Drinking Your Meals

I have been seeing advertisements for McDonalds - oh sorry,  "McCafe" - frozen strawberry lemonade.  I see the commercials on my computer when I am watching TV.  It played several times while I was watching a show last night and I just couldn't stop myself from Googling the drink name right then and there in order to get the calorie information.

It has 200 calories, which I think is a lot for a beverage.  For example, it is 200 calories MORE than water or a diet soda.  If you know how to choose and prepare food, 200 calories can take up a lot of space on a plate.

 The other beverages that came up on the website were even worse! Take a look at this link.  If you hover your mouse over the picture of a drink, the nutrient content info will appear in a little box.  Some of the shakes have over 500 calories - yikes! The list does not include the word sugar, I wonder why, but does say carbs - which is the same thing in this regard.  You will notice that they are very high in carbs!

Investor Risk Over Patient Risk?

Recalled and Black Box Drugs

As the cases unfolded some years ago, I kept track of the noted concerns that led to the removal of Vioxx and Betra and the significant warnings for Celebrex.

Click here if you want to see these past posts - I was pretty hot. 

I will restate my personal connection to these. 
I was given both Vioxx and Bextra by my physician in the early 2000s and I reported feeling an increase in my blood pressure. He told me that I was not in the "risk" group for  problems.  The drugs were given to me as samples.  He gave me bags full of them.  Later, both drugs were associated with adverse health outcomes - regardless of one's "risk" profile.
My father was taking Celebrex  when he died of a heart attack in 2002, but his pre existing heart disease prevented a drug connection.

I have strong and varied concerns about the drugs, such as

• the known and hidden risks attributed to them 
• the pharmaceutical industry's effort to cover them up, and
• their efforts to push them, even for conditions they were not originally approved to treat

But this is all old news which I've covered enough.  (If memory serves me correctly, only Vioxx lawsuits went forward - for those who had heart attacks and for those whose loved ones died of heart attacks).

It is the newest lawsuit that has caught my ire.  Investors are suing the makers of the drugs because they hid from them the research that indicated problems. I.e, the people who took the medicine, in clinical trials, were suffering adverse events.  The investors bought stocks in the companies because they thought the drugs would be blockbusters but instead the pills turned out to be widow makers.  Shares plummeted. 

I agree that hiding results is a huge problem and the companies should be held accountable.  I am not arguing this fact.  I just have to wonder, do the investors have more power in our court system than the people who lost their lives or those they loved?

Remember it's Calories Per Gram

I have mentioned, I think, that I enjoy Joseph's Pita Bread which is made from whole grains and is very low in calories.  I may have said here, but certainly on my You Tube channel, that it is a thin pita.  Thin is not necessarily bad because what is more important is what you put in the pita.  I love this pita bread - I make pizza and wraps with it and use it like toast (for a snack) with a cinnamon and splenda topping.  I have a package in the freezer at school for afternoon snacks.

I noticed that someone else had brought in pita bread.  It was a different brand and I wanted to see how it matched up to mine.  It is certainly bigger and thicker, but at a significant caloric cost.  My Josephs has 60 cals for the whole pita which weighs 37g.  The other brand has 200 cals for the whole pita and weighs at least twice as much 79g.  

The test then is calories per gram. 
In fact, there are more than 1.5x as many calories per gram in the other brand.  Josephs has 1.6 calories per gram the other has 2.53 calories per gram. 

Remember, low energy dense foods are a recommendation of the 2012 DGA.

PS the 200 calorie pita is not made with whole grains.

Control What You Can

OF course it saves me time to just embed this video in my blog, but it is a message you should hear.  

It is less than a minute long, and may give you some things to consider.   If you do not see the 'movie' below, you can try this link instead, or visit the blog website.

Visit msnbc.com for breaking news, world news, and news about the economy

the Chocolate Study

I guess it IS true - but it is not a prescription for recklessness!

The people in the study all lived in California.  Almost 70% were men.  The average age was 57.  The people in the study were not in an experiment but answered survey questions about their health and history.  The 975 who responded exercised more than 3x a week on average and ate chocolate 2x a week.

The people who ate the chocolate had lower BMIs than those that did not.  The scientists said that this was not related to overall caloric intake or exercise variation.  As this was not an experiment, people were not followed over time and there was no confirmatory evidence (no proof that the responses to the surveys were accurate (i.e.height and  weight, exercise, food frequency - were all self report and we tend to misrepresent ourselves).

Chocolate does have antioxidants and health promoting properties.  It is certainly possible to include chocolate in the diet without having the saturated fat and excess calories do you harm. 

I read yesterday, in a story about this research, that one should eat very small amounts, about an ounce a day (or less) and that cocoa powder was a great alternative.

I have a friend who has a little Hershey miniature once a day or so and I bake cake and cookies with the cocoa.  I exercise daily and my chocolate is part of my overall calories.

Here is the summary of the research letter published in the Archives of Internal Medicine.

Raisins and Blood Pressure

Several news outlets have reported on findings that were discussed this past weekend at the American College of Cardiology Annual Conference, but I have not been able to track down the actual published research.  It may not be published yet. 


