Tuesday, November 30, 2010

D Update

Not D - as in Deirdre, but D as in the vitamin - I have been promoting Vitamin D in response to research and recommendations from two of my favorite health experts, Walter Willett and Kenneth Cooper.  Others have also suggested that the daily recommended amount of Vitamin D be increased as research supports its role in strengthening bone and preventing some disease. 

Many physicians have begun testing blood levels of Vitamin D as some experts warn of individual D deficiencies.  The vitamin D supplement industry has certainly benefited from these actions as food sources of Vitamin D are rare. 

 As readers know, the only supplements I DO support (as a health educator, not a doctor or nutritionist) are D, calcium and fish oil.

So today the Institute of Medicine released its report on the current Vitamin D and Calcium recommendations.  They have increased the amount of Vitamin D, the Dietary Reference Intake (DRI) as opposed to RDA (the DRI is considered newer and based in research that considers the body over the lifespan).  The DRI is different for children, adults, teens, elderly,etc. You can see the report brief here and the different suggested amounts.  For middle aged adults, the DRI had been 200 IUs and many experts have suggested 1000 IUs.  The panel does not agree with the 1000 IU recommendations but has increased the DRI to 800 IU.  I am going to continue with my 1000 IU.  The IOM panel also set an upper limit - an amount not to exceed per day and that was 4000 IU.  The report addresses calcium supplementation as well, and in that case, some age/gender recs are lowered.  Check yourself.

I am reporting this to you because I want you to know what the IOM found.  Though they did not support everything that emerging research suggests, they absolutely recommend Vitamin D supplementation because the amount needed 400-800 IU is not available in foods.

Wednesday, November 24, 2010

Family Time

Taking a few days to visit family who have gathered in my beloved Florida.  Though I often like to blog during my travels, especially in regards to keeping it healthy along the way, I expect to be busy with my school work on the plane and not to challenge the security personnel with my foods.  (so I am trying to keep it simple with pre-packaged items, but certainly I am traveling with snacks)

I have a few running and walking dates lined up and my mother and sister are ever so accommodating with regard to serving (me) light and healthy meals - thus I am in good hands.

I am struggling not to make any Debbie Downer comments for our day of gluttony - I mean Thanks, Day of Thanks - but I just can't do it - So taste everything, especially those things you only get once a year (my sister's advice really) and remember to stuff the turkey but not yourself :0

Tuesday, November 23, 2010


Well I am not really throwing in the towel or claiming defeat, just frustration.

I opened the paper during my dinner and saw too many articles about drug companies.  There were articles about one company wanting to buy another, a company who is concerned about generic competition, another trying to get its brand name drug approved in a new population even though people aren't yet convinced it is helpful in the original group, a company being sued because its drug may cause fractures and more more more....

So instead of getting an idea of what to write about today - I just felt burdened.  

Monday, November 22, 2010

Lattes and Apples

No they weren't together - just two points to make from the day.

I attended a community meeting tonight and the Healthy Carolinians group which I am becoming a part, provided the dinner.  They served subway sandwiches, but there were loads of veggies, baked chips, only water to drink and prepackaged apple slices.  They ran out of the apple slices :)

I saw a Starbucks promotional ad in the weekend paper - I saw it today because I am behind and the promo is now over.  The offer was a "buy one get one" free so that you could share the holiday cheer with a friend.  It only involved these three drinks - Peppermint Mocha, Caramel Brulee Latte and Gingerbread Latte.  I thought it would be worse, but the 16 oz drink would have shared 250 to 330 calories :)

Sunday, November 21, 2010

Odds and Ends

Medicine and Weight Gain - Yesterday I spoke to a group of women.  My topic was physical activity and heart disease.  One of the women in the audience told me that she was put on medication for her diabetes and she began to gain weight.  She asked the doctor if there was something about her medicine that she should know, but was told there wasn't.  Eventually, she did find out that the medicine was affecting the way her body handled some nutrients and now she is trying to do something about it.  She was a very large woman - well, she wasn't, but she is now.  One of the things I had the class do was slowly lift one leg at a time while sitting in their chair.  This is to work the core muscles.  This woman could not do this well because her stomach was laying heavily on her thighs.  I tell you this because I am angry that someone did not tell her that the medicine would have such an effect.  I still believe that food is what makes us gain weight, but someone should have told her to expect a change in metabolism , so that she could adjust her eating and exercising habits.

