Start the New Year Informed

Like many or most of you, I am preparing for the new year. What might be different is that to be healthy I simply (or not so simply) need to keep doing what I have been doing. Whereas, many others start every year pledging - resolving - to do things differently. With that in mind, I want so share some truths with you.

The most important things that any of us can do are these (listed, not necessarily, but maybe, in order of impact):

1. Do not smoke tobacco (don't start or do quit).
2. Exercise - everyday (30 to 60 minutes of activity that increases your heart rate).
3. Maintain a healthy weight (this is relative, but for most people it means losing weight).
4. Eat within a calorie appropriate (controlled) recommended dietary pattern, e.g., the Mediterranean Diet, which is plant based.
5. Get some sun, but not more than 10 minutes without protection (also relative to time of year, your skin pigmentation and where you live).
6. Avoid alcohol in excess (for some this means any alcohol, for others excess means more than 1 or 2 a day or 7 to 14 a week (never more than 3 or 4 in one day).
7. Get vaccinated according to the CDC recommendations for your sex and age (and take your children in for their shots).
8. Practice safer sex - i.e., use condoms and discretion.
9. For those suffering from any substance use disorder, SAMHSA can direct you to supportive services
10. Do not fall for diet and supplement scams - nutrition comes from food and weight control comes from balancing intake with expenditure. If whatever supplement or plan you are hearing about was as much of a break through as the ad says, we would NOT have an obesity epidemic. Please believe me.. there is NO pill for you. Reread numbers 1 - 9 above, this is the key to health.
11. Remember these final words of truth:
1. Non-GMO only means something does not contain genetically modified ingredients, not that its low calorie or necessarily good for you.
2. Organic means something has been raised according to specific standards, and so the plant or animal was not treated with chemicals or antibiotics. Organic foods are not scientifically better for you than conventional foods (though there IS concern about antibiotics in the food chain). Organic foods are not necessarily or ever lower in calories than similar non-organic foods.
3. All natural is finally being defined by the FDA - but stay tuned for the final rule and then years before companies have to comply.  Even if something is truly natural - not at all processed - that does not mean it is good for you, wont' hurt you, or is low in calories.
4. There are legal definitions for low calorie, low fat, low sodium, etc.. and 'lower' means something different than low.
5. Read the nutrition facts panels, think about serving sizes.. pay attention to calories (usually a lower calorie item will also be low in sugar). Hopefully, the added sugar declaration will be added to labels this year and that will lead manufacturers to reformulate their products.
6. Some fat is good for you! Especially consider adding omega 3 fatty acids from food, like salmon.
7. ONLY 1% of white people in the United States have CELIAC DISEASE, and even fewer people of other races/ethnicities do. That means, YOU probably don't need a gluten free diet.
8. Gluten free does NOT mean low in calories or good for you.
9. The health promoting property of olive oil is destroyed when you cook in it. To get the nutrition you are seeking, drizzle a teaspoon over your cooked veggies instead.
10. Get your fiber from plant based foods and whole grains, not mixes and pills.

On a sad note, the national vending and menu labeling law which is NOW set for compliance in May of 2017 is part of the Affordable Care Act - and may or may not survive the next presidency. That means that local and state laws could once again begin to populate which could be better for us and a nightmare for industry. Stay tuned

Lastly and sincerely,  I wish you the healthiest of New Years....remember, though I focus on food, physical activity is the sine qua non of health... make sure you get plenty this year... all year.

~ Deirdre

Odds and Ends

Bigger than Brand X One of the explanations for an increase rate in obesity in any country is the change in portion sizes of meals away from home, drinks and individual food items.  Research suggests that when we have more food in front of us, we will eat more.  A bigger serving means more calories (unless they just add water).  So increased portion size = more calories = weight gain.  (of course, we could have all started to be more physically active when the food portions got bigger but we know THAT didn't happen).  My dismay should be easy to understand then.  This week I noticed a new veggie burger.  A company that sells other frozen meals has joined the veggie burger fray.  The package said something like, "10% more pattie than the leading brand."  I flipped the package over because there was no front of pack nutrient information and noted that it also has 70 more calories per serving.  We have got to stop this.  More food, whether you are a customer or the food provider is NOT what we need right now.

Mammograms and 5 Year Survival For some time, the utility of regular breast cancer screenings with mammogram have been questioned.  The mammogram can detect smaller lumps than a self breast exam, but the lumps are often (not always) harmless. The harmlessness of the lump is not known until subsequent invasive tests and months of  increased stress are endured.  Furthermore, the mammogram does not appear to reduce the risk of breast cancer death. An observation piece written in the online version of the British Medical Journal is quite informative.  When considering the effectiveness of a test or treatment, we often use 5 year survivability as a measure.  The five years begin at the time of diagnosis.  Drs. Woloshin and Schwartz provide a great example in the article.  If a group of women are all diagnosed at the age of 65 and die before they are 70 than the 5 year survival rate is 0.  If those same women were diagnosed at age 63, the survival rate will be increased if they die after age 68.  HOWEVER, they will all still be dead at age 70.  It is a matter of how long one is living with a diagnosis more than whether or not an early diagnosis changed thins.   The important part is what happens AFTER the diagnosis.  The treatment.  You have to make an informed decision about mammograms but I will tell you this - examining your breasts  (feeling them) and looking for lumps IS an effective screening tool. 

