day. So all my weekends since moving to NC have involved one day waiting for a TWC tech to come to my house. At 4pm, the 130-330 slot had gone by. I called and was told "OH, they were supposed to tell you it is the pm slot 12-530. But we will give you a 20 dollar credit" AND Juliette said, "I will have the tech call you." He/She never called and at 7 PM I contacted Pearl - who gave me a 20 dollar credit and at 730 dispatch called to say, "sorry, but he should be there around 8:30 PM or so." Are you kidding me? I spent the whole day captive and the night too. Never mind! And she asked about rescheduling to which I replied, "I am sorry, but I think I have had all the TWC help I can stand." I am stuck with them for Internet, but I am cancelling my TV on Tuesday.

Health Note:

I cannot find the news story that caught my attention last night, but that is okay who has time for all this WORK. It was, however, regarding humanpapilloma virus and oral cancer, specifically throat cancer. There is growing incidence of oral (and throat) cancer from HPV and the course of disease is rather different than throat cancer from tobacco. BTW, oral cancer from this sexually transmitted virus effects both sexes - we more often think of cervical cancer in relation to HPV and men of course, do not have a cervix, but we all have a mouth and throat.

The news story was more about why the HPV vaccine makers are not interested in pursuing a prevention for oral cancer. Reasons offered included the cost of getting FDA approval to market for it - and Gardasil was mentioned in the article. I am not a fan of the vaccine, but I cannot give you a sound argument against it. What I did recall last night is that there IS an HPV vaccine that addresses oral cancer. I also remember talking about it in this blog, mocking it, and then coming back to say "OH, HPV can cause oral cancer, now I get it." Here is the post in which I mentioned the particular vaccine that could prevent some oral cancer. Thus, I am confused about the article I read last night!

Best Laid Plans

Dateline: IT services - UNCG. While my blackberry is being reconfigured I thought I would try to get my post started.


My meeting with my would be nutrition mentor did not go as well as I would have hoped. In fact, there were tears. Seriously, I cannot believe I said that out loud.


Her area of research and focus is preventing hypertension in young adult black males, pretty much exclusively. She is spending much time writing for publication and her next step is to partner with a physician in an attempt to have the most impact. In other words, she isn't interested in children or obesity! Ah well, I still hope that she will agree to be on my planning committee - though she has to think about it.

While we were talking, she did say something that made me think. She said that the most vulnerable of the community, those most at risk for obesity are the disadvantaged or poorest members and they do not have time to begin to think about what to buy, how to cook it and issues such as these. She said that it is a matter of social justice in that regard. She said this after I said that my interest was NOT in social justice. So yeah, okay I messed up there. Though I did say I support efforts in the area of social welfare, etc, it just isn't my area of focus. But in retrospect, the issue for me is that people should NOT have to work hard, think hard, etc to have a healthy diet. The options should be available and affordable - and that may also be a political construct, and I firmly believe it.


Anyways, she did give me permission to take one of her graduate level nutrition courses, so that is a start - Cross your fingers for me on the planning committee -


Okay - hoping my black berry will be ready in minutes...

Beliefs About Hypertension

I have reviewed a research article regarding beliefs that young African American adults - aged 17 - 20- hold about high blood pressure. The study was and is important because there is a disproportionate number of hypertension cases and adverse outcomes, stroke and heart attack for example, in this population. We explored these disparities in a past post related to the Vital Statistics report from the CDC.

I read the research because I have a meeting with the lead author/investigator Margaret Savoca, PhD, tomorrow. [Isn't that what I was hoping for - to read some one's research and then meet them. So cool.]

Anyway, she and her team looked at the beliefs of four groups of persons. The young adults were divided by sex and risk status. So high risk black males and low risk black males and same for females. The categorization criteria is detailed in the actual study.

The researchers used structured interviews and gathered a lot of information from this group. The end result, which was learned from the population in question, is what they knew and didn't know and how they would like to learn additional information. I was very excited because it sounds very similar to what I want to do with the obesity issue. The people in this study did say that they thought that the education on hypertension and especially prevention should happen in the schools!

This study was qualitative and I am leaning towards a quantitative or mixed method study, but that is in the future.

BTW, hypertension is related to weight status, sometimes salt intake, genetics and smoking. Exercise and a nutritional diet are helpful. Stress may play a role but it is not the most impactful variable.

My Class Journal Entry

My goal is to reduce the incidence of chronic disease in the 20-40 year old age group of Americans and the prevalence of it in the over 40 population. The CDC’s August Vital Signs report offers a snapshot on the obesity problem in the US. I mention this because obesity is a risk factor for most if not all the chronic disease to which I refer. That being said, even a person not exposed to the science of weight loss knows that losing weight is far from simple and far from easy. For this reason, I wish to reduce if not eliminate obesity in the country’s children through prevention efforts. This is a goal of the Let’s Move program which began this past year and which has the support and endorsement of the President of the United States.

Though I have a concrete plan for which to address this issue, I feel that it would be the best use of this practicum to apply for a OLSL (office of leadership and service learning) Community Based Research Grant in order to take a step back, review the current situation, especially in light of the information I have highlighted below, and with the results of my community research I can either proceed as intended or revise my plan to incorporate the existing community strengths and programs. Either outcome, it is my hope, would then lead to a submission to the CDC or similar agency for greater funding in this regard.

To that end, this past week I have begun to sketch out the next steps in such a plan, which of course includes presenting it to the class – or my journal.

I have also scheduled a meeting with a professor in the nutrition department Margaret Savoca, both for my program and for this endeavor.

If this all seems feasible, I will begin work on gathering the data needed for the OLSL application and either way will attend the September 2nd interest meeting.

I will review more thoroughly the links that I have posted below. I have also located and bookmarked the websites of Guilford County Schools, the Guilford County Health Dept and its Get Healthy Coalition (waiting for response) and I have requested to be on the mailing list for a state wide Food and Nutrition list serv (response received). I am looking into permission to join the School Health Advisory Committee also.

I expect to use secondary data sources to begin my statement of need, etc and hopefully the grant would allow me some primary data collection through interviews of key stakeholders, etc.

My other interest is in having an instrument I created, professionally edited and validated for use by health educators in this area of obesity prevention/awareness. Perhaps this is something I can pursue in the summer.

I have some disappointment this week as well. I am on email alerts for workshops for both NCTracs and the OLSL which have very timely and relevant topics that I will miss due to being in class - OR already attending other workshops!

http://www.letsmove.gov/communityleaders.php
http://www.letsmove.gov/healthierschoolfood.php
http://www.cdc.gov/chronicdisease/recovery/