Cholesterol - A certain drug company, Merck, is very excited about the results of its new cholesterol drug.  It has been very effective in not only lowering bad cholesterol but also in raising good cholesterol.  What we do not know at this time is if the levels of each as seen in the study are going to have any impact on the outcome of interest.  The outcome of interest isn't how low we can get cholesterol but whether or not it prevents a heart attack.  That information is pending, as is the question, can it be too low?  In fact, the article I read about this study was in the WSJ and written by Ron Winslow.  In that article the LDL level was something like 45  - 45! and that number was referred to as very low.  I thought it was ridiculously low.  RL-LDL.  It was said to be the level of low density lipoprotein with which we are born.  The reason I am writing has  more to do with these statements.  The first is from one of the researchers, Dr. Rossetti who noted that cardiovascular disease was a great opportunity (for Merck).  And from the journalist, "the cardiovascular franchise is emerging as a promising opportunity."  The cardiovascular franchise - that statement alone should inspire you to eat smart and move more - drug companies are profit driven - period.

Rheumatoid Arthritis - All that being said, when I spoke with my 85 year old aunt today and learned that her week was pretty hard because of the pain associated with her RA, I immediately thought of this new drug that was doing well in phase 3 trials.  You can read about the study here. This link is to the technical abstract.  In RA, the most effective drugs so far have been the biologics and injectables, but side effects can be quite serious.  The new drug is being evaluated for reducing the disease activity and the symptoms a person experiences.  Another measure of effect is the the ability of the individual to do certain self care or daily activities.  The team looked at 20% improvement in the activity and symptoms and 70% improvement.  There was a larger percentage who got the 20 percent improvement, but still, some had the 70% improvement and I sure wish that could have been my aunt.  I also wish her doctor would have put her in the trial.  Of course, she is old, frail and has other diseases - not exactly who you want in your study.  I say all of this to admit that though I abhor medications and believe first and foremost in prevention - I see when medication is the necessary option.

Alcohol with Energy - I may have mentioned this as recently as last week.  Alcoholic beverages that contain caffeine have been a growing concern for many states and health advocates.  Some legislatures have banned them.  One of my professors, Dr. David Wyrick spoke with me about the drinks recently.  He told stories of young persons who were on their second or third drink when the effects of the first one hit them.  He said that much of the concern was for people who were like me - small and female.  Good news is that the FDA is involved.  Here is the update on letters of concern that have gone out to the companies making these beverages.  The companies are not taking this well.

Weight Loss Patch - I saw a headline that said something like, "could a stick on patch help you lose weight?"  I did not seek out the article ( I cannot do much seeking anymore) but my out loud comment was, " SURE - if you eat less while wearing it"

Scanners - Boy was I right to think that the airport scanners were back in the news, and HOW.  Updates on that include that pilots will NOT have to use them and that the airport I am flying out of Thursday does not have them.  As I understand it, you only get the pat down if you refuse the scanner or have some other unusual security issue, but just because the airline doesn't have the scanner doesn't mean you get a pat down.  On Science Friday (NPR) this week there was a discussion about the two types of scanners that are in use. Only one emits the radiation and is of concern (as far as we know).  The guest didn't really know why the radiation scanners were being used at all, since the other type  works just as well.  I imagine it has to do with money - what do you think? 
 By the way, my aunt saw some of the travel uproar on the news this week and asked me, "Do they really make you take your shoes off?"  Oh, my dear auntie - it has been too long since she has flown.

Now it is Sunday night so you know what that means - FOOTBALL

Saturday, November 20, 2010


Postprandial Lipemia, Endothelial Dysfunction, Oxidative Stress, Atherosclerosis

So what does all that mean?  What part matters to you?  Should I just cut to the chase?

Postprandial is after a meal
Lipemia is fat in the blood (from that high fat meal you just ate) and is also called lipidemia
Endothelial dysfunction is the chemicals that are met to protect the lining of our arteries become unable to do their job. I.e. when the lining of your arteries are adversely effected (nitric oxide protects our artery walls and it becomes depleted under extreme oxidative stress) and plaque can build up
Oxidative stress is when the actions of our body on a cellular level leave a residue that can build up and cause damage - to our artery walls for example
Atherosclerosis is  thickening of the artery from the plaque buildup that occurs when we have excess oxidative stress and endothelial damage!

The only real new thing here is the lipemia story -

I read an article about this today in the ACSM's Certified News and it was incredibly technical. 

As a population, we know that we should limit red meats and saturated fat and because most of us do not,  statin medications are very popular.