McDonalds - Look Here

P&G Snacks Save the Day -  The consumer products company reported a 45% increase in sales from Q4 2011 to Q4 2012 and gives all the credit to its snacking business.  (dratz)

Fruit V Fruit Juice  Dr. Robert Lustig continues to educate people on the problems with fructose as found in sucrose and HFCS.  In a radio interview, he closed his presentation by addressing the issue of fruit.  "YES" he said, People should absolutely eat fruit but just as certainly, avoid fruit juice.  He said that the most important thing that fruit offers us is fiber. He noted that most people will not over consume oranges.  They will eat one.  But think of how easy it is to drink 2-3 glasses of orange juice which has many more calories minus the fiber.

Shower Scene As I was going from the pool area to the locker room one day last week, a younger student(20s) was behind me.  She asked, out of nowhere "How do you stay so thin?"  OF course this turned into a long conversation (I exercise a lot and do not eat too many calories) and a referral to my You Tube channel where she could learn about Volumetrics.  But I also shared some personal info with my young enquirer.  At one time I weighed much much more than I do now, and I have weighed the same lower weight for over ten years. During our conversation I was either in a swim suit or a towel - so yeah - no hiding under clothes.  And she said, "But your skin looks so young."  Awesome right?.  What I think that she meant was that it had elasticity and tone.  Nice. (exercise, use lotion, don't smoke).

Odds and Ends

HPV and Herd Immunity  I believe I've mentioned herd immunity when discussing seasonal flu.  Basically, it means that if enough people in your group are immune to an illness, your chances of getting sick decrease even if you are not immune.  The disease gets blocked before reaching you.  I mention it today because there is a suggestion that herd immunity may working to protect some people from HPV.  Public health advocates hope that young men and women will NOT depend on herd immunity.  I am sure that Merck and GSK also hope that you don't skip the vaccines.

Pretentious Grocers  I frequent stores such as Whole Foods and Earth Fare as rarely as possible as I cannot afford to shop at them. I only go if I cannot find a product somewhere else.  In the last week or so I have had to visit both stores.  As usual, the visits led me to gasp at the prices.  Prices on items that I buy at other grocers were priced, not a few cents more, but dollars more.  That is nuts.  The items come from the same place!  These stores promote themselves with offerings of all natural, organic, people and environmentally friendly products, but exclude a great number of people with their prices.  It must be noted that none of the healthy eating indexes (HEI, AHEI and the AHA version) or the DGA, explained here in the last month, mention all natural or organic items in terms of reducing the risk of overweight or disease.  This is because science has yet to make such a link.

Physical Activity When I first presented my exercise tracker, I noted that I did not include general physical activity.  Instead, I focused on what would be considered exercise, by definition.  I did not include all the activity breaks that I take in a day.  Many of those are walks around the block which I have had to limit with my calf injury. So I noticed that in the last 7+ days, I've done more physical chores than usual.  I have cleaned my bathroom and kitchen, using an old fashioned sponge mop instead of my 'swifter,' and getting better results.  I went to the local coin car wash and washed my own car.  Again, it was cleaner by my own hand.  I spent extra time at the community garden, watering, harvesting and pruning.  These are activities that people do much less these days - meaning we are sedentary in general and specifically.

Hyatt Menus The company press release included a statement on the increase in overweight and obese children, but the menu description does not mention any SoFAS or calorie moderation.  It does note choosing food suppliers whose agricultural practices involve sustainability which I value as an environmentally focused person.  However, the rest of the focus is on organic foods.  Intuitively, organic foods should be better for us if they contain less contaminants or additives, but there is nothing to suggest that using them leads to less calorically dense meals.  So if the hotel chain wants to address obesity they are going to have to do it by lowering calories.  If they want to cater to the deep pockets that shop at Whole Foods and Earth Fare, well, they have that covered then.

Aerosol I learned today that aerosol cans are recyclable.  I thought that disposing of the 'contents under pressure' cans was problematic and checked my city's recycling website to see what I could do.  Indeed, I can recycle as long as the can is completely empty and the nozzle is removed.  Pretty cool.

Odds and Ends

ABA and Self Regulation
The American Beverage Association is airing promotional messages in which they highlight efforts to limit sugar consumption.  I imagine that this is a strategy to push back against SSB taxation.  The ad I saw mentioned more "no" and "low" calorie beverage offerings as well as reduced sizes.

Subway at the 7-11
A friend texted me in disgust yesterday afternoon.  She had just eaten an "800 calorie monstrosity."  She made her choice without the benefit of a menu label and once she got home and looked it up, she realized why I was so passionate about them.  I do not know why there were not labels at the Subway, unless the convenience stores are exempt from the legislation and franchise owners can decide whether or not they are going to participate.  I told my friend that her lunch was half the calories I eat in a whole day when its a high exercise day - AND I eat no less than 7 times a day! (LED)

Gaming and Mental Health
A study which needs replication, showed that youth who played special video games vs youth who received "talk" therapy, did as well or better in reducing their depression.  I would love to see this study used to compare video games and medication because the side effects of psychotropic medications are pretty significant.  Of course, we already have evidence that exercise works as good as medicine for some people, but I guess video games are more enticing.

5 Hr Energy Drink
These commercials are everywhere. I see them when I am watching TV shows on line, when I watch the news, listen to Pandora and even NPR!  Today I heard another which specifically promoted a contest for work sites that use 5 hour energy.   Let me just say - caffeine in coffee has been found to have health benefits, but it's a dose response that is not linear.  In other words, caffeine to a certain point is helpful and over that point, it starts to cause harm.  There is NO research on the benefits of these caffeine drinks.  Also - if one wants to improve work performance - activity breaks should be policy!

