When Willett Speaks

As you may be aware, I am a huge fan of Dr. Walter Willett  who created a food guide pyramid that I have previously included in this blog.   He notes the importance of the nutrients in a plant based diet and the benefits of fish, wine and vitamin D for example.  I also subscribe to the Harvard School of Public Health's Nutrition Newsletter - Dr. Willett is a professor and researcher at Harvard.  I received a newsletter today and in it they discuss the positives and negatives of the new US Dietary Guidelines. Dr. Willett has some things to say and you can read all about it here.  

This is the pyramid from the HSPH - and Willett

Odds and Ends

Genes v Jeans:  A very cool event is happening on campus this month, but I have mixed feelings about the message in the message.  The idea is that if your pants do not fit, you should just get rid of them.  I believe that if our clothes make us uncomfortable  - no matter the size of the person - they should be tossed.  Clothes that lower your self esteem are not clothes you want to spend the day in.  Wonderful idea  - lose the jeans.  But in the flyer about the event the message is that you can't change your genes but you can change your jeans.  IF this is meant to encourage self acceptance it is good, if it is meant to accept being overweight or obese - that isn't a healthy message.  Sorry - I know that some are concerned about encouraging low weight eating disorders, but they are rare in the grand scheme of things and healthy weight programs have not been found to increase eating disorder or distorted body image. 

Hot Bulbs:  I have managed to change most of the bulbs in my apartment to the CFLs.  The other night I turned on the hall light to change those, and immediately thought, "Oh you don't want to take them out or put them in with the switch on!" and turned it off.  I immediately got up in the chair to unscrew the bulbs and they were HOT - so I sort of get how the old bulbs baked cakes for me as a child and increase my power bill as an adult.

Cellphones and the Brain:  I blogged about cell phones and radiation several times over the last year or so.  In fact, I found that my phone was one with high SAR and decided to get a different type.  Below is what I wrote in Odds and Ends for December 2009.  This week more news came out but it was equally inconclusive  - the brain reacts to the cell phone - ok.  It is still wise then to use a headset and not hold the phone to your head  - try texting :)
From December  2009 Cell Phones: This week CNN ran a story about the possible risks from using cell phones. This is not knew news and hearing about it again startled me. Why were they bringing it back up? I wrote about this in a blog in 2008 http://yourhealtheducator.blogspot.com/#uds-search-results. Surely Dr. Gupta didn't just now find out about it. Seriously, the issue of SAR is the same as before and some devices emit more of this non ionizing radiation than others ( a heat that the scientists are not in consensus about with regard to harm, but it is not the same radiation we get from XRAYS), and the concern is life time use of these devices, esp. because some people allow very young children to have cell phones. I know that when I heard about this over a year ago, I changed my cell phone for one that had a lower SAR (specific absorption rate) and then forgot all about it. Unfortunately, a few weeks before Sanjay announced on CNN that the worst emitter of SAR was a black berry curve, I bought one. So anyways, this to me is just more support for texting.



Pot Liquor: I have been reading community assessments which capture the eating and cooking preferences of African Americans - not all black people are the same of course, but several different studies have included a discussion on soul food. Soul food is  comfort food and I think that all ethnicities have such dishes.  I am Italian and my grandparents came from Italy to the USA.  We have traditional meals that are not necessarily healthy, but they nourish our souls and we only eat them on occasion.  Black Americans remind me of Italian Americans.  Today I saw a reference to pot liquor- pot liquor is the broth or juice that is left over after slow cooking vegetables - my dad would call it stock. Some black Americans will drink the pot liquor or feed it to infants believing (probably correctly) that it contains the nutrients from the vegetables.  Pot liquor - pretty darn cool. 

Helmet Laws:  Doing some writing for my professor these days and that always involves looking up more information.  I learned yesterday that 22 states in the USA have mandatory helmet laws - state wide, but with different age limits and that over 200 cities or counties also have them. The bicycle helmet safety institute has a cool map and lots of data on this issue, in case you are interested.  To note, in 2008 91% of the 714 bicycle related fatalities involved persons NOT wearing a helmet and 13% of the dead were under the age of 16.

Obesity and Love: The CDC recently released an MMWR  which focused on health disparities. An MMWR is a morbidity and mortality weekly report.  The one released January 14, 2011 had a special section on obesity.  Obesity prevention and informed eating is my research area of interest.  I am very mindful of the difference in rates of obesity and its adverse health consequences (heart disease, stroke and diabetes) between blacks and whites.  For this reason, I saved the entire document to my computer but printed and reviewed the obesity section.  I am not going to tell you all the numbers but suffice it to say, we are an overweight country and blacks bear more of the burden than do whites -this is not because of individual short comings - but environment, access, opportunity etc. Anyway, the report is about differences amongst all ethic groups and this statement pertained to the culture of the Mexican American community but it is very much pervasive throughout much of America - the statement was this, ".. such as equating overweight with healthiness in children or the use of food treats by parents as tokens of love and caring, might influence childhood obesity..."