This research is indicating that there is more to it than bad cholesterol and that at each high fat meal, damage occurs and this damage accumulates.  What did help in this study, was exercise. 

Scientists can measure the after meal blood fats and the chemical reactions that occur in the body.  Here they had people walk on a treadmill a couple of hours after the high fat meal and  learned that there was an immediate response - less endothelial dysfunction.  People who were very physically active to begin with, had less of a bad response to the high fat meal right after eating and if they too exercised after the meal, the dysfunction was decreased.  It sounds like the type, frequency or duration of the exercise is not important for this particular issue.  Exercise increases the odds that the chemicals that protect the arteries are working properly.

Take home message - DO limit saturated fat and DO exercise regularly - remember Exercise IS medicine - without the side effects.

The review that I read was in  ACSM's Certified News July-September 2010; Vol 20:3

Friday, November 19, 2010

Do You Need Another Reason??

Exercise is IN!

Soon- probably next week, I am going to begin sharing excerpts of the paper I have been writing which describes the impact of exercise, macronutrients, calorie moderation, and sedentary activity on various aspects of our health.  I will share them one at a time - noting that they are all good for something - maybe many things - but they do not equally influence weight.  So stay tuned for those posts.

When you read my piece on physical activity, you will not see the part about how exercise reduces upper respiratory infections and appears to boost the immune system.  This is because, the research that supports that assertion is just now available.  You can access the journal summary here.

The  Appalachian State University study involved more than 1000 persons aged 18 to 85.  The researchers used self report for determining the amount of exercise each person engaged in and the frequency and type of cold symptoms they experienced in the 12 weeks for which they were followed.  Self report is not enough to suggest a causal link between exercise and wellness, but it offers a correlation.

The results are still easy for me to believe.  The people who exercised the most - no less than 5 days a week - compared to the least - no more than once a week - were the least likely to get sick, stay sick or feel "real" sick when they did.  The inactive group were nearly 6 x more likely to get sick.  The active folks had 30 - 40 percent less sickness, symptoms and severity.

I can give personal or anecdotal evidence as well - in my small world - at work, school or home (family) I am one of if not the most physically active person(s) in each group and I am also the least likely to catch a cold (except I just jinxed myself).  Actually, I must admit that my Mom and Fl sister, both quite active, also have very infrequent acute illnesses.

Now to be fair - as I must or my family will call me out - I have more injuries than any one in those groups too!  Sigh - everything still suggests that exercise be an every day thing and I consider muscle strains and aches to be proof of use and insurance against atrophy!

Thursday, November 18, 2010

Informed Eating for Kids

This little nugget found me today, and surely I can take a moment to share.  As is well known to my university peers and many others, my passion is point of purchase food and beverage information which informs eating and MAY lead to healthy food choices.

The concern is how to choose the healthier food without knowing the difference between food A or B.  There is a lot more to be said about informed eating - the education piece is vital, for instance.  With regard to dining out, I am a believer in menu information.

I met my NC sister at Border's Books today - in the cafe.  I noticed a pamphlet on the counter.  The title was Kids Beverages.  Sweet!  No really ... sweet.  Ha ha.

There are nine beverages offered and all have 10 ounces except the Cocoa Trio which has 8.
The drink with the lowest amount of sugar, by grams had 14 and the highest - brace yourself - 58!  Fifty eight grams of sugar in a ten ounce drink.  The calorie range for these drinks is 60 to 370 with most being in the 200s. 

Don't you even think to say that kids don't need to be mindful of empty calories - 20% of our children are overweight and a staggering 10 percent of preschoolers are obese - 2-5 year olds.  How can that even be possible.  An obese three year old?  In case you are curious, the rate of obesity in the 2- 19 year old group is about 16% and the overweight rate is 30%.  Want to read more?  A study published in the Journal of the American Medical Association is available here.

Wednesday, November 17, 2010

Handing You Off

Ok - I won't make a habit of this, but I have been holding on to a website link to use on a day that I was too busy to post my own content- It appears that those days are becoming more frequent-

With Thanksgiving a week from tomorrow - now is a good time for you to see these great suggestions from the Cooper Institute - click here!

