If I remember correctly, I had a dearth of information last week and now I have a bunch. So let us get right to the brief points for the week's end.
FSC: This stands for Fire Safe Cigarettes. Cigarette packs now carry these initials, and I hope none of you have a cigarette pack to check. I believe that most US packs have those initials, though another acronym is RIP as in Reduced Ignition Propensity. Nearly every state in the USA as well as Great Britain, Canada and Australia have passed legislation mandating the sale of fire safe cigarettes due to numbers of deaths associated with cigarette related fires. These smokes will go out if not actively "puffed" and most states have enacted the legislation, following the lead of NYC. (not all the laws are yet in effect)The cigarette is made by adding bands of extra paper, so that there are speed bumps if you will. That paper is attached with the adhesive, EVA (ethylene vinyl acetate) which when burned could be considered another one of the 4000+ toxic chemicals in tobacco smoke. When I was researching these cigarettes I saw a quote from a smoker. She was upset at the GOVERNMENT for using her as a guinea pig. Seriously, the government? The same entity that raises the price of cigarettes through taxes and works to ban smoking in every public place possible, YEAH, that's right - they are the ones trying to kill you.
Braccinalysis: Or some such analysis. I heard a commercial that preys on the fears of women. It suggested that women take the genetic test for the breast cancer gene. In the commercial, I woman claims that she had the test, has the gene and is now going to do the things that can prevent breast cancer - right - like before the test she figured what the hell, it couldn't happen to her so why use preventative measures. (?)
Sweets and Baked Good: A story came out this week regarding how foods high in sugar and TFAs are especially associated with stroke in women over 50. I found this very disturbing because I work with two women over age 50 who eat significant amounts of foods like those. Ironically, we had some high sugar, mega calorie, trans fat laden danish in the office this past week and those two women were the one's eating them. My point to a coworker was that I sincerely believe that if those danish had not been in the office, those women would not have eaten them. Just as much as we have to make healthy food "present" we have to make unhealthy food "absent". Yes yes everything in moderation - what a bunch of bologna - guess you can have a stroke in moderation too.
Move More and Live: Just to note that a study I mentioned previously keeps getting press. That is the need to NOT sit at one's desk all day - or couch - or car, etc. Being sedentary for hours, even in very active people, can increase the chances for any kind of death - or as the researchers say - all cause mortality. This basically means that looking at comparison groups of any age - say over a ten year period, finds that the ones who sit down more, have higher rates of death from any cause than those who get up and move around every hour or so.
Interval Training: Which brings me to my concern about another headline. This one, out this week, is telling the public that have very intense exercise sessions are more effective for health than the everyday 60 minute activity at low intensity. In the news, scientists say that we have known this for years, and that it is a form of athletic training, meaning athletes train this way. Heretofore, experts have been afraid to tell "normal" people to do this as they may not be fit enough to handle the demand. Well, I just want to say two things, well three. Of course, pushing the body hard will improve oxygen capacity and ability, but athletes do intense activity like that MOST days of the week and lastly, I have read countless articles about this and none of them say how many intense sessions should be done a week. Of course, I see that I can challenge my body and reach new goals if I add more intensity, but I am not going to take my six or seven hours a week and drop it down to two - esp. because of the previous blurb and I am afraid that the headline alone could reduce total exercise hours in persons who need it the most -as many sedentary people are on the lookout for short cuts!
Pizza Trickery: I love pizza. I am also on the lookout for healthier versions and often buy regular or "low calorie" options and then cut them into 100 calorie or so pieces. Well, usually the lean cuisine or healthy choice versions have about 300 calories each whole pizza. Today I saw another brand that was in the same size box with very big print saying 200 Calorie. Wow I thought, I could just cut that in two instead of three or four, meaning BIGGER and YEAH! But when I took it from the freezer and looked closer the label really said 200 calorie portions, portions per package - two. So instead of being 100 calories less than what I usually buy it was 100 calories more - so trickery.
Goals and Evals: OK, gonna save this one for tomorrow and elaborate.
Sweet Bay: Ah, just today I heard this commercial that completely validated Dr. Epstien's research that I noted yesterday. It was a commercial that was a fake call in radio show where people were talking about things that the bought at Sweet Bay that were so price friendly - the last one ended with the caller saying, "With the money my wife saved we can buy more super chunk chocolate ice cream." To be fair, I just finished having ice cream, but it was not so fattening :)
Tomorrow then...
Making the latest health and wellness recommendations understandable, relevant, and possible.
Sunday, February 28, 2010
Saturday, February 27, 2010
A Case for a Junk Food Tax
I, personally, do not need to read any one's research to convince me that raising the price on soda and sweets is a good idea. I enjoyed the economic scenario that was presented some time back by the NY Department of Health and appreciated that the tax, if nothing else, would be a great source of revenue. And YES it sounds like the cigarette tax because it is the same type of thing. Of course, like cigarettes, the first few years of the tax will bring in the most money, so good for the budget, but at the same time and over time, the result could be less money spent on those non nutritive items and ideally, obesity rates would decline.
But this week, there was another bit of news about the issue. A researcher from the University of Buffalo, Dr. Leonard Epstein, has completed at least a little experiment, but I am not finding any publication. Some of the major news outlets reported on it, but the University website does not have anything. (I did see that Dr. Epstein had a lot of published work regarding both obesity and tobacco. And he created the basis for the GoSlowWhoa programs, which I think are awesome)
Anyway, he and I imagine some of his research students, set up a very small study of 42 women who went "virtual" shopping. The stores they set up had pictures of items, not real items. They were given budgets and told to shop for the week as if there were no food at home. The grocery stores were then set up in a few different ways. One had the items all priced at current retail costs. In other words, the junk food cost what it cost and so did the healthier items, fruits, vegetables, yogurt, sugar free beverages, etc. Another scenario had the junk food prices the same as usual but the healthier items cheaper and another had the healthier items constant but the junk food items MORE. Only in the last scenario did the researchers see a change in behavior for the better. It appeared that when the shoppers saved money on the healthier food items, they used the extra cash to buy more junk food. (WHAT?!)