There were actually two stories making the headlines - one involves raisins and the other soy products.  Both are said to be associated with a lowering of blood pressure in the people studied.

The raisin research (for which I have no rich details) involved at least two groups of people.  One group had a snack of about a handful of raisins three times a day and the other group had a different snack, like cookies.  The results are that the raisin group lowered its blood pressure numbers and the mechanism is thought to be the potassium in the raisins.  Potassium has been found to lower blood pressure.
I want to look at the study to see 1) what else was going on 2) how much the blood pressure changed, and 3) if the snacks were equivalent calorie wise.  The raisins would have about 85 calories times 3 servings.  Over 250 calories of snack food every day.  Raisins are not a low energy dense food so those 85 calories are not that many raisins.

Just some things to think about - perhaps another place to get potassium is in bell peppers!

Odds and Ends

Mushroom Powder - Dole Foods has received an innovation award for a new product in a nutritional category.  I do not have all the details about the prize or who awarded it, but I was intrigued by what the product was.  It is a mushroom powder.  I dismissed the first news article I saw because of my stance against most supplements and my belief that nutrients are best delivered on a plate. I revisited the notion of a mushroom powder because it is intended to address vitamin D needs and vitamin D is the one supplement I do take. Mushrooms are a good source of it and a very low calorie food.  I add them to my lunch salad almost daily.  However, to meet the recommended daily vitamin D needs, you'd have to eat a bushel.  So I have decided to keep a watch on this one.

Colon Screening and Sedation - My hopes for a safe, effective, non invasive alternative to the colonoscopy are alive and well. No news on that front however, I still have a few years to go before I "need" one.  I am concerned by a report out this week that suggests many people are receiving excess sedation during the current procedure.  Another reason to come up with a better way.  I have grave concerns about anesthesia and will avoid it as much or as long as I can.  My reason is related to evidence of cognitive impairment or memory problems in some people who have been over sedated or frequently sedated.  This appears to be a semi permanent aftereffect.

Misplaced Blame - Drug makers Targacept and AstraZeneca are parting ways after a drug compound that they planned for treatment of depression (because we don't have a gazillion pills for that already) failed in clinical trials.  Targacept doesn't put the fault in their drug but in the placebo effect.  First,this drug is meant to simulate nicotine receptors in the brain.  That is actually a good idea because the neurotransmitter activity that follows a puff of a cigarette is pretty much a mood elevator and stress reliever.  The drug part didn't work out though.  IN order for a medication to get FDA approval it has to do something that nothing wouldn't do(get that?!)  People in the study were given a set of questions and the answers produce a depression score.  After a sample was given the drug and a control sample was given a "no" drug, the tests were retaken.  Forty percent of the people not taking the new drug, got better.  To me, and not to Targacept, this means we do not need drugs for some cases of depression.

Whitney Houston - Heart disease from smoking.

Environment and Over consumption - When I say over consumption, I mean eating more calories than you need to maintain a healthy weight.  At one grocery store this weekend I saw four big signs, banners, hanging in the front windows.  They were advertising big BOGOs - Buy One Get One free.  The items were - potatoes, hamburger, ice cream and cookies.  That is what people mean by making the unhealthy choice the easy choice.

Weight Based Terminology

Puhl RM, Peterson JL, Luedicke J. Parental perceptions of weight terminology that providers use with youth. Pediatrics. 2011;128:e786-e793

I came across an article from Medscape that had to do with doctors addressing obesity or overweight with their young(child) patients.  I had just posted my comments about kids and calories when the Medscape Week In Review landed in my inbox, so I saved it.

I took a break from my studies today, just to give it a quick read for the purpose of summarizing it here.  Well, of course, the advice to physicians comes from the results of a research study.  A survey based one at that (my favorite).  So you know I had to track it down and read about the sample, methods and data analysis.  I am a nerd that way.

These tangents were fine when I was in Florida, but are an indulgence with a price these days.  

So bottom line:

• docs need to address the issue because overweight/obesity lead to adverse  psychological and physical outcomes (teasing, alienation, disease)
• parents respond differently to the language doctors use
• the least stigmatizing or blaming terminology should be used - suggestions are based on the survey responses of nearly 500 parents  (70% of the sample was white and the majority had more than a HS education) 
• the words used (along with some personal traits of the parents) has an impact on the parents response to the physician's assessment
• even when the doctors used the words that the parents found the most blaming or stigmatizing the majority (71%) still said that they would encourage their children to lose weight
• the researcher is concerned that other parents will either find another doctor, not follow up with health care, or worse - put their child on an extreme diet

The survey results found that the terms the parents found most motivating (for weight loss) and least blaming were "weight problem", "unhealthy weight" or just "weight."

The words that were most stigmatizing and least helpful were "obese", "fat" and "extremely obese."
My favorite way to say it is "unhealthy weight."  I think that parents need to hear the connection between weight and health.  