Tuesday, November 16, 2010

Ah, go ahead - have a little more

Full body scanners for use at airports are in the news again, but I am not sure why.  It may be that the holidays bring about more travel and the realness of this security measure is becoming more apparent.  It could also be that more airports have installed the scanners.  To the best of my knowledge, a traveler is still able to refuse the full body scan and have a "pat down" instead.  Why would someone go the more invasive route?  The two reasons most often given are fear of being seen "naked" on the display and fear of radiation.  I fall into the second category and absolutely will NOT expose myself to the extra radiation.  The people who tell us the level is low or the level is safe have not always been right about these sorts of things. They have at times minimized what an exposure can do and how exposures can add up.  (exposure being radiation, air pollution, tobacco smoke, etc)   In fact, radiation exposure has become a greater concern especially in that medical imaging, as it begins in children, is a cause of adult cancer.

But back to airport scanners - I will be flying for both Thanksgiving and the Christmas Holiday.  My travels will involve three airports - SO - I will let you know if I do indeed have to be searched.  Me and my lunch box - HA  - fun times.

But I write today (in the midst of crazy semester ending madness) because I heard a report on the radio during which some airline employees were bulking at having to be scanned. One of the responses given to them was that they were exposed to low levels of radiation every day while flying.  This was supposed to make them feel BETTER?  With regard to radiation and its effect on the human molecular system - MORE is MORE!!!  That was the nuttiest defense of radiation I have ever heard - well, "I don't know what you're complaining about, you already get more exposure than the average person, what's a little more."  That little more just might be the sufficient dose to induce cancer -

Sunday, November 14, 2010

Odds and Ends

WOW - My notes for each point are two words at the most - I may not be able to make a cohesive post out of them!

Blair Underwood - I noticed that Mr. Underwood, an actor, is now a spokesperson for a new sweetener (product) that claims to be  natural and promotes health in numerous ways.  The ingredient list does not sound very natural, except that the first ingredient is inulin which comes from a plant (many plants have it actually) and has some protective properties.  This however does NOT mean that the processed supplement itself would be health promoting and I am pretty sure that its cost would be prohibitive to most.  The high price may be necessary to pay a famous spokesperson.  A box of Susta with 50 single serve packets is about five dollars. (Oh and I say the same thing here as I did with Stevia - if you want fiber - eat fruits,veggies and whole grains)

GSK/Wellbutrin - At some point this week I read about GlaxoSmithKline and its drug Wellbutrin.  This drug has been around for a while and is an antidepressant.  When the same drug is prescribed for smoking cessation it is called Zyban.  One of the side effects of the drugs is that it dulls appetite.  In fact, as people who quit smoking may initially gain five or so pounds, treatment professionals often point out that there is less weight gain when quitters are on welbutrin/zyban.  Apparently, the company tried to market welbutrin as a weight loss drug.  That is off label use and cannot be encouraged through marketing.  (studies on dose, efficacy and safety for weight loss have not been done OR have not been submitted to the FDA)

Let them eat Chicken Nuggets -  Most seriously - a friend shared this story with me.  Her MIL of 15 or so years has always frowned on the healthy cooking that goes on in her son's home.  When she visits she brings candy and junk and often takes the kids to fast food restaurants.  My friend, hoping to counteract some of this damage, makes sure to always have ample amounts of fresh fruit on the dinner table.  At the last visit, the kids were given chicken nuggets from McDs (sometimes my friend will make them from scratch and her children are used to them and LIKE them that way).   On the table was a bowl of fresh strawberries.  The MIL aka Grandma told the kids to "stop eating those berries and eat your chicken nuggets!"

Water and Drugs -  A couple years ago, when the first murmurings of prescription drug water contamination began, my brother in law suggested it was an exaggeration by environmentalists.  He is a smart and health conscious guy, but I think he was wrong on this one.  Federal, state and local governments are encouraging proper disposal of drugs and even set aside special days and locations to dispose of unwanted, used or needed drugs. I am going to link four different websites for you that have addressed this in the last two years.  This first is an article published in the American Academy of Pediatrics (the links they promote do not work from there, but I found them for you :)), the second is the White House Drug Policy statement, then the FDAs suggestions and lastly, a non government website, SMARxT Disposal.  Please pay attention and do your part to keep drugs out of our water and soil. 

Saturday, November 13, 2010

The Time it Takes

Today I want to share something I learned while reading some articles for a class. The article was regarding our measurement of disease in the population and how effects of strategies, interventions, and  policies, are not always seen immediately.

Most of us are familiar with the latent period with regard to a disease, even if we do not know the terminology. Basically, the latent or latency period is the time from disease occurrence to the time of symptoms or clinical signs. So a person may become sick with a cold one day, but sneeze and cough the next, simply put.