Alzheimer's and Exercise 
Guess we can't say it enough this week.  Get Moving.  Not only does what you eat matter, so does what you do.  Persons who exercise on a regular basis (several times a week) appear to be less likely to suffer from Alzheimer's Type dementia than those who do not exercise.  My theory would be that exercise increases oxygen flow which helps to transport free radicals and cholesterol out of the system.  This could reduce plaque build up in the brain- which is one suspected cause of AD.

Odds and Ends

Salt - There was news out this week that Americans are consuming an average of 3300 mg of sodium a day which is twice what is recommended.  Salt and sodium - for the purposes of limiting intake- are the same thing.  The food you purchase may say low salt or low sodium (note that 'reduced sodium' does not mean LOW - it means less than the regular version and could still be high). Labels may list sodium mg on the nutrition fact panel.  The biggest source of all this salt is processed foods, including; lunch meat, cheese, soups, pasta, chicken and breads.  In fact, 44% of our extra salt comes from only 10 foods.  According to the CDC, 90% of us are getting too much salt and in population studies, the more salt consumed the higher the rates of hypertension or high blood pressure.  Read more about the sources of this salt in the February 2012 Vital Statistics Report from the CDC.
Ensure - Perhaps you have seen the commercial for the new Ensure "flavor" - muscle something or another.  This is (once again) an example of misrepresentation of science or clinical studies.  There is no proof that this product will strengthen your muscles.  There is an ingredient in the drink that may have done so in some condition or context (like a lab and maybe with animals and not people even).  This product is not your way to bigger or stronger muscles.  The commercial does have one thing right - if you do not exercise you will lose some muscular functioning as you age.

Pets - A few days ago I made note of the incomprehensible notion of overweight/obese children and soldiers. I later heard that we had reached another milestone in the USA - 50% of our dogs are considered obese.  (I wonder how THAT is measured.  Do they have doggie BMIs?) Dogs are active by nature - the only explanation that makes sense - high fat, high calorie people food in their bowls.
Push - Women 'choosing' to have c sections instead of giving birth naturally is not new. It was mentioned in the news and in this blog some time ago.  However, the risk to the baby is now becoming apparent. It is a dangerous habit for a society to get into - I hear it is called "Too posh to push."  Problem is, those lazy Mom's are putting the infant at risk.  Read more from the Mayo Clinic. [this is only in reference to cesarean sections by choice, btw - not medical need]
Medifast - AAACK - Can I express my discontent for diet programs any more often or emphatically?  Blek.  Plans that require you to eat packaged foods are just not appropriate - they are not "real life."  Anyways, the commercial for Medifast has an actress who expresses her excitement for the program.  She exclaims that when she finally  got down to  a size 10 after x amount of years, she cried.  Well - you know I talk back to these ads... guess what I said to this one?  "You're gonna cry harder when you realize that 10 is really a 14."

Odds and Ends

Oral Cancer - To continue on an issue of concern... HPV is the virus associated with cervical cancer, but it is also linked to oral cancer (more so than smoking or smokeless tobacco).  This week researchers who published in the Journal of the American Medical Association or JAMA, found that 7% of us (US Adults and Teens) carried the HPV in our oral tissue (mouth).  Transmission of HPV is through sexual contact, i.e. the genital area including the anus . It is believed that the virus is transmitted through all types of sex; oral, anal and vaginal - but not through kissing.  Still, the finding of the virus in the mouth can help to explain the increase in oral cancer cases that we are seeing.  Once the virus enters the body, the cells that it tends to attack are of the cervix and oral cavity - with regard to cancer.

Grief - There is an effort underway to have grief added to the diagnostic manual that psychiatrists use.  If this were included in the manual,  one can be said to be suffering from grief in the manner of a psychiatric disorder.  Everyone will, at one time or another, lose a loved one (human or pet) and experience grief. Who would benefit from identifying this normal and inevitable part of life as a disease?  Well, as I have said, name it - treat it - medicate it.  I am 100% against this initiative.  You can hear a podcast about the debate at this link from Australia's national radio.

Tablets - I am passing on some advice I heard somewhere this week - probably the NBC nightly news.  People who have tablets, notepads - basically your IPAD, who read from them in laps or on the table - without using the little legs that let you tilt the screen, are having painful cases of neck strain.  The advice is - don't do that.

Heart Disease - The biggest for last today.  In a study that is being published in the NEJM, scientists looked at certain risk factors for heart disease in persons at various ages and tracked the outcomes up to age 80.  In other words, they looked at people who had or did not have the risks at age 45, 55, 65 and 75. The risks that they considered were related to blood pressure, cholesterol, diabetes and smoking. The ideal profile is to be normal for all levels and to not smoke.  The researchers compared the normal profile to persons who had two or more of the risk factors.  The results were staggering.  A 55 year old person with two or more factors was much more likely to have a heart attack and die, have a heart attack and not die, have a stroke and have fatal heart disease - any and all of those things before age 80.  The difference between people with no risk factors compared to those with two or more - in regards to percent of adverse outcomes was approx. 6% and 30% . In other words, I might have a 6% of having a heart attack and a person with high blood pressure who smokes might have a 30% chance of having one.  A further point of the research is that it didn't matter at what age the risk factors were present, the risk of death or other bad consequence was much higher among the group that had only two of the factors (i.e. high cholesterol and high blood pressure) than those with none.The full article was not available this week but I expect that there are increased risk differences based on age of onset of the 'factor.'  I hope to review the full article soon.

SWOOOOOSH!