Good News or so I thought

I was excited to tell you this story a few days ago and as I was finally getting around to it today, a news story came out that made me think of it again, but alas, I always have to look things up to make sure I get it right and this time, doing so sort of derailed me.

First, if you are a fairly new reader, you must know.  I am very concerned about mercury contamination - air, ground, water, seas - food!  I did a project on it during my MPH program - (there is a link "Good Fish Bad Fish" on the side panel - or maybe it just says Fish).  I learned about power plant emissions, but also that mercury was in some household products.  Thus we need to be mindful to not put batteries, cell phones thermometers and such - into our trash OR recycle bins.  Instead, they are to be taken to special collection sites, OR put out when your community has special hazardous pick up days. 

That was my back story - here is today's news.

A few weeks ago as I was looking at the Duke Energy website where I pay my power bill I noticed that I qualified for FREE CFLs - Compact Fluorescent Light bulbs.  I know that they are expensive because I have bought them once or twice.  I know that they use much less energy and will last a lot longer than  regular bulbs or incandescent bulbs that most of us have used.  They are good for the environment - they use less energy -and they are good for your budget- once you pay for them initially.  This free offer was ideal and I accepted. 
 My bulbs arrived last week - so many more than I need really.  The instructions said to go ahead and change out the old for the new now, not to wait until my other bulbs went bad because the energy efficiency was so great as to make up for any waste of discarding the others. 

[I have changed two lamps so far, but do not have a ladder to get the ceiling lights - sigh.]

Today I heard that the beloved Easy Bake oven which cooks with the old fashioned light bulb was going to have to revise its methods because congress has banned the incandescent heat producing bulbs.  I imagine we will have time to make the change and I imagine that many of us will receive free offers - and whoever makes them is likely tickled to death.

But the caveat - the CFLs contain mercury.  AAAGH!!!! What that really means however, is we need to be very careful with them.  Mercury is a neurotoxin  - re: think of the mad hatter.  This is the same type of mercury as in a thermometer - so be mindful.  Do NOT put these in the trash or recycle bin as you could cause harm to a person and to our planet. 

I guess they are still a good thing. I also appreciate getting them for free - however, (I just went and looked) the note card that tells me to change the bulbs today gives a web address to access for disposal instructions.  There is no warning about the bulbs no advice for what to do with the old ones.  What if a person doesn't know what I know and what if a person doesn't know how to use the computer?  That was pretty reckless  - not really an opinion either - that was dumb.  People need to know not to put them in the trash...

 Gee - I had such fun times with that easy bake oven :)

Helmets Not Lollipops....

I just read this great article about the substantial benefits across dimensions that could occur if there was a shift to active transport, in this case bicycling, from light vehicle (cars) in trips where the distance was about 4.5 miles or less. It was based on New Zealand numbers, but in the USA we cycle for commuting at about the same rate - barely 1% of us cycle to work. The researchers looked at pollution, cycle injury/crashes, health benefits from physical activity, decrease in adverse health events related to pollution, environmental effects. etc. They used many different models to estimate the effects of this reduction in vehicle miles and increases in biked miles. It was quite telling and I am convinced that it would be a great thing to do. Now this is not about exercising, just commuting. And I learned a new concept today. It was "safety in numbers" in that when the percentage of cyclists goes up the percent of injury or fatality associated with cycling does not go up equally. Meaning if the rate doubles, the risk of injury doesn't increase by 50% but maybe 30% and thus the risk to any one person is less as more people begin to cycle. Makes sense for many reasons that I will let you figure out for yourselves.


Here is the citation for the article:
Lindsay, G. Macmillan, A. Woodward, A. Aust NZ J Public Health. 2010; 54-60


But I meant to tell you this tonight:
I saw this yesterday at the arboretum near my house. This arboretum has a paved path of over a mile for people to walk and run and see the plants and flowers. It also has paths through the wooded areas. It is very popular, especially on nice days and especially for dog walkers. Yesterday was a beautiful day (today was an ugly day and I am still pouting about it).