The responses or answers were compared by some demographics and other traits (called psychographics).  For example, did the choice of most helpful response (unhealthy weight) change based on a persons race, gender, income, education level, own weight status, history of personal victimization or child's victimization, or the parents score on the fat phobic scale.  Yeah, thought that last one might get you.  I looked it up and it is attached below.  

The answers were pretty consistent by all traits with only subtle differences noted.

Here is a link to the Fat Phobia Scale (I would call it the fat negativity scale myself)

Here is the summary for the research article by Dr. Puhl.

Cheezy Chicken Balls - On a Stick

It's what's for breakfast!
A friend of mine is traveling internationally this week and sent me this photo today.  He said that he immediately thought of me when he passed this display.  Of course, I understand that he would.  
His comments that accompanied the picture gave me a chuckle, I believe they were, "because who wouldn't want cheezy chicken balls on a stick for breakfast."  
I have no idea where this is from - I think an airport maybe. I googled Cheezy Chicken Balls (scarey that!) and only found recipes (yuck) and not a fast food joint.  If you look at the picture closely, I think its an Asian place and my friend had gone to SE Asia so that would make sense.  I am sure that the food is meant for Americans though.
Anyways, here they are!

Caution - Not a low energy dense food!

 

Healthy Vending

I was telling my office mate about a recent meeting with the University's vending company.  I met with the vendor a week ago and he gave me samples which are in a box in my cubby.  My friend asked, "What's up with the chips?"  
After I told him the story, he shared this video clip from a TV show.  It is only about 10 seconds long - but oh my gosh - if you read yesterday's post - you will know how darn fitting this clip is!  Watch below or click here if you cannot.

Kids and Calories

As I have said before, I am involved in two vending machine initiatives. One of them is research and will take place next fall (I will do the final preparation this summer, but have been working with my partners for almost a year)

The other is a community based intervention driven by a small grant. As real life goes, it has gotten messy.  The original goal was to increase the amount of healthy vending in 50% of the local high schools.  We are now trying to do "something" in just one school.  There really isn't a way to make the machines healthy unless we change all the products, and we don't have that power.  We talked about teaching the students about food labels (of course my idea) and using FOP systems to identify the healthier options. Of course, none of that really makes the vending healthier.  It only educates the students on what to look for in a product.

As we were discussing this today one of the people in the room said, to me... "Deirdre, they don't care about calories," to which someone else said, "And most of them don't need to."  
We all paused.  Then said, "well that second part's not true."
(recall that more than 30% of adolescents ARE overweight or obese)

So much more to say about this issue, but I haven't the time, except to say.  The Ottawa Charter, written in 1986 made a very important point: we need policy, education and motivation.  All of these are necessary to create change.
Sadly, for this one activity - we do not have the time or manpower to make that happen.
 My research for next fall - will.

Bowling Alleys and Movie Theatres

After my studies yesterday, I met a few classmates at the local bowling alley.  (my peers force me to be social once a month and it darn near kills me, just saying....)

I have not been to 'the lanes' in a very long time and I have not been since I became passionate about all of this labeling stuff and access to healthy foods.  

I noticed a few things during my 2 hours there.  A sort of subculture exists among the bowlers.  I remember this from my childhood.  My parents were on a league and once a week or so, I would go with them and run and play and eat french fries and candy along with other kids whose parents were bowling.  Everyone was smoking, drinking and having fun.  Now the smoking is outside.  (right in front of the doors - I might add)

I saw several leagues in play last night and lots of elementary school aged children running, laughing, playing, eating.  I thought about being a parent, coming after work for my league and what I might feed my children.  No outside food or beverage is allowed.  I went to the food area and reviewed the menu.  There was not ONE single thing that could be considered low calorie or low fat - not ONE thing.  No salad, no fruit, no vegetables.  There were many burgers, hot dogs, chicken sandwiches, chicken wings, fries, and pizza.  I checked out the vending machines, nothing there either.

Today I received an email from CSPI which included a video link.  It was timely so I have included it here for you.

 Watch the video - it's informative!  (if this is not accessible in the email feature, just click on the health educator link and visit the blog itself)

Soda and Heart Disease

Sweetened Beverage Consumption, Incident Coronary Heart Disease and Biomarkers of Risk in Men

Koning,L. Malik, V., Kellogg, M., Rimm, E., Willett, W.,  Hu, F. Circulation. 2012

The above named scientists reviewed two very big longitudinal studies.  The people involved in the studies were men (health care professionals) and women (nurses).  The people joined the study several decades ago.  They answered questions about their health and diet and had lab work completed.  As the years passed, they continued to give information on their diet and lifestyle, diseases that they contracted (confirmed by records) and more blood samples at certain times.  This is the kind of study that is helpful in establishing links between what people do - or what they are exposed to - and disease occurrence. 

A person is interviewed and measured (weight, blood pressure, insulin test, etc) at the start.  This is their baseline.  They do not have any indication of heart disease or lung problems (if they do, they are not included in the study, for instance).  Every year or so they tell about their diet and behavior and when a disease does present itself, the scientists can associate that disease with something that happened in between.  This is not a randomized controlled experiment - which is the only kind of study that can really show cause.  It is however, a very good study and when you have thousands of people instead of ten or twenty the links from lifestyle to disease appear much stronger.  Even then, the link is found in a big sample of people and applies to big samples of people - it is not individual risk.