I hope that I can do this story justice, as it must be told.  No one was really there to see it – what a waste.  It is a funny story.  It isn’t about disease prevention directly, but I suppose it qualifies indirectly.  It is a story about what happened when I went running yesterday morning – and running is exercise and exercise is medicine and the fountain of youth so let’s dig in:

On Friday, I needed to get up and complete my run before a meeting on campus at 11am.  I wanted to run about six miles and was considering trying an amended route.  I had explored this on USATF running routes to make sure it would be about right and I would not get lost.  I was looking forward to the run because we have been having some unusual weather here in Greensboro NC.  It has been very cold (for me, for NC), and I have run in hats, gloves and tights in 25* weather but it has also been in the 40*s and even higher.  It also has rained often, but I have managed to work my run days around that.  I keep a steady eye on the weather, as I had Thursday evening.  And the expectation was a near 60 degree morning for Friday!  Crazy, I know.  I had put out running shorts and a tee shirt the night before as I had not run in shorts since my December visit to Florida. 

I was ALL set.

The first thing that went wrong was my GPS watch – but I didn’t know that until later.  Instead, as I awakened with my coffee and the news, I was confused because the rain showers from the night before had not exactly ended.  It was not raining, but storms or showers were still possible for the next hour or so.  Of course, I could not wait – I had a meeting.  I vacillated, but I could not stay undecided for long.  The weatherman was saying that the temperature would be moderate all day, but would be dropping, not rising.  I finally decided to go out.  Thinking, I can always turn around if it does start to storm ( I say, and never do).

As I started running, in my shorts(!), my watch failed.  “Oh, bother.”  I did not want to run the new route without my tracking device, but I was fine.  I chose another way.  About ¼ of a mile into my run, it began to rain.  Not heavy and it was not cold.  About one mile out, well, it was raining pretty hard.  At about two miles, it stopped and the sun came out.  It rained again later, but at about mile five, when I was almost done, it seemed that the rain was all past.  I smiled.  I was proud of myself for sticking with it.  The day would be even better because I had gone on this run.  I had even run a little faster than usual (it was raining and a bit chilly after all).

So here I came into the home stretch.  Of course, this was not the first time I ran in the rain, heaven’s no.  And certainly it was not the worst rain I have run in.  Not on purpose, but I have gotten caught in storms so bad I was certain to meet ‘my maker’ with a lightning bolt. I have run into and through puddles that came half way up my shins.  And I have chosen to start a 13 mile run in a very heavy downpour in Florida (no thunder and lightning then - though).  I have run when it was cold enough to freeze my face and another time, when ice cycles formed on my gloves (I knew because I heard a funny sound and it was the rubbing of the ice on my stomach as my arms and hands moved back and forth).  I have run in wind gusts that pushed me backwards.  Oh YES – ' - insert chest thumping ' – I AM a RUNNER.

But I had NEVER experienced what was about to happen at mile 5 of my Friday 6 mile run…

I came around the corner which had me back on same traveled ground – if that makes sense.  Can’t show you the map because the watch wasn’t working. But here is a similar map.

I had run up one road, crossed over so I ran back on a parallel road and then came back across at an under pass.  So that the first and last mile were on the same roads – get it?

I crossed the street at the light, and in the glory I described above, went back under the bridge (see where the lines reconnect) and as I did so….. cars were in both lanes going West past me (I was on the sidewalk).  The car in the nearest lane to me hit a puddle that literally gushed over me from Feet to Face – drenched as though a tidal wave had hit me.  I was totally engulfed in the water, and I squealed out loud. I don’t think the driver caught it, but the lady in the outer lane sure did.  It was PRICELESS.  My shirt and shorts, everything was plastered to my body, to the left side of my body - because of torquing water flow.  The splash went directly into my face as well.  

Of course I kept running!!  About a ¼ mile after that, because I had no running buddy to say it for me, out loud I exclaimed, “THAT was Awesome!!”

Relationships

My studies and this blog are specifically related to chronic disease that is attributed to dietary factors and exposure to tobacco or other carcinogens.  Generally however, I am interested in anything related to health and so from time to time the blog post may wander in another direction - like financial health for instance.

Today I mention something associated with  relationships because I have been reading an article that mentions theories that lead to successful ones. 
One of the theories is exchange theory and according to Buhrmester, Furman, Wittenberg and Reis (1988), an important component of exchange theory is this:

-"appropriately asserting displeasure with others"-

I think you should read that line again.  It is really saying TWO things.  The first is that when you are in a relationship (romantic, friendship, or familial), it is important that you DO share your feelings when you are displeased (unhappy, etc). The second part is that you do so appropriately.  
Sulking and withholding affection or attention, for example, are NOT assertions.  Yelling that your spouse is a jerk IS communicating, but not appropriately.

I think what I want most to impress upon you, the reader, is this:  It is not healthy to keep things inside.  It does not help you or the relationship.  Suffering in silence - being a dutiful (yet,conflicted) person  - or being unhappy, gracefully - these are not strategies to improve the health of a relationship.  It does not help you, the relationship, or the other person(s).

Your Health in 2012

I will try to keep this New Years Day post in the tradition of 
Sunday Odds and Ends

Fight Fat (No Ali?) - This is the year that you will not spend any money on diet products, pills, powders, shakes, etc - these products are more gimmick  - more foe - than friend.  Science does not support their use.  IF you read the fine print, you will notice that the results are not typical and diet and exercise are necessary to achieve weight loss.

Celebs and Diet Ads - This year you will believe science over celebrity.  If you MUST trust a program - trust Weight Watchers.  There are NO products that you have to buy with WW- every thing you need is at your local grocer.  The education they provide is legitimate. The lessons are doable and all is safe.