But back to my observations: A girl about 3 or 4 years old was riding her tricycle (YAY!) and her Dad (or a man figure) was riding his, too. (YAY!) No one was wearing a helmet AND the little girl had a lollipop lodged deeply into her mouth as she peddled furiously through the park... Sigh oh sigh oh sigh -

Carrots are for Rabbits Aretha

In a news story ( by Bridget Bland) that you can read here, the Queen of Soul, who has not been well, is quoted as saying,

"When you come off (a high-energy concert), a carrot or some celery just isn't going to work," she said. "I've gotta do a fresh fruit thing ... and come up with some tasty and satisfying recipes that are going to work for me after concerts."

I read that story last week and just found it again so that I could share it with you.  When I read what she said about needing something more substantial than a carrot or celery my heart went out to her.  Of course, she needs much more than that and it is sad to think that she, and many others, do not understand that calorie moderation does not have to mean restriction and going hungry. 

I am sometimes too full but always emotionally and physically content after my mini meals and snacks that I create by using low energy dense foods.  The foods are volumous and very nutritious (usually) but not high in calories. 

It is not always/often money that prevents us from eating well, but mental road blocks and lack of education on how to eat nutritiously, satisfyingly, and traditionally WITHOUT taking in excess calories.

Hey Aretha Franklin - check out my You Tube videos, or just give me a holler - I will help you out!

Chew on This

For a moment today I actually thought I was going to be able to pull together an Odds and Ends post, but then I admitted defeat.

I did find something interesting while doing school work however.  It is an entire handbook on the 2010 Dietary Guidelines for Americans.  I "thumbed" through it quickly and saved it to my computer because it is a great resource on how, why and what to do for healthy eating.

You be the judge... take a look at the table of contents and skip on over to what you are most interested in.   Click HERE

Bicycle Helmet Use

I am preparing my kitchen table for several days worth of writing - (a paper on a particular research theory). I expect to clear it of all that is covering it now to literally paper it with journal articles.   I will get this done before bed tonight so I can get straight to writing after my run.  It is likely I won't make it back to the blog before Sunday - oops, maybe not then either - I am seeing a childhood friend for dinner.  I do hope I remember to tell you my thoughts about Aretha Franklin...

Before I check out, however, I wanted to share very general themes that I have uncovered in my reading on bicycling, bicycling injuries, and helmet use in bicycling.  In reviewing the chart the professor is having me keep, I have read 20 articles - most of which involve interventions or observations.  They focus  on children and adults and they cover the globe - more or less.

I am NOT copying that bibliography here but rest assured it exists.  The picture that is beginning to take shape in my mind is this:

The USA has some of the highest rates of both injury and death with regard to bicycling.  This is in large part due to infrastructure issues.  In other words, the country is set up to make driving the easiest way to transport.  Roads across the country are significantly lacking in  bike lines, side walks, traffic calming measures, and traffic patterns.  The USA promotes driving as opposed to walking or cycling to work.  Parking is often free or cheap, gas and taxes on automobiles are also very low compared to other countries.  In other words, we are automobile focused and automobile friendly.  This is bad for the cyclist AND the environment.

When a bicyclist crashes, either into the road or a vehicle, the most serious injuries are to the head.  I do not believe that head injury is the most common injury, but the most deadly.  Head injury can be prevented with helmet use.

Most people who bicycle do not wear helmets.  Some of the worst accidents occur in children and unless mandated by law, the use of helmets in children is among the lowest of all age groups.  Both cost to the person through disability, time in rehab and or death and cost to society from these injuries can be significantly decreased by proper and consistent helmet use.

There is also a difference in helmet use between races.  The rate of helmet use and cycling in general is very low for black Americans.  I have not looked very closely at other groups of persons of color.   Importantly, people say that they will or do wear helmets much more often than is the case.  This is known from research studies that use self reports vs observations.

There are some things that seem to increase the use of helmets:

• Laws/Policies
• Educational programs emphasizing or including:
• Free or Reduced Helmet access
• Belief that the helmet will protect against serious injury
• Having friends and especially parents who WEAR them
• Comfort and Look of the helmet

If you ride a bicycle, wear a helmet.  I do!  It doesn't hurt a bit and it could save your skull. Since I am putting all this knowledge into mine I guess I better protect it.

This is not about whether or not you can ride a bike without falling.  It is about the cars that are not paying you any attention who will knock you off that bike - either into the ground or into a  car.  Keep your brains off the street!

www.pedbikeimages.org /mike cynaki

Unneccessary Medical Imaging or Scans

I am a strong believer in the physical exam, medical history and clinician insight in regards to diagnosis.  I often ask a doctor how a "film" is going to change the treatment recommendation and more often than not, I choose, I choose because I am in charge of me, not to have a scan.  [this does not mean that I categorically dismiss them but that I make an informed decision about their use].