This is not a conclusive case for raising the junk food tax, but an interesting little study none the less.
But this week, there was another bit of news about the issue. A researcher from the University of Buffalo, Dr. Leonard Epstein, has completed at least a little experiment, but I am not finding any publication. Some of the major news outlets reported on it, but the University website does not have anything. (I did see that Dr. Epstein had a lot of published work regarding both obesity and tobacco. And he created the basis for the GoSlowWhoa programs, which I think are awesome)
Anyway, he and I imagine some of his research students, set up a very small study of 42 women who went "virtual" shopping. The stores they set up had pictures of items, not real items. They were given budgets and told to shop for the week as if there were no food at home. The grocery stores were then set up in a few different ways. One had the items all priced at current retail costs. In other words, the junk food cost what it cost and so did the healthier items, fruits, vegetables, yogurt, sugar free beverages, etc. Another scenario had the junk food prices the same as usual but the healthier items cheaper and another had the healthier items constant but the junk food items MORE. Only in the last scenario did the researchers see a change in behavior for the better. It appeared that when the shoppers saved money on the healthier food items, they used the extra cash to buy more junk food. (WHAT?!)
This is not a conclusive case for raising the junk food tax, but an interesting little study none the less.
Friday, February 26, 2010
Mandatory Health Insurance
I do no follow every word of the health care debate, nor do I know the intricacies of the proposals. I probably hear as much as you do and I try my best to stay away from the vitriol.
I can tell you that the system is not okay and that I'd rather they do something than nothing. I sense that there is much waste and that addressing it, (billing fraud, entitlement fraud and abuse, polypharmacy and unnecessary pharmacy, vanity drugs and procedures, and treatment spent on preventable conditions) would probably give us the money we need to expand coverage and care.
But unequivocally I believe that health insurance should be mandatory. I was reminded of my belief when a certain Congressman was speaking on CSPAN last night. I do not recall who he was or where he was from, except it wasn't Florida because I remember looking to see. Anyway, this person implied that forcing people to have health insurance coverage was not at all like forcing them to have car insurance. He said that if individual states, like MA decided to do it that was fine, but a federal program was an invasion of privacy. He said that people had a right NOT to have the insurance. Well, I say NO they don't. I know those of you who are healthy as a horse do not think you should pay for something that you do not need today. I understand that your plan is to pay for your health care on an as needed basis, but the ability of REAL people to do that, just doesn't exist. Of course, because there is great health disparity in the USA (and most countries) the people who need the most care have the least money. (and yes, many smokers are in that category, which is why tobacco should be outlawed, but I digress)
My counterpoint to the Congressman is more simple than that. He said that people should not be mandated to have health insurance - but that only works if the health care force can refuse to treat, and they can't. SO it is not American to mandate coverage, but it is American to mandate care. When people are in a health crisis, they CAN NOT be turned away - they will be treated and that means EVERYBODY will pay more for health care,. Those with health insurance will continue to cover that care in sky rocketing premiums, and all of us will see higher taxes. (i.e. we are already paying!) Not having health insurance is sort of like shop lifting . When someone takes without paying, the ones who do pay, pay more. It is not an acceptable option.
I do like the idea of insurance pools, interstate coverage and all that jazz - it absolutely should be like car insurance however, as Medicaid and Medicare are sorely lacking in reach and oversight.
PS a second "hey wait a minute" political moment occurred this morning when a radio show was discussing passage of the jobs bill, I think. The point was that the politicians worked together and something was passed. But that was not how the guest referred to this positive outcome, no, he noted that one of the sides "defected". Since when is working together to solve the worlds problems an act of treason?
I can tell you that the system is not okay and that I'd rather they do something than nothing. I sense that there is much waste and that addressing it, (billing fraud, entitlement fraud and abuse, polypharmacy and unnecessary pharmacy, vanity drugs and procedures, and treatment spent on preventable conditions) would probably give us the money we need to expand coverage and care.
But unequivocally I believe that health insurance should be mandatory. I was reminded of my belief when a certain Congressman was speaking on CSPAN last night. I do not recall who he was or where he was from, except it wasn't Florida because I remember looking to see. Anyway, this person implied that forcing people to have health insurance coverage was not at all like forcing them to have car insurance. He said that if individual states, like MA decided to do it that was fine, but a federal program was an invasion of privacy. He said that people had a right NOT to have the insurance. Well, I say NO they don't. I know those of you who are healthy as a horse do not think you should pay for something that you do not need today. I understand that your plan is to pay for your health care on an as needed basis, but the ability of REAL people to do that, just doesn't exist. Of course, because there is great health disparity in the USA (and most countries) the people who need the most care have the least money. (and yes, many smokers are in that category, which is why tobacco should be outlawed, but I digress)
My counterpoint to the Congressman is more simple than that. He said that people should not be mandated to have health insurance - but that only works if the health care force can refuse to treat, and they can't. SO it is not American to mandate coverage, but it is American to mandate care. When people are in a health crisis, they CAN NOT be turned away - they will be treated and that means EVERYBODY will pay more for health care,. Those with health insurance will continue to cover that care in sky rocketing premiums, and all of us will see higher taxes. (i.e. we are already paying!) Not having health insurance is sort of like shop lifting . When someone takes without paying, the ones who do pay, pay more. It is not an acceptable option.
I do like the idea of insurance pools, interstate coverage and all that jazz - it absolutely should be like car insurance however, as Medicaid and Medicare are sorely lacking in reach and oversight.
PS a second "hey wait a minute" political moment occurred this morning when a radio show was discussing passage of the jobs bill, I think. The point was that the politicians worked together and something was passed. But that was not how the guest referred to this positive outcome, no, he noted that one of the sides "defected". Since when is working together to solve the worlds problems an act of treason?