Say Yes to Change- In research studies there is always an interest in the effect size.  For example, a certain teaching method may improve the scores for students who receive this new method as opposed to students who do not.  Thus the new method is effective.  But, HOW much so?  Are the scores 5 points apart or 10 or 20?  I.e., is the effect size small, medium or large?  Small changes will get you small results.  IF you walk ten minutes a day it will not improve your health as much as a twenty minutes a day.  However, NO change will lead to NO change.  Start where you are this year and take it from there - but this year, you will START.

Scrub Your Own Toilet - Not sure where to put this little gem, but I must include it.  I saw a commercial for a toilet bowl scrubber that is automatic.  You attach it to the bowl and it does its thing.  It is devices like this that add up to make us an overwhelmingly sedentary society.  This year - you will use less automation and more elbow grease.

Clothing - Beginning today - man or woman, if the clothes you put on make you feel unattractive or uncomfortable - take them to Goodwill.  They could very well make someone else feel beautiful.  You should feel beautiful or handsome, too.

Sit Less - This is a change you can make.  Vow to keep those sit downs to one hour or less.  This does not mean that you have to take a 30 minute walk every hour, but you must get UP.  Remember, this improves your brain functioning and reduces the risk of dying from any cause - as it relates to metabolic changes that occur when you sit for prolonged periods of time.

Move More - This is NOT the same as sitting less.  What ever physical activity you have now - unless it is 60 minutes 7 days a week - do MORE.  If you do not do any, start with 15 minutes a day.  IF you find that you can not do 15 minutes a day, change the activity, not the 15 minutes.  This year you will move more - not a few times - but consistently.

Eat Better - One more time again - more fruits and vegetables, whole grains, lean protein and fish.  Less fried foods and saturated fat - reduce (restrict) sugar and processed food consumption.  Not sure what to do with fresh food?  Subscribe to my You Tube channel - or just visit it from time to time.  It has a search feature.  You could search green beans, cereal bars and dessert - for example.

Be Open to New Findings - Science is improving.  We will learn that some medications, screenings and foods are better for us and some are not necessary or helpful.  Don't be afraid if the new science challenges your old beliefs - we need to accept that things change and change with them.

Buy and Wear - a bicycle helmet!

Avoid Extremes - There is no quick fix and there is no need for extremes. 

Avoid All Forms of Tobacco Smoke - active or passive - it is all toxic - it is a carcinogen - tobacco smoke is proven to cause cancer and severe lung diseases, heart disease and a multitude of other fatal, acute and chronic conditions.

This year you will make healthy choices every day because each day is the foundation for the next -  this is how you stack the deck in your favor for the years to come.

Breast Cancer Report

I will be brief here because I am going to link you to a handout that should answer most of your questions.  The best part in highlighting this report by the Institute of Medicine(IOM) is that it was commissioned and certainly funded by, the Susan G Koman foundation.  I have donated and raced for Koman, so my money and probably some of yours, helped to pay for this.  We made this report on the environmental factors associated with breast cancer happen.  How AWESOME.
In this report, instead of reviewing the non genetic or non changeable factors (i.e. age and family history), things that we may have some control over, either personally or publicly (policy) were explored.  Remember though, there is always the unknown element and the under-the-skin piece.  The environmental factors in the report were broken down into the categories below.  I will give a quick overview and then I encourage you to go to the handout.  There are also plenty of news stories on this topic today.

• Evidence of Cause - certain types of hormone therapy, excess weight, esp. after menopause, alcohol consumption and medical radiation (yes, those scans I keep warning you about and railing against)(ionizing radiation), and to a less conclusive but still suggestive extent, smoking
• Evidence to Prevent - physical activity  - meaning that women who are the most physically active (but exactly the same in other ways) have less breast cancer
• Things that do NOT cause it - hair dyes and the other kind of radiation (non ionizing) found in microwaves and other electrical devices like cell phones
• Possible Associations- second hand smoke, any tobacco smoke and chemical pollutants, such as we find in gasoline fumes and the air we breathe
• Probable or Plausible Factors - scientists believe that the chemical BPA (discussed here recently) used in the making of plastics and banned in some countries could cause the cancer.  In other words, it makes scientific sense when studying it in the lab and in animials.

Please do not stop here - also read the handout which has more  information.
Disclaimer:  I am not sure if I have been open about all of this in my blogging, but heart disease, arthritis and breast cancer are in my family history.  I have at least two relatives who are breast cancer survivors and my paternal grandmother died of breast cancer long before my birth.  That being said, it is always a personal issue for me.

 

Odds and Ends

CHEESE!: I was in one of the higher end grocery stores yesterday to pick up a few items that I cannot get at Walmart.  One of those items is Smartbeat Cheese slices.  As I came into the aisle, a youngish woman was holding two packages of Sargento Cheese - a provolone and a muenster.  She stopped me and asked about the two cheeses.  (funny thing I actually once worked in a deli and could offer some input)  As I was explaining what I knew, inside my head I was trying to find a way to gracefully encourage her to choose the 2% reduced fat Sargento, instead.  I did, I said, "well I always buy the 2% and I saw over there (pointing), they are on sale this week".  She actually did change and get a 2% pepperjack variety - which I could then say was a favorite of my Mothers.  Bottom line: YAY!