The article that I am linking you to now is about a survey that collected responses from physicians that order these tests .  It supports previous research that suggests that many CTs, MRIs etc are ordered not to improve outcomes but to prevent law suits.  And don't go blaming just the doctors - some people are the opposite of me and demand to be scanned.

Trust me - cost is not the only issue.  Discomfort and in some cases radiation are additional concerns.

Decorum

Let me just take this moment to tell you what happened today - not the first time, won't be the last .. but I always marvel at the audacity though most often I am not offended by it.  Today I was not offended, especially as the comments/questions were from a community group colleague.  It went like this:

"You are so little, what size do you wear a zero or ...?  How much do you weigh?  Do you weigh 90 pounds?"

Sigh - I said, "yes, something like that," and "95 I think with rocks in my pockets." 
Then she said, "wow, and you look so healthy!"  and I said, "Well, I am real healthy." 

I know - barely 30% of the population is at a normal weight (with MUCH variation based on gender, age, race and SES) so I am unusual.  But what if the conversation went like this..

WOW - You are So big?  What size do you wear?  Are you like a XXXl?  Do you weigh 300 pounds?  Hmm but you look healthy.. or maybe, but you look so ill? 

Boundaries people - they do a body good - oh wait, that's milk... well....

Odds and Ends

 I have four O&Es for you this week.

Salad at the LOOP:  When my friend suggested we go to the Loop for lunch, I reviewed their menu on line.  I ended up ordering my own way, grilled fish on a side salad, but I noticed that they were providing calorie information for a few of their items.

Peroxide:  My dear friend who works as a health insurance coder and thus knows many physicians, was told by 3 of them in separate encounters that hydrogen peroxide was poison, or toxic, or just should not be used because of its effect on the skin.  She was also told not to use Neosporin, then told to use Bacitracin, until finally, she was told to just use Vaseline.  She had a cut on her forehead from her cat.  So I wanted to share the Hydrogen Peroxide bit with you as I have always used it to cleanse wounds.   I did a quick search of reputable web sites and could not find this same concern however.  In fact, WebMD still suggests that it be used as an antiseptic and mouth rinse, BUT as my friend had heard from at least one of her docs, it does need to be diluted with three parts water.

10 Minutes:  Remember, if you are not exercising yet, or if you are coming back from an injury, 10 minutes a few times a day may be better on your mind and body than 30 or more minutes at once.  Most often, the worst thing to do is nothing.

Ice cream:  Not long ago I blogged about B12 and how I was searching for it in the products I already consume while considering whether or not I needed to take a supplement.  Remember?  Well, you can read it again right here.  Funny thing - I decided at the time to buy the more expensive milk because it had a good amount of B12 instead of a supplement.  I noticed this week that the cheap ice cream I have always bought ALSO has B12.  Very cool. 

It can be chocolate.....

I caught a part of a webinar today that included speakers from the USDA and the Food Research and Action Center.  The title of the webinar was "What You Need to Know to Make the Most of the New School Nutrition and Wellness Improvements."  It had to do with the recently passed  Healthy Hunger-Free Kids Act (P.L. 111-296).

In a way this is like the Act that was passed in regards to tobacco regulation.  Many stipulations and rules were legislated that have to be broken down and implemented over time. 

With regard to the Healthy Hunger-Free Act, the USDA which oversees the federal school lunch program, is tasked with taking the regulations and creating standards, rules and guidance to implement them.  The standards won't be ready for another year and in fact, public comment is requested.... After the standards are posted, schools have a certain amount of time to meet them, once met, the schools receive an additional six cents per child per meal.

Much of what was said today is awesome and impacts what  children eat and drink throughout the day at school - all foods.  There will be less fat, salt and sugar and more fruits, veggies and fiber.  The RDAs and upper limits of nutrients for adults that were recently revised for the Dietary Guidelines of Americans are to be followed in the schools as well.

For today's post I just wanted to share these two NEW things...

Water must be offered at all meals at no cost.  All milk must be LOW fat - I say I said, no whole milk.  The children will receive 1% and skim.  Flavored milk is discouraged, but when provided it has to be skim - fat free and flavored or a little fat but no flavor.

Why might this be?  Why are our kids not receiving whole milk or 2% milk?  Because as a country or a population, we consume far too much saturated fat and one of the easiest ways to reduce that is changing to fat free dairy products.  Milk (without fat) it'll do a body good :)

My Second Favorite Topic

I do get focused on a few things - labels are one of them (nutrient/menu labels) and radiation is probably the other -

Because I have blogged about the risk of radiation, especially from medical testing, including chemical and imaging devices, I felt it important to take a minute from my studies to report the results of someone else's.