Thursday, February 25, 2010
Medicine
My plan for tonight's blog does not seem to be materializing. I could use some of my ideas that I have for later in the week, or expand one of the Odds and Ends I have put aside, but I am pretty stubborn that way- and don't want to do that.
So I will explain where I was going to go with today's post first, then I will mention the article I was going to blog about before I had that "brilliant" idea that didn't pan out.. And THEN I will just call it a day.
I came across a term teaching a class last night and the meaning escaped me - which bothered me. The word was anxiolytic. It got me thinking about analgesics, antibiotics, anti inflammatories, diuretics,psychotropics, anesthetics, antiemetics etc . I know analgesics reduce pain but I couldn't for the life of me recall what an anxiolytic did. It is an anti anxiety medication or chemical - duh, but we always call them that -anti anxiety drugs- not anxiolytics. I was hoping to find a list of drugs by their scientific names and then to describe them all, but that list doesn't really exist. Surely there is a fancy name for a fever reducing drug, but I couldn't find it. Just to be thorough, since I did mention a few- I will explain them. The first is a pain reliever, the second fights bacterial infections, the next, inflammation, diuretics are fluid pills, psychotropics are drugs that can affect ones mood, anesthetics reduce consciousness and antiemetics are anti vomit medications.
So that's all I have for that thought.
Yesterday I was intrigued by a brief story regarding Medco which is a pharmacy benefits management company. In other words, a health insurance company might use Medco to review and determine what medications are on the formulary and what copayments apply to them. Medco was the company that first reported a drug interaction between a proton pump inhibitor and plavix. The company CEO has stated that they are going to spend more resources - staff and money - on independent research in the coming year. I know a lot of people get upset about benefits managers telling us which drugs we should take, especially because all those commercials we see make the newest drugs appear to be the best, but I for one am GRATEFUL for comparative research, and if it saves money that is all the much better because the country's insurance premiums seem to rise in unison.
So I will explain where I was going to go with today's post first, then I will mention the article I was going to blog about before I had that "brilliant" idea that didn't pan out.. And THEN I will just call it a day.
I came across a term teaching a class last night and the meaning escaped me - which bothered me. The word was anxiolytic. It got me thinking about analgesics, antibiotics, anti inflammatories, diuretics,psychotropics, anesthetics, antiemetics etc . I know analgesics reduce pain but I couldn't for the life of me recall what an anxiolytic did. It is an anti anxiety medication or chemical - duh, but we always call them that -anti anxiety drugs- not anxiolytics. I was hoping to find a list of drugs by their scientific names and then to describe them all, but that list doesn't really exist. Surely there is a fancy name for a fever reducing drug, but I couldn't find it. Just to be thorough, since I did mention a few- I will explain them. The first is a pain reliever, the second fights bacterial infections, the next, inflammation, diuretics are fluid pills, psychotropics are drugs that can affect ones mood, anesthetics reduce consciousness and antiemetics are anti vomit medications.
So that's all I have for that thought.
Yesterday I was intrigued by a brief story regarding Medco which is a pharmacy benefits management company. In other words, a health insurance company might use Medco to review and determine what medications are on the formulary and what copayments apply to them. Medco was the company that first reported a drug interaction between a proton pump inhibitor and plavix. The company CEO has stated that they are going to spend more resources - staff and money - on independent research in the coming year. I know a lot of people get upset about benefits managers telling us which drugs we should take, especially because all those commercials we see make the newest drugs appear to be the best, but I for one am GRATEFUL for comparative research, and if it saves money that is all the much better because the country's insurance premiums seem to rise in unison.
Wednesday, February 24, 2010
Peri WHO?
It is still Heart Health Month in America, so I will take advantage of some political news to discuss a heart condition that has not yet been discussed in my blog . That should be a clue that I am not going to talk about Clinton or Chaney. As they both have heart disease conditions that are often related to genetics, environment and lifestyle.
The politician I am referring to today, is Umaru Yar’Adua, the president of Nigeria, who has not been presiding, if you will, due to being hospitalized for treatment of his pericarditis.
This is a condition that involves the protective sac that surrounds the heart. This area is called the pericardium. In medical terms, the ending of words often indicates the type of disease process. Like alga (pain) and osis (increase in) and itis (inflammation). So a person who has pericarditis has inflammation of the sac that surrounds the heart. The redness and swelling occurs because of rubbing in the pericardium.
There are a few diseases that cause the pericardial inflammation, so that pericarditis is usually a symptom of another illness. Doctor's will of course treat the inflammation, which is usually painful and the person may feel a sharp pain when breathing or less often, like pressure on the chest. Lying down makes it worse. Medications are used and tests are run to make a diagnosis. Other symptoms include swelling in the lower limbs, coughing, being tired and having a fever. This condition may be diagnosed as a heart attack and vice versa. After comforting the patient, the goal is to cure or treat the underlying problem. The cause of pericarditis is not always discovered, however.
Ironically, today was another day for observing differences. In America, one of the most popular or most interviewed medical experts is Sanjay Gupta, a neurosurgeon who is also a reporter for CNN. Oh, you might recognize the name as he was once considered for nomination to US Surgeon General - which he declined. Anyways - I heard the story about Nigeria's ill president on the BBC World News, and they had their own doctor to interview.
He did say that kidney disease could be a cause as could infection, such as TB or tuberculosis. Oh there is another ONE, osis - meaning an increase in something or even an invasion of something, like a parasite. The British physician also noted systemic diseases like rheumatoid arthritis and recent heart attack as possible triggers for this condition. Pericarditis is considered a chronic condition if it lasts more than six months. It can also become more serious if it leads to excess fluid in the pericardium as this pressure on the heart can make surgery necessary.
At last word, the cause of the Nigerian President's case was unknown.
This is a condition that does not appear related to eating too much or exercising too little, or even smoking! However, if a person with this condition is overweight, inactive or smokes, I bet that would be addressed in treatment!