In this study, the scientists found that sugar sweetened beverages, (soda, juices and such, but mostly soda) were associated a higher risk of heart disease.  The important part is that they know why..  Just as being overweight doesn't cause heart disease directly, drinking soda doesn't lead straight to a heart attack.  If scientists can find the in between factor, the mechanics, and they make biological sense -it contributes to the "evidence".  

Here they found that the SSB consumption did change biomarkers or under the skin conditions that are themselves associated with heart disease.  People who drank several sodas a day compared to those who drank none, had higher triglycerides, lower HDL, more inflammation (CRP, inter luekin 6, TNf) and their leptin (appetite suppression) hormone was less effective.  The researchers expect that process is being triggered by the fructose.  Those who drank the most soda had about 20% higher risk of heart disease. 

The people in the study, again, were health care professionals.  They did not drink that much soda to begin with and may not be representative of the larger US population.  However, there is every reason to believe that drinking a lot of soda is not good for people. (it is important to note that in data analysis, there are procedures that allow us to pretend that everyone was the same weight and ate the same way - so that the impact on these biomarkers could be attributed to the soda and not some other part of the persons life)

The best part of the article is this statement - for my personal reasons: From p 14 in the above referenced study - 

Our results highlight the need for cautious interpretation of studies reporting positive associations between diet drinks and cardiometabolic and cardiovascular outcomes.

What that means is that they do not at this time support the hypothesis or suggestion that diet drinks cause the same problems as regular soda.  Yeah me! (cardiometabolic - think heart - so blood pressure, cholesterol, blood fats, inflammation - and metabolic - digestion and enzymes - insulin resistance, appetite control)

Odds and Ends

Tanning - States are talking about banning indoor tanning.  This is good news because tanning of any type is related to an increased risk of skin cancer, including the deadly melanoma.  The link between UV rays and cancer is established and confirmed in lab studies.  Unfortunately, the 18 states that have an indoor ban in mind are only setting age limits - not actually banning it.

Big T in Canada- A civil lawsuit for damages for tobacco related disease (cancer and addiction) is underway in Canada.  It is the biggest civil suit that country has seen.  The spin for this suit, as opposed to the 1998 suit in the USA, is that the tobacco companies tricked the consumer.  This lawsuit is late in the game (we know tobacco kills).  Many countries, including Canada, spend a lot of time and energy regulating tobacco and advocating against its use because of the health risks.  Several popular press sources have run a story about the Canadian lawsuit, here is one.

Graphic Ads in USA - Speaking of tobacco or more specifically smoking it, the USA may not get its graphic pack labels, but the anti tobacco folks can still proceed with graphic anti smoking ads.  This type of ad is effective - as evidenced from some great work out of Johns Hopkins.  I have not seen the new ads, but I have put this on my to watch list.  They are being produced and disseminated through the CDC.

Pink Slime - ah YES.  Been around for years, but is finally getting some press.  Here is a very basic overview.  Pink slime, named so by a microbiologist, is meat.  Consider ground beef.  Most packages will tell you the percent of fat or leanness of the hamburger.  One way to have lean ground beef is to grind up lean beef.  Another way is to modify higher fat beef - i.e. use pink slime. Consider a higher fat  hamburger product.  Remove some of that beef, run it through a process that strips out the fat, give it a blast of ammonia ( for coloring I think) and put it back in.  Its a filler and a leaning process.  The FDA has signed off on the procedure as safe, but of course, when we KNOW what is going on, we eschew it.  I believe that Marion Nestle was recently quoted as saying something like, " social media has been able to do what we have been trying to do for years."  End this process.  It is hard to tell if the lean hamburger product at the store has pink slime - it doesn't have to be declared.  You can look it up(google it) though because there are some ways to know for sure - of course, the pure lean beef costs more.

White Rice - A study published in BMJ March 16, lead author Emily Hu, shows an association between white rice consumption and incidence cases of type 2 diabetes in Asian and Western groups - with higher consumption related to higher risk.  Interestingly, the risk is greater in Japanese and Chinese populations than in Western.  What is very helpful in the study is the introduction. The scientists explain the mechanics behind white rice and disease.  They suggest that high glycemic loads/index increase the risk of type 2 DM and that white rice has a GI value of 64, brown rice 55, whole grains 41 and a much lower 25 for barley.  I choose barley, bulgar and quinoa over rice - always.  The authors discuss how the rice is processed and that it is primarily starch.  Starch is what ups the GI.  Recall my favorite steamed basket of shrimp and veggies at Asian restaurants.. I always turn down the rice.  Here is a link to the research.

Meat Labels - Yup.  I did remember to go over to the meat case and turn over a few items today, chicken, turkey and beef.  It appears that the serving size for each was 4 ounces.  The chicken breast had about half the calories of the other two.