The induction period is a little different and what I want to talk about now. There is very rarely if EVER only one thing or factor in the cause of disease. I have spoken about cancer as one of the illnesses that takes a long time to detect – for the cell changes to become a detectable tumor for instance, but I was only getting it half right. With cancer there are often initiators and promoters. With disease we may have three or four things that have to happen (most often unseen and unbeknownst to us) before the disease occurs. Some diseases will have symptoms the minute that last thing happens, and thus a brief or nonexistent latent period. The induction period however is staggered. If the factors, as explained in my reading, are the letters A, B, C, and D the time from A to D is As induction period and the time from B to D is Bs, etc. D has no induction period as once D occurs the person is diseased.

The induction period cannot be reduced exactly. If there are multiple factors that create a disease however and a subsequent factor can be stopped or postponed then the induction period is lengthened (a good thing) . The latency period, the time between induction and disease detection, might be shortened through screening and more sensitive tests.

Thus the recent study on which I lamented ( CT screening in smokers) does not change the time it takes for the cell mutations in the body to become cancer, but once initiated, the cancer might be discovered sooner by a more sensitive test.

This also speaks to the nature of genetics and environment. There is likely no disease that is 100% one or the other and most are multiple so whatever one can control – for instance physical activity, will keep the other, say genetic susceptibility, at a suspended induction mode.

Friday, November 12, 2010

To the Front

I am most pleased to report that progress continues in the informed eating arena. 

This past week several hundred public health educators, researchers, policy makers and the like, met in Jackson Mississippi for the Global Obesity Summit.  It ended today so the presentations are not yet available.  I saw that Kenneth Cooper was there - sigh - as I was not.

In the popular press, stories abound about a statement that our HHS Secretary Kathleen Sebelius made while at this conference.  She reported on the progress of voluntary front of package nutrition labeling for processed or grocery store foods.  This will be accompanied by an industry created educational campaign about the labels. 

This is exactly what I have been writing about for one of my classes, so - hmm, day late and dollar short on that one -

Here is the website for the food industry announcement - it may not be perfect and of course, the bottom line for the food industry is profit, but maybe they are considering their impact on the other Ps - people and planet?  Let us hope in altruism.

Thursday, November 11, 2010

Aren't we ALL Pre Hypertensive

let me be clear - I fall into the camp of health care / public health folks who DO NOT think that prehypertension is a disease, that it should be categorized as one or that it should be medicated.

I do not know what triggered a WSJ article on hypertension and it's possible consequences (stroke, heart attack and death) this week.  The point of the article was not to discuss the number one killer of Americans (except North Carolinian men apparently) which is heart disease, but to introduce the seven or eight year old debate on pre hypertension.

Hypertension, or high blood pressure is determined simply by numbers.  If one has a blood pressure reading, consistently over time, that is 140/90 or higher, they are hypertensive.  Medication is almost always given at this time, unless, in my opinion, the patient is fortunate enough to have a medical practitioner who suggests non medicine treatment first. (there is certainly a time when the blood pressure reading is so high that it MUST be addressed with medicine immediately)

Some, and I am guessing they either ARE the drug company, have stocks in the company, do research for the company or are paid by the company, believe that people who have numbers ten points below 140/90 should be called prehypertensive.  In other words, 130+/80+ .  These persons are now diseased.  The pre hypertensive person should be given medication to get the numbers down before it becomes a true (?) hypertensive case.

But others, NO -  they might say to a patient, "your number is a little higher than I'd like to see, so - stop smoking, eat less and lose weight, exercise every day, don't drink so much, use less salt and watch the caffeine and stress, if you can..."

This they contend can prevent said person from having a heart attack or stroke - it could prevent said person from having to take medicine later - to prevent the even more likely heart attack or stroke associated with the  higher blood pressure-

SURELY a person would want to follow those sensible recommendations in order to live, right?

And let us not really be fooled into thinking that pills are better (necessary at times, but better?) as they are an inconvenience to take (every day, multiple times - or they do not work), expensive, and oh, they have side effects so blood work is often needed on a regular basis.

Anyways, if the drug camp gets their way on the prehypertensive category - pretty soon it will be 120/70 is awful close to 130/80 so......

Wednesday, November 10, 2010

Concepts to Share

In my practicum class today, we had a guest.  Her name is Risa Wilkerson and she is part of the Healthy Kids Healthy Communities program from the Robert Wood Johnson Foundation.  RWJF has a childhood obesity prevention portfolio which includes about 17 programs across three spectrum.  They are action, advocacy and evidence. 