The politician I am referring to today, is Umaru Yar’Adua, the president of Nigeria, who has not been presiding, if you will, due to being hospitalized for treatment of his pericarditis.
This is a condition that involves the protective sac that surrounds the heart. This area is called the pericardium. In medical terms, the ending of words often indicates the type of disease process. Like alga (pain) and osis (increase in) and itis (inflammation). So a person who has pericarditis has inflammation of the sac that surrounds the heart. The redness and swelling occurs because of rubbing in the pericardium.
There are a few diseases that cause the pericardial inflammation, so that pericarditis is usually a symptom of another illness. Doctor's will of course treat the inflammation, which is usually painful and the person may feel a sharp pain when breathing or less often, like pressure on the chest. Lying down makes it worse. Medications are used and tests are run to make a diagnosis. Other symptoms include swelling in the lower limbs, coughing, being tired and having a fever. This condition may be diagnosed as a heart attack and vice versa. After comforting the patient, the goal is to cure or treat the underlying problem. The cause of pericarditis is not always discovered, however.
Ironically, today was another day for observing differences. In America, one of the most popular or most interviewed medical experts is Sanjay Gupta, a neurosurgeon who is also a reporter for CNN. Oh, you might recognize the name as he was once considered for nomination to US Surgeon General - which he declined. Anyways - I heard the story about Nigeria's ill president on the BBC World News, and they had their own doctor to interview.
He did say that kidney disease could be a cause as could infection, such as TB or tuberculosis. Oh there is another ONE, osis - meaning an increase in something or even an invasion of something, like a parasite. The British physician also noted systemic diseases like rheumatoid arthritis and recent heart attack as possible triggers for this condition. Pericarditis is considered a chronic condition if it lasts more than six months. It can also become more serious if it leads to excess fluid in the pericardium as this pressure on the heart can make surgery necessary.
At last word, the cause of the Nigerian President's case was unknown.
This is a condition that does not appear related to eating too much or exercising too little, or even smoking! However, if a person with this condition is overweight, inactive or smokes, I bet that would be addressed in treatment!
Tuesday, February 23, 2010
Whose Responsibility Is It?
It is interesting to read the news of how countries besides my own (USA) deal with public health issues. This time it is Scotland. I caught a talk show last night that was responding to some recommendations that the Scottish National Party had released. I also found a newspaper story on line regarding the same issue.
The ideas and responses are familiar. Limit high calorie foods, especially fats and sugars, and pay attention to schools and the stores that are near to them. Limit the serving size of foods and put nutrition information on labels . Make those labels easy to understand.
The grocery and retail industries of Scotland responded with assertions that they are already doing these things voluntarily and that it should continue this way. One even said that the ideas from the government were NEVER going to get passed or followed because the companies that make the foods, all over the world, are not going to participate. Of course, there is more than one political party in Scotland, so getting them to agree on legislation aimed at reducing obesity will probably go as well as the USAs attempt to reform health care.
Before I point out a few things that caught my attention, let me tell you the broader goals of the SNP and why the Health Minister published the report.
First - the extent of the problem. Recall a recent blog that noted Mexico as having a higher rate of obesity than the USA - in Scotland, the word is that the only countries with worse weight problems are the USA and Mexico. In fact, the fear is that over 40% of adults will be obese in twenty years. It appears that about 20% or 150,000 Scottish children are currently obese.
Second - the proposal. Reduce calories consumed, increase physical activity, improve "behavior" at work, and target children early.
Now two or three things from me in response to what I heard and read.
When the counter argument is that the change has to be at the individual level by individual free will and choice, it is couched in the term "individual responsibility." I agree, but when the individual is NOT responsible than who is? Who pays for and suffers the consequences for the explosion of illness associated with being overweight and obese? Society (fat and not fat) does. [same as all society pays for tobacco illness] If the behavior affects the government (which is there to protect the people) then the government not only has a right to intervene, but a responsibility to do so.
The Health Minister of Scotland is Shona Robison, and she was quoted in press (Times Online-2/22/10) as saying that NO country had been able to get a handle on obesity and that Scotland needed to. She referred to the environment and how it actually encourages and promotes over consumption and makes weight gain almost "inevitable". To this I say what is becoming a Deirdre-ism, but true is true. We have got to make maintaining a health promoting weight socially possible and sometimes that requires legislation.
That does bring me to the one point I unequivocally disagreed with in the government's proposals. The idea of using expanded labels with the additional information of how much of a certain activity, like walking, would be needed to burn the amount of calories a person consumed in whatever product they were about to eat. It is not that kind of simple. I think they would be wise instead to educate, and yes, start with kids, on calories, nutrition and the body. If not, they are going to have to have three page labels explaining how variant and multi factorial the burning of calories can be.
You guys have it easy! Just use the many websites I have thrown at you over the last year!
The ideas and responses are familiar. Limit high calorie foods, especially fats and sugars, and pay attention to schools and the stores that are near to them. Limit the serving size of foods and put nutrition information on labels . Make those labels easy to understand.
The grocery and retail industries of Scotland responded with assertions that they are already doing these things voluntarily and that it should continue this way. One even said that the ideas from the government were NEVER going to get passed or followed because the companies that make the foods, all over the world, are not going to participate. Of course, there is more than one political party in Scotland, so getting them to agree on legislation aimed at reducing obesity will probably go as well as the USAs attempt to reform health care.
Before I point out a few things that caught my attention, let me tell you the broader goals of the SNP and why the Health Minister published the report.
First - the extent of the problem. Recall a recent blog that noted Mexico as having a higher rate of obesity than the USA - in Scotland, the word is that the only countries with worse weight problems are the USA and Mexico. In fact, the fear is that over 40% of adults will be obese in twenty years. It appears that about 20% or 150,000 Scottish children are currently obese.
Second - the proposal. Reduce calories consumed, increase physical activity, improve "behavior" at work, and target children early.
Now two or three things from me in response to what I heard and read.