Walking Stories

No - I haven't finished the soda article....
 I have two walking buddies (in NC) now.  I still have my Saturday buddy - who you have heard about already.  The second is an old acquaintance with whom I have reconnected since moving to NC. She is also a doctoral student (and a mom).

Yesterday my Friday walking friend (we walk to talk about our school work and commit to certain weekly academic goals) somehow got me talking about peanut butter.  I know, like that was hard.  Upshot - the other day her daughter did not finish her PB sandwich and when my friend saw it, the peanut butter had separated and she thought, "YUK." But after talking to me, she realized that she was buying the good peanut butter.  (funny right!)

And today - I asked my Saturday buddy about her exercise and diet, because she is worth it.  She has stopped her morning tread climber activity because she really doesn't like it.  She did commit to walking in the evening on a daily basis.  My point with her is this. She underwent a dangerous, surgical procedure that changed her digestive system -forever - and she needs to remember that (which is what I said to her).  
I thought more about weight loss surgery later in the day. 

Most people, including my friend, know that I am against WLS.  I am against the surgery, but I am not against the people who have it.  I do think it should be called The Drastic Gastric.  It is a drastic measure that best be taken seriously.

Even more on the labeling law status

A few days ago I mentioned a communication I had with someone from the RUDD Center who shared information from the Center for Science in the Public Interest re the current status of the menu/vending labeling laws.

Today, Hannah Jones from CSPI responded and suggested that I sign up for their action news letter.  I am going to do so as soon as I finish this post.  The content from her email is below.  When I responded, to thank her, I did ask if she had any updates on the FOP situation.  Notice that there is a link below, if you would like to sign up for the newsletter or just visit their website.

Thanks for reaching out.  We don't have a specific list for menu labeling, but one way to stay informed of our policy issues is to sign up for CSPI's Action Network: 

http://my.cspinet.org/site/PageServer

I'll also add you to the nutrition policy database, which we use to send out periodic updates and action requests.

You're right, things are moving slowly for menu labeling at the moment.  As I'm sure you are aware, menu labeling passed in 2010 as part of the Affordable Care Act; however, the FDA is still working to finalize the details of the regulations.  Unfortunately some industry members (mainly supermarkets, convenience stores and movie theaters) want to be exempt from menu labeling and are lobbying the Administration pretty aggressively to get out of the law.  It will be interesting to see what happens.

The Red Meat Study

The soda and heart disease study continues to await my further attention.  I am very excited about dissecting it with my new but still minimal statistical skills.  That I have to put my actual coursework before this article, is not to my liking.

However, not liking something and not doing it are two different things. As I get back to my studies, I will leave you with an overview of the research I mentioned yesterday (in someone else's words).  This is the study my professor was referring to when he said that the findings do not mean that if you eat red meat you will have a heart attack or get colon cancer.  Instead there appears to be an association between eating meat and having the adverse health outcome.  I have not been eating red meat for about ten years.  This is not the first report linking red meat and heart disease.  If I were still eating red meat, I would at least consider cutting down.  The study released this week cannot prove cause, but the results are still convincing.

The researchers for the current study are based at Harvard University and the link below is to the Harvard School of Public Health's own press release.  Enjoy.

Red Meat Consumption Linked to Increased Risk of Total, Cardiovascular, and Cancer Mortality

what the reporters say

During my statistics class this afternoon, the professor stopped to make a statement about the difference between a randomized experiment, like with mice you can control and an observational experiment, like reviewing self reported food intakes and some health outcome. 

In the first example, we can say that what we did - what we introduced - caused the change in the mice.  In the second example, we can not.  We may say that the people who reported eating the most red meat were the ones whot had the most heart attacks, for example.  
We then might say that there appears to be an association between red meat  consumption and heart disease - in the population.  This type of statement is usually followed by, "this study does not allow us to make a cause and effect statement, but it does support the need for further research."

You already know these things because that is why I write this  blog.

My professor then gave an example referring to the study released in the past week re: red meat and heart disease. He said that he had heard and read a report in the press and then found the manuscript - the real study and the data analysis of it.  He was frustrated because the reporters were making causal statements from an observational study.

He did not have to convince me.  The irony was that I have the other study that was reported on the same day - the soda consumption and heart disease - in my book bag.  I had been reading it before class so that I could talk about the TRUE findings in my blog!

I tracked the soda one down because Walter Willett was one of the scientists involved and any time his name comes up - you hear about it from me.

All this to say - I am completely spent - and need a little more time to finish the article and wrap my mind around it.  (Ok - so you know - the study includes diet soda intake and heart disease outcomes - I do drink diet soda < 2 a day; so I have a personal connection)

More to come.

Label Change

There is some news to report on the labeling front today - well not on the FOP labeling -  but on Nutrition Labeling.  

Some previously exempt products are now required to post information related to calories and fat.  This is in keeping with the IOM recommendations on changes in product labeling.
It is one of the many things that are supposed to be happening and since this one actually went into effect - I am again hopeful for informed eating policies.

As of March 1st, the USDA is requiring that most ground meat and poultry plus popular cuts of both be labeled or have signage at the point of sale.  The products will be required to give the amount of calories per serving and the total and saturated fat content in grams.
You can read a little more about it here.  