Print, Copy and Lunge:  I thought of you Friday or maybe it was Thursday.  YOU - my blog readers.  I was waiting for a document to print and later for a document to copy.  In both instances, I stood there for a second and thought - "why am I standing here, I have been sitting at my desk for like an hour".  The first time I waited, I did those real slow marches which work the abdominal muscles and the second time, I did some walking lunges.  Bottom line:  Yay again :)

Nicotine and Muscle Power: I ran across a flyer in the Rec Center on campus yesterday.  It was a recruitment flyer for a research study.  The grad student and his faculty supervisor are going to study the effects of oral nicotine (i.e. NOT smoking) on muscle strength or power.  I wish I could remember exactly what the flyer said. I do recall that the people had to already be users of nicotine in order to participate. And why would that be???  I hope that you answered because it is addictive.  Anyways, I did email the professor, as I had just been introduced to him about a week ago.  I told him I would be around this summer if they needed any help with the data analysis etc.  He told me that they were having some trouble finding people to participate.  I suppose that is a good thing really (yay again).  You may also recall from my posts a few years ago that I DO believe that nicotine has some positive attributes, it is smoking and tobacco in general that I dislike (abhor).

Free Sample: It was just my lucky day at the Rec Center yesterday.  (I was there because my walking buddy had to cancel our walk and I thought if I used the treadmill I could also read the articles I had to read for my classes - multitasking YAY).  Near the group fitness studio I spotted some samples.  We get freebies from time to time, deodorant, perfume, Avery products, etc.  Yesterday there were samples of Fiber One Honey Squares cereal.  Interesting thing is that the little box had a NFP (nutrition panel) for the serving size of 3/4 cup but it said that there was less than that in the sample.  It has 10 grams of fiber, and promotes itself as healthy.  The ingredients are corn based however and sugar is near the top of the list, as is sucralose.  I am very curious to see if that cereal would get FOP points under the proposed criteria, which I am still reviewing.

Putting it All Together:  Yesterday I spotted a woman and immediately thought 'smoker'.  I wondered about my gut categorization and thought that it had to do with many things.  We make our decisions based on a convergence of things.  For example, I was a smoker once (past experience).  I have read about smoking and the effects it has on the skin and the hair (research and book knowledge).  I noticed that her skin and hair looked very dry, she was wrinkly but looked like she was too young to be so wrinkly (generalization of aging), also as all this was being processed in my head, I walked by her and the third hand smoke smell lingered on her clothes (using my "senses").  Bottom line:  No YAY about smoking.

Workout:  I finished my 4 of 4 workouts on Thursday so I need a new routine starting tomorrow.  I think that I will visualize it all in my head tomorrow while I am drinking my coffee.  I'll let you know what I come up with - I anticipate more challenging leg work and maybe chest flies with dumbbells for starters... WAIT - I said I would figure it out tomorrow..... sigh -

sXe

As part of my Qualitative Research Methods coursework, I had to read an article on a research study that used a particular methodology.  The ethnography.  The study was conducted and article written, by a sociology professor at the University of Mississippi.  If you visit Dr. Ross Haenfler's faculty page and scroll down a little, you will see titles of  his study publications.  
The ethnography (a study of a culture or subculture) I read was meant to capture the Straight Edge subculture that grew out of the Punk and Skinhead scene of the 70-90s.  The sXe way of life involved a commitment of abstinence.  Members chose to refrain from alcohol, tobacco and other drugs - completely, and to avoid casual sex.  In reading Haenfler's study and the quotes therein, I thought about harnessing some of that positive energy from these youth.  They did not want to put anything into their bodies that would have an adverse physical or mental affect. They did not want to cloud their ability to think for themselves nor detract from their ability to self actualize.
I really understand this - and though alcohol has health promoting properties, many of the youth who were drawn to a subculture, were escaping the problem drinking of their parents or peers.
The sXers in the study also cared about the foods that they ate.  That is the mentality I would like to harness.  The body IS that important.  Eating junk type food (in excess or at all some would argue) for the "pleasure" or hedonism of it has consequences. 
It could also be detrimental, preventing people from reaching their full potentials.

Thus I propose a sXe stance against gluttony :)
 

Vaccines

The Institute of Medicine released a report which details their study on vaccines and possible side effects.  From their website comes this statement - verbatim:

Using epidemiologic and mechanistic evidence, the committee developed 158 causality conclusions and assigned each relationship between a vaccine and an adverse health problem to one of four categories of causation:

• Evidence convincingly supports a causal relationship
• Evidence favors acceptance of a causal relationship
• Evidence favors rejection of a causal relationship
• Evidence is inadequate to accept or reject a  causal relationship

 The IOM also created a chart which I find very helpful.  You  can view it by clicking this link.  It does take a while for this link to open so be patient with it.

To learn even more about the committee research and vaccine safety please go to the website and access the full report, which you can do here.

Hot Dogs and Oxymorons

It is hard to point out faults or contradictions when people are doing their best and have a noble cause.  But I write a blog and some things people say or do are blog worthy...

So the first - at a planning meeting for a gathering where mini health screenings will take place refreshments were being discussed.   Hot dogs will be served.  In addressing this, the person who will be conducting the health screens explained that all the buns could not be whole wheat.  In fact, she said, some of the buns were to be whole grain and others white.  The person put great effort into explaining this issue.  I sat quietly, as this was not my show, and thought to myself "It really doesn't matter what you put it in, it is a HOT DOG!"

I am conflicted about the second part of this post because I really wouldn't want someone to read it and know I was talking about them.  Suffice it to say, calling yourself one of the "healthy obese" is using an oxymoron.  The two conditions are mutually exclusive (they cannot occur at the same time).  I know I alot of people will argue this fact, but arthritis (or wear and tear of our joints and discs) is caused by only a few things and being overweight is one of them.  