When the counter argument is that the change has to be at the individual level by individual free will and choice, it is couched in the term "individual responsibility." I agree, but when the individual is NOT responsible than who is? Who pays for and suffers the consequences for the explosion of illness associated with being overweight and obese? Society (fat and not fat) does. [same as all society pays for tobacco illness] If the behavior affects the government (which is there to protect the people) then the government not only has a right to intervene, but a responsibility to do so.
The Health Minister of Scotland is Shona Robison, and she was quoted in press (Times Online-2/22/10) as saying that NO country had been able to get a handle on obesity and that Scotland needed to. She referred to the environment and how it actually encourages and promotes over consumption and makes weight gain almost "inevitable". To this I say what is becoming a Deirdre-ism, but true is true. We have got to make maintaining a health promoting weight socially possible and sometimes that requires legislation.
That does bring me to the one point I unequivocally disagreed with in the government's proposals. The idea of using expanded labels with the additional information of how much of a certain activity, like walking, would be needed to burn the amount of calories a person consumed in whatever product they were about to eat. It is not that kind of simple. I think they would be wise instead to educate, and yes, start with kids, on calories, nutrition and the body. If not, they are going to have to have three page labels explaining how variant and multi factorial the burning of calories can be.
You guys have it easy! Just use the many websites I have thrown at you over the last year!
Monday, February 22, 2010
The Biggest Loser is Often Not the Smartest Loser
I scanned over some negative press last night regarding the TV show, The Biggest Loser. The arguments made against the program were ones that made perfect sense to me. Some of the following points were in the news piece though I added things that I have learned through various workshops and research studies, as well.
First the TV show is NOT real life! Very few of us can put our jobs, families and other commitments on hold and dedicate full days every day for weeks or months to engage in such a rigorous program. Second, the TV show ends, but the struggle to maintain a health promoting weight does not. Third, the competition is more likely to have a negative psychological impact on the "contestants" than a positive one. And I don't know about you, but when something upsets my psyche I am hard pressed to engage in positive coping skills - and if you are new to a behavior, the relapse potential is at least orange, if not RED. (I.e. high or severe threat!)
Then there is the science behind weight loss and physical activity. Losing weight fast can cause health complications, including gall bladder problems and anemia. Going from being sedentary to engaging in vigorous physical activity most days of the week for hours at a time, can and probably will lead to muscle and joint injury. It is also a good way to get someone to hate exercise.
The real weight loss winners are the ones who work with a physician and dietitian to determine the right caloric intake for them and then to follow the guidelines of health experts. For instance, Canada has this food guide for its citizens to follow. And the USA has this one. I promote Dr. Walter Willett and Dr. Barabara Rolls, as well as the Cooper Institute. I am perfectly comfortable with both the DHHS Nutrition and Physical Activity Guidelines. Oh and the website for Australians is especially colorful. You get the idea. There is a lot of evidenced based information out there that you can access and apply to your own life. And as I like to say in my own classes - this stuff only works if YOU WORK IT!
Do set goals - reasonable, achievable, smart - do engage in physical activity and do get support from friends. Health challenges are GREAT - nationally broadcast competitions, not so smart.
First the TV show is NOT real life! Very few of us can put our jobs, families and other commitments on hold and dedicate full days every day for weeks or months to engage in such a rigorous program. Second, the TV show ends, but the struggle to maintain a health promoting weight does not. Third, the competition is more likely to have a negative psychological impact on the "contestants" than a positive one. And I don't know about you, but when something upsets my psyche I am hard pressed to engage in positive coping skills - and if you are new to a behavior, the relapse potential is at least orange, if not RED. (I.e. high or severe threat!)
Then there is the science behind weight loss and physical activity. Losing weight fast can cause health complications, including gall bladder problems and anemia. Going from being sedentary to engaging in vigorous physical activity most days of the week for hours at a time, can and probably will lead to muscle and joint injury. It is also a good way to get someone to hate exercise.
The real weight loss winners are the ones who work with a physician and dietitian to determine the right caloric intake for them and then to follow the guidelines of health experts. For instance, Canada has this food guide for its citizens to follow. And the USA has this one. I promote Dr. Walter Willett and Dr. Barabara Rolls, as well as the Cooper Institute. I am perfectly comfortable with both the DHHS Nutrition and Physical Activity Guidelines. Oh and the website for Australians is especially colorful. You get the idea. There is a lot of evidenced based information out there that you can access and apply to your own life. And as I like to say in my own classes - this stuff only works if YOU WORK IT!
Do set goals - reasonable, achievable, smart - do engage in physical activity and do get support from friends. Health challenges are GREAT - nationally broadcast competitions, not so smart.
Sunday, February 21, 2010
Odds and Ends
Fitness Facility Injuries: This first note is not exactly what I wanted it to be. I just spent my dinner time (I was eating) searching for an article that was referenced in a story only to find it was a book, not a journal and I cannot get my eyes on it. Really sucks. I read an article in an ACSM journal about law suits and treadmills. In that article it said that treadmill injuries were the fifth most common health club liability claim. I do not have access to the full list, but I sure wanted to see what the top four were. When I try to Google - injuries-, I get mistakes instead. Of course, not warming up and using improper form were noted. I am very curious about the other claims, maybe I can find the book at the library. Of note, I imagine some injuries happen on the other cardio equipment, the weight training machines and with free weights, in cycling and in step aerobics class - in fact, someone fell in my class last week!
Health Insurance Commercials: I have been noticing health insurance commercials recently - advertisements for private insurance that shows the premiums one might have to pay based on age, gender and such. The commercials show three or more examples and I noticed that above the sentence, woman age 45 (ex.) it says in lighter letters, "tobacco free". I work in tobacco education as my career and I knew that tobacco users paid more than non users, but really hadn't seen that distinction in an ad. To me, that proves more than anything that tobacco causes disease!