I have not seen them because I do not buy these products, but I will try to keep my eye out for the labels or signs this weekend.

Americans Benefit from New Health Law

Last night I heard a politician say that Americans do not like the current health care policy known as the Affordable Care Act or ACA.  I do not think that is true.  

Many people are already benefiting from the law which has not yet been fully implemented.  The law can save you money and this WSJ article (yes the Wall St Journal) gives several examples.  Pay special attention to item 7 as it gives you the same advice that I offered here in 2009!  Interestingly, I was also referring to a WSJ article in that post.  

The WSJ article that pertains to the 2012 benefits is a nice accompaniment for this post, but the inspiration for today  was the statement from the politician.  

Money is the focus of my response.


Does healthcare reform drive up health care costs or address them?  To answer that, or to begin a dialogue, let's consider what we are spending the money on.  We are treating chronic disease conditions - ones that once started after the age of 50 and now exist even in children.  So we are treating hypertension and diabetes across a person's life span.  People live longer, but not free of disease. It has been said that 75% of the 2.5 trillion spent on health care is related to chronic disease. We are spending money on treatment in general - instead of prevention which costs less in the end.  We are shelling out a great deal of money for screening, scanning and medicating.

I expect that the Americans that do not like the Affordable Care Act are the ones involved in private enterprises that profit from this waste.  It is with their millions and billions that they lobby congresspersons.  The congresspersons then tell US that we do not like the law.  The law that saves us money, mandates preventative care,  gets us a rebate if our insurance provider does not follow the rules and even addresses informed eating.  Well -I LIKE IT.
Read this article.  It is not long or scientific.

Odds and Ends

Label Policy : First, a great thanks to Jennifer Pomeranz at the RUDD Center for getting back to me so fast on the labeling law update.  She gave me some information that comes from the Center for Science in the Public Interest, or CSPI.  I have mentioned them before and am a fan.  Here is the email content from Hannah Jones, Nutrition Policy Project Assistant:

As you may know, a number of policy issues are holding up the final rule for national menu labeling.  
The key policy issues to address are:

 
Definition of Retail Food Establishments

• The final rule should cover all retail food establishments that sell restaurant-type food, including movie Theaters, supermarkets, and convenience stores.

Alcohol labeling

• Alcohol should be required to be labeled in the final rule.  According to the Dietary Guidelines, alcoholic beverages are the fifth largest source of calories in American adults’ diets.

Vending Labeling

• Vendors should not be allowed to post a sign next to a vending machine instead of posting calories beside each individual item or the selection button.  Nutrition information needs to be easy to see, find, and use.

Colace: At some point this week, I heard a commercial for the OTC product Colace.  I don't even remember what was said, only that I thought - No No - these pills are just not the best way to maintain regularity.  So I wrote down Colace on my O&E list and today I looked it up.  I found  information on a PubMed website.  Colace is a type of stool softener that should be taken on a temporary basis by people who need to avoid "straining" to have a bowel movement.  Oh, let us all avoid straining - don't you think?  Whole grains and fiber - unless you are unable to eat actual foods (and some people really can't) - are a much better way to maintain your constitution.  Food is so much better than pills, powders and enemas! 

Heinz/TGIF -REALLY?:  Heinz Co has a business relationship with TGIF - at least the TGIF frozen food items that you can buy at a grocer.  This week a business wire story proclaimed the benefit of this relationship ($250 million for Heinz) and highlighted a new product.  I had a bit of a jaw drop over the product - macaroni and cheese wedges.  (Who is it that thinks the food manufacturing industry cares about obesity?)
The snack is pasta and cheese that is made into a wedge, breaded and then baked? fried? - who knows.  A 3 wedge serving, just 81grams, has 240 calories and 3.5 g of saturated fat.  The ingredient list is HUGE and certainly would not qualify as minimally processed!
Here is a paragraph from the Business Wire article published 3-7-2012.

T.G.I. Friday’s frozen Mac & Cheese Wedges combine macaroni pasta with a creamy cheddar, Parmesan and Romano cheese sauce and are coated in a crispy breading. This innovative new product that embodies the fun and flavor of the T.G.I. Friday’s brand begins shipping this month and will be available at major retailers in a 15.5 oz box for a suggested retail price of $5.99.

Grown Ups and Milk: I will attach the story that caught my eye, especially because Marion Nestle is quoted there in and she says some things that I have said.  (I always like that!) The gist of it is that schools are under order to limit the amount of sugary sweetened beverages students have access to, and the percent of fat in the milk served(good changes based on efforts to reduce overweight and obesity in our children).  This however, leads to a reduction in sales for the milk industry and so  - adults are the new target for chocolate milk.  And make no mistake, those Milk - It Does a Body Good campaigns are NOT from a health organization - they are from a retail organization. And because they are coming after you, you might want to read the story here. 
I will leave you with some great words of wisdom from  Marion Nestle (from the attached article).