TLC and all the Cs

I have been reading a little lighter fare today - an article in the ACSM Certified News.  The article is about cholesterol factors that are related to coronary heart disease and risk of a cardiovascular event - such as a stroke or heart attack.

Most of us are familiar with the Cs that are tested in annual blood work and the article gives a great overview and glossary of them.  This includes the values associated with the tests.  Sometimes we aim for a higher value and other times a lower one.  In either case, they are a risk factor for disease. 

The tests include:
TC = total cholesterol
HDL-C = high density lipoprotein cholesterol
LDL-C = low density lipoprotein cholesterol
TG = Triglycerides (another blood fat)
VLDL - C = very low density lipoprotein cholesterol

Each of the above tests has a target value and usually a person is trying to get below that number - i.e. below 200 for the TC.  But the HDL value is one where we want to be high.  If that value is above 60 it actually can protect a person from a heart event.  You can read more about specific target values here.

The article describes a newer test as well.  It is not at this time recommended as part of the adult cholesterol panel, but  is used with persons who have very high TG - diabetics often have high TG even when they can control their LDL.
The new value is called Non-HDL and is the difference between TC and HDL.  Literally - take the total cholesterol value and subtract away the high density lipoprotein value and that is your NON-HDL value - if you do not have heart disease and have less than 2 risk factors for heart disease (i.e. your other values are normal) than your Non HDL should be < 190. 

All of our cardiovascular risk factors can be addressed with TLC - that stands for therapeutic lifestyle changes.  TLCs that you may be familiar with include exercise, changes in what you eat (i.e. less red meat and more fish) and weight loss. Learn more about ways to improve your health and prevent heart disease at the American Heart Association website.
Here is the info on the article I referenced today:
Title: LIPIDS AND HEALTH; A GUIDE FOR THE FITNESS PROFESSIONAL
BY: WILLIAM SNYDER; CHANG CHAU; AND SARAH MAKOSH;
AND JAMES R. CHURILLA, PH.D., MPH, M.S., RCEP, CSCS
IN: ACSM’S CERTIFIED NEWS • APRIL—JUNE 2011 • VOLUME 21: ISSUE 2

The Great Monetary Effect of Calorie Reductions

I recently reviewed this research article and as it supports the things that I believe to be true - I like it!

The reference is:

Dall, T. M., Fulgoni, V. L., Zhang, Y., Reimers, K. J., Packard, P. T., & Astwood, J. D. (2009). Potential Health Benefits and Medical Cost Savings From Calorie, Sodium, and Saturated Fat Reductions in the American Diet. American Journal of Health Promotion, 23(6), 412-422

In this study, the scientists used modeling or simulation to estimate the impact of certain dietary changes on health and how those changes would impact spending on treatment for specific conditions.  The data on the population was gathered through existing sources, such as national survey and examination databases that track our behavior and health over decades (which is why we know things like how much more we weigh, how much less we do, how rates of hypertension and diabetes have risen, etc etc).

As I continue to read articles that refer to TEI and TEE (total energy intake and expenditure) the formulas  become more familiar to me.  Many of the researchers refer to "the" doubly labeled water technique.  This appears to be gold standard research which captures the absolute total energy burned and consumed by persons under laboratory controlled conditions.  The results only involve small groups of people, because the technique is costly and intricate but are the basis for most equations. The formulas begin with some baseline numbers that are tweaked with factors (mathematical) related to age, gender and activity level.  

This study included a formula for estimated energy requirement or EER.  I like this one.  It was used to compute one of the findings that I embrace.  I will now share both with you. 

With their formulas and modeling the researchers looked at the impact of reducing sodium intake in persons with uncontrolled hypertension (high blood pressure), lowering saturated fat intake for those with high LDL (bad cholesterol) and lowering caloric intake to address overweight and obesity.  These three things did save billions of dollar each year over a simulated four year period, HOWEVER, the strategy that saved the most money - 58 billion dollars a YEAR, was reducing calories just by 100 - per person.  The researchers isolated this to model a population at a certain physical activity level at 100 cals a day less than usual without changing anything else.  So, many people eat 2000 cals a day (or much more) and instead they were projected to eat 1900 - every day.  This strategy reduced the number of overweight and obese Americans by 71million (58 billion dollars saved).  The sodium and fat calculations only reduced medical expenditures by  2.3 and 2 billion dollars, respectively (per year).  Thus it was concluded that the focus should be on getting people to eat less calories.   When the research model calculated a 500 calorie decrease, perhaps 1500 calories a day - the model predicted that nearly all of US adults would be in the normal weight category in four years!  
That brings us back to Swinburn's article which suggested that Americans are consuming and extra 500 calories since the 1980s and that the extra is equal to a fast food burger (intake) or two hours of extra walking (expenditure)!   

Now here is the formula for estimated energy requirement - male and female - though you have to plug in some of your own values and you MUST do the math according to the rules of operations or whatever it is called when you have to do it in a very specific order to get the right answer (Melanie - you can ALWAYS comment on these posts on the website :)) 

EER=
[662-(9.53 x age)] + [PAL x (15.91 X weightkg)] + (539.6 x heightm )  
for males 


[354-(6.91 x age)] +[PAL x (9.36 X weightkg)]+ (726 x heightm ) for females


choose a PAL here

sedentary 1- 1.4
low active 1.4-1.6
active 1.6-1.9
very active 1.9 - 2.5
or
low 1.4 - 1.69
moderate 1.7-1.99
high 2-2.4

You can use this link to convert your weight and height to kg and meters. 

When I did it for myself it came to just over 1800 calories - I usually eat 1600-1800 depending on my activity levels - so I think it was pretty accurate. 