Chesticles and Shrinkage: I really wish I could remember which show or commentator or host made this statement as they should get the credit for this, but I cannot. Of course, I have been vocal about the negatives of using supplements, protein powders, growth hormones, performance enhancing drugs and steroids. We have almost all heard of roid rage - so we know that steroids are not without significant risks. What I heard someone else say this week was that steroid use also led to chesticles which I will leave you to imagine and that steroids also shrink a man's testicles. I found that ironic of course, especially because some men I see who are really , I mean REALLY, bulked up, walk like they have some significant um, hardware, between their legs. ( I'm just saying......)
More Drug Company Shame: News is out that the company that makes diabetes drug Avandia, the one with the warning label for cardiovascular risk, knew about the risks long before disclosing it and in fact, continued to conduct clinical research trials to compare it to another drug that was safer - even when subjects were suffering the consequences.
Most Important Statement of the Week: After Bill Clinton underwent a second procedure in regards to his heart disease, he said that he was going to be more "disciplined about exercising every day."
Health Insurance Commercials: I have been noticing health insurance commercials recently - advertisements for private insurance that shows the premiums one might have to pay based on age, gender and such. The commercials show three or more examples and I noticed that above the sentence, woman age 45 (ex.) it says in lighter letters, "tobacco free". I work in tobacco education as my career and I knew that tobacco users paid more than non users, but really hadn't seen that distinction in an ad. To me, that proves more than anything that tobacco causes disease!
Chesticles and Shrinkage: I really wish I could remember which show or commentator or host made this statement as they should get the credit for this, but I cannot. Of course, I have been vocal about the negatives of using supplements, protein powders, growth hormones, performance enhancing drugs and steroids. We have almost all heard of roid rage - so we know that steroids are not without significant risks. What I heard someone else say this week was that steroid use also led to chesticles which I will leave you to imagine and that steroids also shrink a man's testicles. I found that ironic of course, especially because some men I see who are really , I mean REALLY, bulked up, walk like they have some significant um, hardware, between their legs. ( I'm just saying......)
More Drug Company Shame: News is out that the company that makes diabetes drug Avandia, the one with the warning label for cardiovascular risk, knew about the risks long before disclosing it and in fact, continued to conduct clinical research trials to compare it to another drug that was safer - even when subjects were suffering the consequences.
Most Important Statement of the Week: After Bill Clinton underwent a second procedure in regards to his heart disease, he said that he was going to be more "disciplined about exercising every day."
Saturday, February 20, 2010
Making Group Think Your Think
I have increasingly less patience with magazines that like to quote research. One reason is that the stories seldom delve beyond the headlines and thus don't really tell you what, if anything, the research should mean to you and the other is that the research is often old news or worse, disproved old news.
In a magazine I read through today there was mention of several studies, all small and all by the same researcher, regarding the influence of persons with high levels of self control. The study author, Michelle vanDellen, PhD, contends that people who witness others exhibiting self control or think about persons they know who have high levels of self control, will then exhibit this same self control during testing. For this study, my thought was, AND THEN??? What about when the other person is not around or you are no longer thinking about them?
Dr. vanDellen's study reminds me of other studies that came out last year. These studies indicated that people seemed to model the behavior of their friends and coworkers in regards to maintaining healthy weights, exercising regularly, quitting smoking and eating less junk food.
This sort of group behavior works the opposite way as well.
I do not need a research study to convince me that people who work together can become healthy together - my coworkers are proof. The study I would like to see regards what it might take to get people to INTERNALIZE the self control they witness. How does one go from doing something because their coworker does it, to doing it because it is what they truly want to do?
There are plenty of behavior theories that could explain the process. The ones that make the most sense have to do with whether or not the behavior witnessed is one that the other person feels capable of doing, if that behavior is seen as capable (effective) of providing the desired result(change), if that result is indeed desirable to the person who is trying it, the perception of reward, benefit or satisfaction the doer gets from the new behavior and the response of others when the person does it.
Health educators try to provide role models who are like the target audience so that people see people JUST LIKE THEM doing the desired activity. Health educators also try to show behaviors that are easy, possible, and repeatable. The behavior should also have some immediate positive association. It is hard to make exercise addictive because the pay off doesn't come immediately, but a payoff can be a sense of accomplishment or the verbal praise someone receives from completing an activity.
My coworkers do a really good job of adopting health promoting behaviors, some of them are more consistent than others. The consistent ones, those are the ones we need to study and emulate - not me, I am beyond consistent, a little less driven is better but some drive IS needed. So yes, group influence is great, but only if it's positive and only if it can be internalized.
Sadly, it seems like we are more likely to internalize the "all you can eat" mentality than the " I need to exercise every day" one. :(
In a magazine I read through today there was mention of several studies, all small and all by the same researcher, regarding the influence of persons with high levels of self control. The study author, Michelle vanDellen, PhD, contends that people who witness others exhibiting self control or think about persons they know who have high levels of self control, will then exhibit this same self control during testing. For this study, my thought was, AND THEN??? What about when the other person is not around or you are no longer thinking about them?
Dr. vanDellen's study reminds me of other studies that came out last year. These studies indicated that people seemed to model the behavior of their friends and coworkers in regards to maintaining healthy weights, exercising regularly, quitting smoking and eating less junk food.
This sort of group behavior works the opposite way as well.
I do not need a research study to convince me that people who work together can become healthy together - my coworkers are proof. The study I would like to see regards what it might take to get people to INTERNALIZE the self control they witness. How does one go from doing something because their coworker does it, to doing it because it is what they truly want to do?
There are plenty of behavior theories that could explain the process. The ones that make the most sense have to do with whether or not the behavior witnessed is one that the other person feels capable of doing, if that behavior is seen as capable (effective) of providing the desired result(change), if that result is indeed desirable to the person who is trying it, the perception of reward, benefit or satisfaction the doer gets from the new behavior and the response of others when the person does it.