"As the pressure on schools has grown to get chocolate milk out, they're looking for any new marketing," says Marion Nestle, nutrition professor at New York University. "I'd never recommend drinking a sweetened drink. People shouldn't drink their calories."

Funny that she also advises that after a workout one should eat a sandwich.  I was just telling my friend today that I don’t drink sports drinks (w/ sugar – or calories) and that I actually have gone on long runs with peanut butter sandwiches in my running belt!  

 

The additive effect of SUGAR - or SSBs

I only have four or five items set aside for tomorrow's Odds and Ends post, so I checked out some trusted websites in search of something easy to post tonight (to conserve my brain).

I went to the RUDD Center for Food Policy and Obesity   where I emailed someone to find out what they heck is going on with the FDA final rule on menu and vending labeling, and then I ventured over to a website in LA County, CA.  
The LA cite has a sugar sweetened beverage calculator.   Here you enter the number of drinks of each type that you consume and it calculates several different measures.  For instance, the packets and pounds of sugar you consume in a week, month and year and how much you might be spending on these beverages.  

I do not drink SSBs (I even make my sports drink with a sugar substitute)- so I made believe I was someone else.  Startling results!

BTW - I do eat sugary snacks (real sugar) but I only have about one a day.

Oh I almost forgot - here is the website and calculator where LA County suggests that you ChooseHealth.  AMEN.

It isn't just what you eat

I am going to show a picture at the end of my narrative and this post is about that picture.  

I saw the picture or graphic today on a friends Facebook page and I quickly shared it on my own page.  After awhile, I went back to my page and deleted it because I was feeling uncomfortable.  The display (and the point it was trying to make) was too simple.  Being overweight or obese is not simple.

Recall the photo from last month that showed the three stomachs and compared contents by calorie amounts?  That was a good depiction.  The new photo shows two frame people (women of course) with very different shapes.  The thin frame is full of fruits and vegetables and the overweight frame is full of cakes and fried foods.  That is it.  There is no caption with the photo.  By now, if you read my blog often, you already know what is wrong with that picture....

The type of food does not make one 'fat' the amount of calories consumed does.  We talk about high sugar and high fat foods because they are the ones most high in calories. Eating calorically dense foods increases the risk of over consumption and weight gain.  You can eat more fruits, vegetables, whole grains and such - as the three stomach picture implied - and not consume as many calories.

Now - clearly - the foods in the frame on the right are NOT good for your body - they  increase the risk of heart disease and diabetes due to the metabolic irregularities they may trigger - but if we are talking only about weight - it is calories -period - that matter. 
 (the caption in the picture below is mine)

what you eat impacts your health - how many calories you consume impacts your weight

 

Free or Reduced a Brand is a Brand

When I saw that some major drug companies were being sued over coupon offerings, I had a suspicion what the concern would be. 

I had to go back to January 2008 to find this post, but I addressed the same issue in regards to free samples.  Patients are given samples or coupons to bypass the health insurance company when it will not cover the medicine or will cover it at a higher copay.  The coupon can reduce the copay or coinsurance.  Bear in mind, sometimes the generic IS the better medication.  Generics are often brand named drugs that have gone off patent.

I worked in health care in the past, so I understand that the burden ends up on the patient.  The very worst of this is that most of the time the cheaper medicine IS the better medicine.  The worst -er is that the drug companies convince doctors and patients otherwise - through direct to consumer and provider advertising and manipulation.
Read about the lawsuit in the Boston Globe.

Healthy NE Low Calorie

Natural does not automatically mean healthy and healthy does not necessarily mean low calorie.  I have said this before - but it always bears repeating.   (the abbreviation NE is from data analysis code - it stands for not equal- and I am spending too much time with data!)

About a week ago I saw a press release that announced the the purchasing of a company called Mrs. Mays by Dole Food Co.  I did not find that exact story when I searched again today but here is one from the WSJ.  In the story I read, the spokesperson for Dole was explaining that this was a perfect fit for the company as it is trying to improve vending options with healthier snacks.  Mrs. Mays is known for its natural snack foods.  When I read this, I made a note to look up the company, Mrs. Mays, and their products.  I did so because I know that natural does not mean natural much of the time and 'healthy' is just as suspect.  

I did my looking up today and in fact, I their ingredients hold up pretty well for the natural claim.  And ok - I will give them the 'healthy alternative to junk food' claim as well - should we be thinking candy bars and chips. However, they do not get the 'low in calories' kudos.  It can be tricky, but the serving size for most of the snacks is less than 1 oz - LESS than.  The packages contain a couple of ounces.  Some of the items are not loose - i.e. a fruit strip or a bar - and the serving size for those is just over an ounce.  Taken this way - the products are very high in energy density - over a hundred calories for an ounce of food? 

Mrs. Mays may be a good vending choice, but for me, fresh food continues to give the most bang for the caloric buck - with a high level of nutrients.