The HKHC program falls under the Action column and specifically targets children "between the bells" .  That would be the school bells - so no, she didn't have information for me on the Go Slow Whoa lunchrooms, but she said a couple of things that I did want to share. 

First let me say that HKHC and most of what RWJ funds is connected to Active Living by Design (which includes healthy eating).  Recently, the RWJF funded about 50 different programs/agencies/partnerships across the country in four year obesity prevention grants ( near 400,000 dollars each). 

Most of the programs are in the southeastern USA  - I believe that one of the conditions was that 40 of the 50 grantees be in the highest obesity, disparity and poverty areas.

People have done some really awesome things with these funds.  You can learn more at the HKHC website.

Here however are the two or three arbitrary points:

1) complete streets - this means a street that meets the needs of the pedestrian, the bicyclist and the motorist.  So driving lanes, cycling lanes and sidewalks.
2) 8 to 80 - when designing a walkable community, one should approach it in a way that an eight year old and an eighty year old could have all their needs met (safe travel) - and everyone in between will be covered.
3) triple bottom line - a new concept for business that we all could adopt -"how does what we are doing affect  profit,  people  and planet."
4) eyes on the street-think again of active design - designing our cities or business districts to be walkable.  One thing that works against walking is the threat of crime/violence.  Make the buildings have doors (entrances) and windows right on the streets.  It keeps eyes on the street.  Having side walks and traffic calming encourages people to be out there.  All those eyes on the street are a turn off for the creeps and criminals.

Tuesday, November 9, 2010

Pay to Work

I am frustrated that I cannot locate one of my own posts!  Not too long ago I continued my reporting on doctors who are given stipends, incentives, gifts and fees by drug companies.  I have written about it many times.  Here is one of them, but not the most recent.  In the most recent, I directed you to this webpage as Propublica had released actual payment numbers on doctors in such a way as to allow you or I to look up a specific person.

These are good things and they are having an impact according to a research study out of Mass General and Harvard Med School.  In this research, they asked physicians to complete a survey.  I must admit, it is hard to get a good response to surveys and researchers need large numbers in order to make associations and especially associations that can be applied to larger groups.  So - according to the popular press article I read from L. Tanner and the AP, 64% of the people sent a questionnaire responded. 

The good news is that the medical community is setting guidelines and standards and the practice of wining, dining and paying doctors is easing.

The GREAT irony is that those who completed the survey earned themselves 20 bucks. 

This triggered me to write.  I recall speaking to a room full of physicians who were receiving a catered dinner and a couple hundred bucks for coming to this once a year meeting on how to treat tobacco dependence in their patients.  Yes, we spoke to them about Best Practices - how to use this technique called the 5As - Ask, Advise, Assess, Assist, Arrange.

Another study has actually paid doctor's offices a monthly stipend of up to 500 dollars for doing their job (telling people to quit) and giving the researchers data on how many patients they advised to quit.  The point of the study is to see if money changes behavior as many doctors do not use the 5As and they have been around since 1998.  (if they think money changes behavior, why not just pay the smokers )

So, if obesity treatment and prevention is really to be tailored after all the successful tobacco strategies, we will soon be paying physicians to tell us we are fat.

(to be fair, not all doctors need money to do their job and are quite good at assessing and treating tobacco dependence - it is just a shame when they all aren't)

Sunday, November 7, 2010

Odds and Ends

I spoke to my Mom this afternoon and she advised that I give my brain a rest. She also advised that I not burn anything (side story). So as soon as I finish this post, I am off duty and will perhaps, read a few pages in the latest Sookie Stackhouse novel :)

Caffeinated Beverages : Remember that I enjoy caffeine and have noted research studies that highlight it's health promoting properties. I do hope those studies aren't funded by the coffee industry. I would not have even thought that a few years ago, but geez, there is a lot of manipulation out there. But this is not about coffee or soda or even chocolate - it is about alcohol. I imagine that the same people who are likely to drink caffeinated sports drinks or pick me ups like Red Bull would be inclined to drink alcohol that has caffeine in it. This makes me feel a little old, as I eschew both. There are concerns about youth and alcohol and especially youth and alcohol with caffeine in it. I am using the term youth liberally - far more so than I would have when I was in my twenties. So by youth I mean 16 to gosh -30! Ha ha. Well, a state in the USA has banned the sale of any alcohol that contains added caffeine. I do not recall which state it was, and I know it is being contested - but that was not why I wrote myself a note about it. Oh NO - my thought was, "hello? the concern over this is so great as to cause an outright ban but the same state allows the sale of cigarettes?"