Health educators try to provide role models who are like the target audience so that people see people JUST LIKE THEM doing the desired activity. Health educators also try to show behaviors that are easy, possible, and repeatable. The behavior should also have some immediate positive association. It is hard to make exercise addictive because the pay off doesn't come immediately, but a payoff can be a sense of accomplishment or the verbal praise someone receives from completing an activity.
My coworkers do a really good job of adopting health promoting behaviors, some of them are more consistent than others. The consistent ones, those are the ones we need to study and emulate - not me, I am beyond consistent, a little less driven is better but some drive IS needed. So yes, group influence is great, but only if it's positive and only if it can be internalized.
Sadly, it seems like we are more likely to internalize the "all you can eat" mentality than the " I need to exercise every day" one. :(
Friday, February 19, 2010
What is erythritol?
I would not know what this was if not for a soda I treated myself to and um, then poured out. But I am glad I tried it because now I also know more about sugar alcohol - and that is something I have been asked about in the past.
Sometimes when I am at a health food store called Richard's (which is really not so often) I will treat myself to one of their uniquely flavored calorie free sodas - which USUALLY have a sweetener considered natural. Recently I tried Blue Sky Free, Jamaican Ginger Ale. I thought it contained stevia, the sweetener made from a plant that is very expensive and is also fibrous. After I had a few sips I looked at the label and saw that the soda was pretty much ZERO everything except that it had 11g of erythritol. That turns out to be a sugar alcohol and one of the "better" ones -if you are a diabetic, anyways. It is also reported to not have an aftertaste and to not cause GI upset as some other sugar alcohols will do. I thought the soda was WAY sweet and icky - and I sadly, poured it out.
I do want to make an observation however - regarding erythritol and advertising, in a moment. First, erythritol may indeed be a good choice as a sweetener, with no known side effects in normal quantities and little to NO effect on blood sugar levels, even in diabetics. It does not cause an insulin response. It is virtually calorie free with only .2 cals per gram. It is not however, readily available. But when you see a caption about this or any product (because you can find it on line) that states "all natural and 100% pure" please remember that you need to read beyond that sentence! Some of our most deadly neurotoxins are also all natural and pure, that in and of itself, should not be why you consume something.
So about these sugar alcohols. With the exception of erythritol, most sugar alcohols do contain calories, but are still better for diabetics than sugar. They usually have half the calories per gram as sugar, but are still listed under carbohydrates on a nutrition label. They do have an effect on blood sugar for that reason, but it is minimal. Sugar alcohols break down much more slowly than sugar (glucose) and do not cause a blood sugar spike, like Twinkies. It is the spiking that usually triggers an insulin response, so sugar alcohols do not generally involve any insulin activity. The sweeteners that do NOT effect blood sugar at all are the artificial ones, like saccharin and aspartame and I imagine, sucralose (splenda). Lose indicates sugar where as tol indicates sugar alcohol. (there is no alcohol in sugar alcohols)
The main draw back with sugar alcohols is that they do cause gastrointestinal distress to a good many people if consumed in moderate quantities. The sugar alcohol in your sugar free gum isn't likely to hurt your belly, cause gas or diarrhea, but the amount in your sugar free ice cream may. That reminds me, apparently the sugar alcohols, erythritol included, do not cause tooth decay. Sugar alcohols are processed from plants and fruits and can occur naturally in foods.
Though this post talked about natural low calorie sweeteners and sugar alcohols, others I have written have discussed artificial sweeteners. In case you have not read those blogs, but are curious as to my thoughts - I use artificial sweeteners on a daily basis - sucralose, aspartame, even saccharin if that's what there is.
As I hope I have continued to make clear here, I am not a nutritionist, only an avid nutrition advocate. This post here from Yale-New Haven Hospital taught me alot of what I just shared with you and at the end of that post, the nutritionist(s) lists the names of some of the popular sugar alcohols.
Sometimes when I am at a health food store called Richard's (which is really not so often) I will treat myself to one of their uniquely flavored calorie free sodas - which USUALLY have a sweetener considered natural. Recently I tried Blue Sky Free, Jamaican Ginger Ale. I thought it contained stevia, the sweetener made from a plant that is very expensive and is also fibrous. After I had a few sips I looked at the label and saw that the soda was pretty much ZERO everything except that it had 11g of erythritol. That turns out to be a sugar alcohol and one of the "better" ones -if you are a diabetic, anyways. It is also reported to not have an aftertaste and to not cause GI upset as some other sugar alcohols will do. I thought the soda was WAY sweet and icky - and I sadly, poured it out.
I do want to make an observation however - regarding erythritol and advertising, in a moment. First, erythritol may indeed be a good choice as a sweetener, with no known side effects in normal quantities and little to NO effect on blood sugar levels, even in diabetics. It does not cause an insulin response. It is virtually calorie free with only .2 cals per gram. It is not however, readily available. But when you see a caption about this or any product (because you can find it on line) that states "all natural and 100% pure" please remember that you need to read beyond that sentence! Some of our most deadly neurotoxins are also all natural and pure, that in and of itself, should not be why you consume something.
So about these sugar alcohols. With the exception of erythritol, most sugar alcohols do contain calories, but are still better for diabetics than sugar. They usually have half the calories per gram as sugar, but are still listed under carbohydrates on a nutrition label. They do have an effect on blood sugar for that reason, but it is minimal. Sugar alcohols break down much more slowly than sugar (glucose) and do not cause a blood sugar spike, like Twinkies. It is the spiking that usually triggers an insulin response, so sugar alcohols do not generally involve any insulin activity. The sweeteners that do NOT effect blood sugar at all are the artificial ones, like saccharin and aspartame and I imagine, sucralose (splenda). Lose indicates sugar where as tol indicates sugar alcohol. (there is no alcohol in sugar alcohols)
The main draw back with sugar alcohols is that they do cause gastrointestinal distress to a good many people if consumed in moderate quantities. The sugar alcohol in your sugar free gum isn't likely to hurt your belly, cause gas or diarrhea, but the amount in your sugar free ice cream may. That reminds me, apparently the sugar alcohols, erythritol included, do not cause tooth decay. Sugar alcohols are processed from plants and fruits and can occur naturally in foods.