If I bookmarked this link correctly, it should open on the nutrient facts panel for one of the products.  This package contains 4 ounces and the serving size is just about 1 ounce - that one ounce has 150 calories and I am certain most people would eat half if not all of the package in one sitting.  (remember that declaration from some of the FOP labeling discussion.  The IOM thought that the package should give total calories if it was expected that the entire package could reasonably be consumed in one sitting)

When Supplements Hurt Us

As a health educator, I side with the diet and nutrition experts who declare that the best place to get our essential  vitamins and minerals is in our diets, on our plates.  As a health educator, I compete with the supplement (vitamin) industry which has billions of dollars to use to convince the public otherwise.  In fact, there is little, if any, evidence that vitamins and minerals in pill form do our bodies good and growing evidence that they do us harm.

In a new study, published in the journal Nature Medicine, vitamin E is found to be harmful (again).  This particular finding is especially important as it gets at the heart of why people take vitamin E pills or capsules in the first place.  

People believe that vitamin E slows the physical aging process and the outside appearance of aging.  There is no proof of this.  Considering aging, one of the most devastating illness of late life is osteoporosis - sometimes called brittle bone disease or the silent killer.  This study links vitamin E supplementation with bone thinning, bone loss and in effect, osteoporosis.  

The research abstract is quite scientific and I am sure you can find a popular press overview that is easier to read, but you will not find a different conclusion.  Vitamin E is harmful.

By no means should you despair.  Stop taking the pills, of course, but know this:

There is a way to increase successful aging and keep a youthful appearance.  Don't smoke, don't tan, eat a diet high in whole grains, fruits, vegetables, monounsaturated fats and fish  & exercise daily.  It's a formula for health.

Is that side salad an investment?

Today (during a conversation that started with a discussion about the food  served at meetings) a coworker mentioned that he used to make his meal choices based on cost instead of what was healthy. (bc people tend to serve cheap food instead of fruits etc at meetings)  He said that he would just get the fries or chips with his meal instead of substituting a salad because it cost an extra dollar or two.  Now he sees his health, and that of his family, as worthy of the investment.

There were three of us in this conversation and I was the only woman (just in case you are curious).  We were ages mid 30s to 50.

I shared that I thought that this was a restaurant policy (or normal practice) that needed to be changed.  He was right though.  Have you noticed?  Restaurants always charge more for the salad when you want to have it instead of a starchy, high calorie side item. They seem a little more friendly when it comes to substituting fresh fruit - but many don't have fruit available.

My other colleague mentioned side items at fast food restaurants  - specifically in kids meals. He said that Arby's kid's meals come with fruit by default!  If you want fries you have to ask for them instead.  It was the only restaurant we knew of that made the healthy choice the easy one.  He added that his kids don't even know that kids meals used to come with fries!

I say, "KUDOS to Arby's. I am indeed impressed."

PS - getting the salad is only a healthy choice if you don't load it up with high fat dressing!
PSS - writing this made me get a great idea for a policy initiative - little p - just getting restaurants to buy into offering the salad for free (in place of a high fat item) and then giving them public recognition for doing so....

Odds and Ends

The preparation for this episode of the Odds and Ends began with a note about an advertisement that I saw while watching a show that was 'sponsored' by Weight Watchers.  Things seemed to spiral from there and my notes for the week center on foods - unhealthy ones at that... so this is my fast food odds and ends.

Pizza Hut - This is the one that started it all.  Immediately following the statement, "this show is brought to you by Weight Watchers," a commercial for a pizza dinner in a box with a dozen bread sticks followed.  Why do you need bread sticks with pizza?

KFC - I have seen some ads for a chicken pot pie from Kentucky Friend Chicken.  I looked up the dish - and it has 790 calories.  (that's a big lunch)

Wendy's - It is that time of year - lent.  Fish is in. Wendy's is promoting its Premium Cod Filet pretty heavily.  I was intrigued by the ads because they make statements about people who really love fish going to Wendy's for this sandwich.  I keep thinking, "really?"  I don't know about you, but when I think of great fish, I do not think of Wendy's.  So I looked up the sandwich and found this great review from another blogger.  Also - the sandwich has 510 calories - again - that is a lot for a sandwich.  I was curious, how would a Red Lobster fish sandwich compare - I expected better - but it was worse - 730 calories.  Of course, it may be bigger.

Chik-fil-A - Ok - this blurb was not inspired by a commercial.  On Thursday, I was walking across campus eating my egg sandwich that I had made at home.  It is made with flat bread and has a slice of fat free cheese.  You can see how I make it here.  It is really, really good.  It has 105 calories (leaving room for my fruit and cereal bar). I passed a young lady who was eating something out of a Chik fil A bag and I thought - oh man, I could save you so many calories.  I searched the Chik-fil-A  website's breakfast section to see if I could find what she was eating, but I really couldn't say.  They do serve a chicken biscuit which has 440 calories - but I also saw that a plain biscuit had 310 calories.  That is nuts.

Nutrasystem - Not a fast food reference, but I also saw some of their commercials this week.  I just have to say - having food sent to you in the mail so you can add water to reconstitute it is NOT real life.

(disclaimer - I see a lot of ads in the one or two hours of online TV I watch at night - I do NOT watch a lot of TV!)

Again - WHY do you need breadsticks with pizza?