Bags: As I was grocery shopping yesterday, and yes, buying produce in the grocery store (sorry) I wondered WHY are these plastic bags for the produce so darn big? They did not used to be this big. It could be because we have supersized our fruits and vegetables along with everything else, OR that the stores think that if they give us really big bags they will look empty if we don't buy more food. Or like me, the shopper might feel like they are wasting that bag - that PLASTIC bag- unless they fill it up. Half the time I just set the produce in my cart without bagging it, but I am not sure how good I feel about that.

Timers: I use a timer when I am studying. I set it for an hour so that I will get up and get the blood pumping through my limbs and such. You understand that I am doing all this research on chronic disease and have learned that sitting for more than one hour at a time not only puts us at risk for blood clots (old news) but also increases our risk of death for any cause - sigh. SO I get up, take a walk, and then sit back down. I use the same timer if I am also cooking, while studying. I must multitask. Last weekend I bought some broccoli rabe at Harris Teeter (not cheap). I had them in a pan to simmer while I worked on a paper. The timer went off, but well - a few more minutes wouldn't hurt. I got up when I smelled smoke. Interestingly, my smoke alarm never went off. The one in my last apartment went off ALL the time and had a voice too. Recall, it said, "Fire - Fire." Anyways, I ruined my expensive produce. When I told Mom I burned my rabes, she said, "you should use a timer."

Ad Blast: Have you noticed that I haven't been blasting any commercials lately? It is because I don't have regular TV anymore. I watch shows on my computer and some Netflix. But two things happened that give me some fodder. I received a coupon packet in the mail and I accidentally was given a local Sunday paper. The coupon packet - for goodness sakes - "multigrain potato chips." Yeah okay. And a probiotic supplement called align. It is supposed to help with digestive balance. I bet it costs a bundle. Remember, fiber is readily found in many low calorie foods, especially grains and Deirdre's famous cereal bars. You do NOT need a Digestive Care probioic supplement. I barely looked at the local paper. I do not have time to read the national paper I pay for. After seeing the quality of writing in this rag my decision to go national was confirmed. I must tell you that the one section I explored contained an article that quoted Jamie Lee Curtis. Ms. Curtis does commercials for a yogurt that has fiber - and she was talking about people and bowel movements. Seriously. She said that people thank her for helping them to become regular.

Now I am done. Time for football and vampires.

Saturday, November 6, 2010

Heart Health

I mentioned in one of the little blurbs from last week's Odds and Ends that I was invited to speak at a conference later this month. The name of the conference is the Heart of a Wise Woman. It is being held in Greensboro NC on November 20th if you'd like to come!

All of today and some of yesterday, I spent creating the PowerPoint that will accompany my presentation. I uploaded it to google docs and author stream and the second one seemed to have kept MOST of my formatting and animation (except the sound on the first slide - its a heart beat :)).

Remember, the power point isn't meant to play by itself - the presenter, ME, is responsible for engaging and educating the audience. Still, I am going to share it with you in its first draft form - well, I revised it a time or two, but I am sure it still needs work - my eyes have gone cross eyed at this point. You should be able to access the show by clicking here.

Now, time to relax.

Friday, November 5, 2010

Not Ready For Prime Time

I am done with my school work for today and want to take a moment to address an issue which had me literally incensed this morning. It was a headline story in the WSJ, which I had seen on my home page last night ( Yahoo and AP).

Most readers know that I have some expertise in regards to tobacco and disease. Most of you also know that I have a strong concern regarding the use or overuse of medical radiation. As a health educator, I am aware that lung cancer is nearly always caused by cigarette smoking and that lung cancer is the most deadly of the many cancers that we have identified. It is NOT the most prevelant - meaning - a lot of people do not get lung cancer. The lifetime risk for nonsmokers is very low (less than 2%) and in smokers it is about 16 percent for men and 12 percent for women.

Lung Cancer kills people because it is detected late and there is no cure. Treatment can involve chemotherapy and surgery. Some scientists and oncologists suggest that a screening tool which could find this cancer sooner would save lives. They are often basing their argument on the success of the mammogram. Breast cancer is one of the most prevalent cancers but not the deadliest.