Plane Ponderings

In the air again - I have these two things to share from my travel to Florida today..

I was able to get the aisle seat on both flights and on the first flight, I shared the row with two men. The man in the middle was overweight and he was telling the man at the window about the seats being "skinny" now a days. In fact, people are bigger, but anyways that is the conversation they had.

As the flight progressed, I was editing a paper that I have been working on 'for months'.  It is nearly complete and I was reviewing the latest version.  The paper gives an overview of the new labeling law and the IOMs work on front of pack labeling.  It also explains the importance of dietary factors in obesity prevention and the need for us to limit calories.  The same things that you guys know I have been researching and summarizing for most of the summer.

The gentleman that had complained about the seats not being big enough asked me if I were a teacher - and was I grading papers.  I said no, that I was a student and this was my paper.  He said, "do you mind if I ask what it's about?"  DEAR ME - ha. I gave the briefest overview and then he went on to tell me about not getting enough exercise since he retired and gaining so much weight (I would not expect that he was much over age 50 - so I am not sure why he retired).  The irony is that this and most of my papers are about the need to actually EAT LESS not move more.... but I didn't go there with my row mate.  Later he told the window seat guy that he was going to eat buckets full of crawdads and such when he got to New Orleans.

On the second leg of my journey, I read a letter to the editor in USA Today.  The writer of the letter was upset that service men (military) were not given priority boarding for air travel. He stated feeling horrible about walking past the men or women in uniform while he went on to his first class or whatever special seat he had.  If you recall, I opt to wait until the last zone is called and then get at the back of the line.  I think that service persons should fly free, first class, and without any fees whatsoever - but I think they should be given the privilege to board at the absolute last minute and get off at the very first!   


Wasn't it just this past weekend that another study came out that indicated an increased risk of deadly blood clots from too much time spent sitting?

 

National Prevention Strategy

The National Prevention Strategy which is the product of the National Prevention Council is about 122 pages in length.  It is a result of the Patient Protection and Affordable Care Act (PPACA) which aims to create a Healthy Fit Nation.  It is a plan for Better Health and Wellness.  The chair person is the US Surgeon General and one of the members of the council is the ever popular Robert Gates.

Though I have begun reading it in full after viewing the pages most relevant to me, I do not plan to bore you with a long overview when I am done.

I do want to tell you a few things about it and if you want to get the full document you can. I think that the section that discusses the key indicators  is one of the better parts.  It shows you the issue, the baseline measure, where the data on the issue is found (what method they use to get the rate of cancer, for incidence), the current number or marker for that issue, where they want to take that number and the length of time in which they hope to do it. The NPS is a 20 year strategy but they have ten year targets.  The indicator list with the baseline and target info begins on page 52 of the document which you can explore here.

The council members include the heads of all the big federal departments.  Naturally it includes Health and Human Services, but also Office of Management and Budget, Depts. of Transportation, Homeland Security, Defense, Agriculture and more. 

The program has 4 Directions and 7 Priorities - it is a whole lot more than an obesity prevention document.  It incorporates all areas because all areas impact our health and wellbeing.  The main goal is to increase the number of Americans that are healthy at all life stages.  So the number of children, young adults, mid adults and older adults that are healthy right now could be anywhere from 75 - 95 % and the plan is for each one to increase a few percentage points in ten years.

The NPS focuses on five diseases/conditions which make up 66% of all deaths.  They are the leading causes of death in the USA:  Cancer, Coronary Heart Disease (heart disease in general is the number one cause of death, but this is specifically CHD), Stroke, Unintentional Injury, Chronic Lower Respiratory Disease (like COPD and asthma)

The four Directions are:

• Healthy and Safe Community Environments:
• Clinical and Community Preventive Services:
• Empowered People:
• Elimination of Health Disparities:

And the seven Priorities:

• Tobacco Free Living
• Preventing Drug Abuse and Excessive Alcohol Use
• Healthy Eating
• Active Living
• Injury and Violence Free Living
• Reproductive and Sexual Health
• Mental and Emotional Well-Being

Triple Threat

I was reading a commentary from 2009 written by the Senior VP of the Robert Wood Johnson Foundation. He said something important that I wanted to share:

"What we need is not more, expensive treatment; what we really need is less disease." 
- in Health Promotion Practice, April 2009 10 (2)

Time and again studies support that the preponderance of chronic disease, including cancer, is related to tobacco use, being overweight, not being physically active and being too sedentary.

For this reason I offer YOU the triple threat against disease:
1) do not smoke (or quit asap)
2) maintain a healthy weight (by eating low energy dense high nutrient foods -i.e. you can be skinny and unhealthy so just limiting your calories isn't enough)
3) get and stay active

normal weight, no tobacco, physical activity
 - triple threat against disease -

weight loss strategy

Of course that would get your attention!  Truth is  - I don't really focus on weight loss and certainly not diets - as they do not work.  Research backs me up on that one.  In order to maintain a low/healthy weight one must behave a certain way all the time.  The does not mean an end to all indulgence, but an acknowledgement that some things are indulgences and should be treated as such. 
Anyways, that is not the main topic of today.  Instead, I wanted to share something that I came across during some literature reviews this morning.  One article had a table of several studies that had been completed.  The studies were explained by number of participants, type of design, setting, outcomes etc.  In some instances, the program themes or lesson plans were listed.  It is there that I noticed this strategy - not the actual "how to" - but the category - ready?

"How to deal with food pushers" 

Now that IS a great topic for a future blog  - in the mean time - refrain from being one yourself :)