The referent study is published in the Canadian Medical Association Journal but the full article is not yet available in my University database.  The gist:  researchers used medical records to track the type of test and  dose of radiation (perhaps estimate) that a group of persons who had had a heart attack received in the ten years following their event. 

These persons, over 82,000 of them, did not have cancer before their heart attack.  Approximately 12,000 of them did develop cancer afterwords.  The scientists were able to show that the addition of doses, doses that accumulate over time, were positively associated with cancer cases.  They found a certain percent increase with every 10miliservet (mSv). 

As I said, I have not been able to review the full research report for things like sample size, statistical tests, and all that science stuff.  What the abstract and news articles don't tell us is important.  I would like to know how many persons who are similar to those 80+ thousand but did not receive radiation and also got cancer.  Is it significantly less?

Dose response is one of the criteria for causation (exposure to outcome).
 I have every reason to believe that radiation from our medical testing is putting us at increased risk of cancer.  I have been very honest about that - still this is just one study, one headline even... so don't think it fact, but do think it important.

Blogs of note, re mSv - from me can be found here.

Coming Soon

Thought I would drop in and let you know some of the things I have been up to which will likely inform what I blog about in the next weeks.

I have been reviewing several different studies on the implementation and outcomes of the CATCH childhood obesity prevention program.  It is a school centered program with some home and community activities.  The current full name (it changed from the original trial in the 1990s) is Coordinated Approach to Child Health.  I would like to find funding to launch this program in NC (at one school first!) - so I have been spending all of my time that I am not doing coursework, engaging with community partners or putting in hours for my assistantship, on CATCH.

For my assistantship (one of them) I have been reading and summarizing many articles on bicycle helmet use in children and adults, globally.  There is a good deal to share about that.

In school, I am learning more about research methods and specifically looking into validating survey instruments.  I have created the sketch of one for my future work with adults.  For the CATCH program they already have reliable, valid measurement tools.  My coursework also includes statistics and feminist theory/methds.

For fitness, I have kept up my two days a week of full body weight training, some kind of cardio work most days, but not too much running.  Today I took a pilates class on campus, as opposed to the Netflix videos.  GEEZ Louissa - it was hard.

Okay - back to work :)

Notes from the field

In this case, the field is really academia though I will  eventually relate this to the real world. In continuing with the theme from yesterday that Lee Ann or "anonymous" noted in her comment - starting where you are and what you have re: physical activity...

One of my favorite topics in regard to obesity is calorie control versus physical activity and in that discussion I am always having to clarify that I am only talking about weight, as physical activity itself,both engaging in it and not doing it, has a HUGE impact on the state of one's health. 

I also make the argument that government get healthy messages are about physical activity and not calorie control. In talking with a professor today, he was not buying my argument and to make his own, said, "if you look at the data, the research, you will see that since the 1980s the levels of physical activity in America have NOT changed."  I said, 'exactly!'  What has changed in the last thirty years is the amount of calories we consume because of cheap, processed and over sized foods.  BUT - the message, the Get Active message, is heard.  The public may not be more active but when asked why they are overweight they say, "because I do not exercise enough."

The next part of our conversation was about WHY people don't exercise and it was brought back to those get active messages - Dr. Perko said, "We need to END with 10,000 steps not START with them." To try to get someone to start where they want to be, not where they are, is an obstacle.  "The start is getting up from your chair."  YES YES - start with breaking up the hours you spend on your ass.

BTW, our physical activity and exercise may not have changed in 30 years, but our amount of sedentary activity, sitting, has.

Start Where You Are

With what you have...

I have long encouraged friends, patients, clients - to start where they are. Whether an educational journey, a self reflecting one or a wellness one.  You cannot start where you want to be, you cannot start where you were, not  even where your friends are - but where you are at that very moment in time.

This week a prominent woman was speaking to my Get Healthy Guilford community (do gooder) group and she noted that when persons such as myself aim to help the communities with the greatest rates of obesity (i.e the poorest) - we tell them what they need to eat and which foods are better for them, but we don't tell them how to make the better choice or the better cooking choice for the food that they are forced to buy (cost or availability).

I am never going to forget those very wise words and will remember to ask people what they CAN buy.

What to Eat?

Ah- it is just killing me for so much news to be happening that is escaping my opining! 

The best I can offer today is a link to an USDA press release and a link to the podcast of a Diane Rehm show which had as guests some of my favorites, including the ever awesome Dr. Walter Willett.

And I suppose we can say that I am so busy now because one day someone is going to talk about MY being the guest on the talk show about obesity prevention :)