For several years there has been a call to use CT scans for lung cancer screening and a push against it. I have been and continue to be against this screening. My two main reasons have stayed the same. The radiation is too much of a risk and this is the wrong smoker disease to be focused on. Lung cancer incidence is much lower than COPD which also causes more death in smokers.

This week the authors/scientists of a study that began in 2002 and ended this year have released some early findings from their National Lung Screening Trial. The popular message is that the CT screening saved lives. Of the 53,000 smokers (current or former but with at least 30 years of one pack per day use) in the study it SEEMS some got X rays and some got CTs - (did anyone get no screens??). Each participant received three - one per year. In that total sample of persons, the current available data does not say how many were actually diagnosed with lung cancer, only that 88 fewer deaths occured in the CT group. The number of deaths in the eight years is 354 compared to 442 (thanks to lauren neergaard for including that fact her story).

I have so many questions, but the research has not been published. It is also said in the two press articles, that 33 sites were used to conduct the study - so there will be variability in radiation dose amongst them - 33 sites, 33 machines.

The data has not yet been analyzed which will tell us about the added risk of the radiation - if it contributed to the lung cancer development. Also, the persons in the study were 55 to 74 years old in 2002 - which ones got sick and which died and how were they put into the separate groups?

I MUST read this study when it is published.

Everyone still agrees on this ONE thing - the best thing to do is NOT SMOKE>

Wednesday, November 3, 2010

A New Favorite

I expect that I will get back to this person and this issue in future posts. This will be after I learn more of Dr. Swinburn's research and when I feel a little less fuzzy headed. (too much something - can learning make you feel dumbfounded?)

Boyd Swinburn is a researcher, an obesity prevention scientist, if you will. He is with a University in Australia, but has studied the issue of obesity both within and outside of Australia as well.

He is going to go on my list of favs, right there with Walter Willett, who you KNOW I adore. Anyways - Dr. Swinburn acknowledges the many factors that impact the obesity pandemic (for surely it has become global) but he categorizes the causes with different strength. For instance, genetics and socio-cultural issues are important, but they are more moderators than drivers. I like that he is identifying what is driving the problem (which began about thirty years ago). The drivers are the causes that are having the greatest impact NOW and which may be the most important and expedient to address in stopping the rise and reversing the trend (of overweight and obesity).

Swinburn believes that increased energy intake is the GREATEST problem in the United States. We are less active and he considers the change in physical activity a driver as well, but not the most impactful one.

I read a few of his articles today and was intrigued by his explanation of socio-cultural contributors. He talked about both our cultural traditions, certain foods we like to serve or beliefs we have about activity. He also discussed the beliefs or norms of our society. He pointed out that some people feel pressure to "over provide food" while others feel the need to "over consume food." Timely statement with the holidays approaching. He says, however, that genetics and socio-cultural factors may set the potential for obesity, but neither cause it. He refers to them as loading the gun and the ENVIRONMENT as pulling the trigger.

See, I love this man. Boyd - yes it sounds manly. Anyways, by the environment he means the things that have made it easier for us to be inactive at home, work and PLAY and the policies and economics that make high calorie food so accessible and cheap.

I am still trying to digest his policy recommendations - but I have to tell you, I saw a reference to the "traffic light" approach for front of label packaging and well, he is now esteemed and on the equivalent of speed dial for research references.

Tuesday, November 2, 2010

I Will Walk That Line

In the past we have talked about walking in regards to peripheral vascular disease and claudication - do you remember? The goal was to help people walk longer before the pain in thier lower legs got to a certain level and forced them to stop.

Well another walking measure is being suggested from a small study that is reported from the citation below: The upshot is that many persons over the age of 80 have heart disease and may benefit from surgery. People with heart disease often have other diseases as well and may not be in the best shape, in fact, they may be frail - unless they are my MOM of course - she could kick my ass - but I digress. Most cardiologists are upset when their patients do no survive surgery. This study suggests that older persons who can walk about 15 feet in six seconds have a better chance of surviving this invasive surgery than those who take longer. Pretty cool - easy, cheap test. In a WSJ article about the same study and similar simple tests, a doctor notes that he gauges the health of some of his patients by their ease in getting in and out of chairs, up on the exam table as well as the strength of their handshake! OKAY, get out our yard stick and stop watch....

Joseph C. Cleveland Jr
Frailty, Aging, and Cardiac Surgery Outcomes: The Stopwatch Tells the Story
J Am Coll Cardiol 2010 56: 1677-1678