Though this post talked about natural low calorie sweeteners and sugar alcohols, others I have written have discussed artificial sweeteners. In case you have not read those blogs, but are curious as to my thoughts - I use artificial sweeteners on a daily basis - sucralose, aspartame, even saccharin if that's what there is.
As I hope I have continued to make clear here, I am not a nutritionist, only an avid nutrition advocate. This post here from Yale-New Haven Hospital taught me alot of what I just shared with you and at the end of that post, the nutritionist(s) lists the names of some of the popular sugar alcohols.
Thursday, February 18, 2010
When Maalox Isn't Maalox
When you do a good job at branding your product, it is a pretty good idea NOT to change it into something else. When I say Kleenex - you know I mean a tissue. When I say Saran Wrap - you do NOT think aluminum foil, you think plastic wrap.
So what do you think of when I say Maalox? Maybe that you need it if your stomach is burning a little and you are feeling bloated or gassy? YES? So Maalox is an antacid, like Tums and Rolaids - it is NOT something you take for diarrhea - right?? THAT would be Kaopectate. And it isn't what you take if you are vomiting - that is Emetrol.... So WHY did Novartis International which owns the brand, decide to make an anti-diarrhea medication called Maalox Total Relief?
Not sure, but the FDA just sent out a notice regarding several medical errors that have occurred because the liquid Maalox we reach for when we need an antacid is NOT this Maalox. In fact, it has an ingredient that is similar to aspirin that people with several conditions need to avoid. Seriously, if your stomach is burning - aspirin or its counterparts - not the best idea.
So be mindful - until the company changes the name of its product, because they will - Maalox Total Relief is for an upset stomach with diarrhea but only if you do not also take a blood thinner, have a history of ulcers or GERD, are a child who has recently had a viral infection, are someone taking medication to treat diabetes, OR someone who is taking an anti inflammatory (think ibuprofen). So I am wondering if Kaopectate has aspirin like substances in it, because this Maalox product doesn't seem user friendly for a great number of our population. {and of course, I had to check and indeed Kaopectate AND Pepto Bismal have that same chemical -bummer}
So what do you think of when I say Maalox? Maybe that you need it if your stomach is burning a little and you are feeling bloated or gassy? YES? So Maalox is an antacid, like Tums and Rolaids - it is NOT something you take for diarrhea - right?? THAT would be Kaopectate. And it isn't what you take if you are vomiting - that is Emetrol.... So WHY did Novartis International which owns the brand, decide to make an anti-diarrhea medication called Maalox Total Relief?
Not sure, but the FDA just sent out a notice regarding several medical errors that have occurred because the liquid Maalox we reach for when we need an antacid is NOT this Maalox. In fact, it has an ingredient that is similar to aspirin that people with several conditions need to avoid. Seriously, if your stomach is burning - aspirin or its counterparts - not the best idea.
So be mindful - until the company changes the name of its product, because they will - Maalox Total Relief is for an upset stomach with diarrhea but only if you do not also take a blood thinner, have a history of ulcers or GERD, are a child who has recently had a viral infection, are someone taking medication to treat diabetes, OR someone who is taking an anti inflammatory (think ibuprofen). So I am wondering if Kaopectate has aspirin like substances in it, because this Maalox product doesn't seem user friendly for a great number of our population. {and of course, I had to check and indeed Kaopectate AND Pepto Bismal have that same chemical -bummer}
Wednesday, February 17, 2010
Is that a good fit for you, honey??
Oh, how I do love research. And it just doesn't get any better than this - condom studies. Okay, it is serious in that condoms can protect us from many, but not all, sexually transmitted disease and to some extent, but not all, they can prevent pregnancy. So how a condom feels to the wearer and the partner, and whether or not it is snug or irritating, or breaks - well, that is serious business.
Of course, if it doesn't FIT right, then it won't FEEL right and if it doesn't feel RIGHT then it probably won't feel GOOD. And a lot of people have sex because it gives them pleasure.... if a condom limits pleasure, that doesn't necessarily mean people will stop having sex, more likely they will stop using condoms, and in many cases, that would be health risk. According to a midsized study of over 400 men between ages 18 and 67, we have a problem. Almost 50% of those men reported issues that sometimes led to the removal of the condom. (I read about this on Yahoo News before looking up the study)
The Kinsey Institute does research on sex, gender and reproduction. They have several current studies and one involves condoms. One part has been completed and I refer to this study in the opening paragraph of today's blog. The full article is available if you have a subscription to a journal or university library, the abstract can be read here. I did not access the full article, the only reason=s I would is to see where the researchers advertised their project in order to get men to take the online survey. I understand that they advertised in some newspapers, but they also had a link to the survey in a blog from a condom sales website. Which condom company might that be? Trojan is the one we all know... does it have a blog? Too funny.
And the conclusion the researchers make is equally amusing and yet understandable. They suggest that people like ME<>quality, which will in turn promote greater satisfaction, thus use, thus protection.
Let me just end with - Safe Sex is Good Sex............ :)
Of course, if it doesn't FIT right, then it won't FEEL right and if it doesn't feel RIGHT then it probably won't feel GOOD. And a lot of people have sex because it gives them pleasure.... if a condom limits pleasure, that doesn't necessarily mean people will stop having sex, more likely they will stop using condoms, and in many cases, that would be health risk. According to a midsized study of over 400 men between ages 18 and 67, we have a problem. Almost 50% of those men reported issues that sometimes led to the removal of the condom. (I read about this on Yahoo News before looking up the study)
The Kinsey Institute does research on sex, gender and reproduction. They have several current studies and one involves condoms. One part has been completed and I refer to this study in the opening paragraph of today's blog. The full article is available if you have a subscription to a journal or university library, the abstract can be read here. I did not access the full article, the only reason=s I would is to see where the researchers advertised their project in order to get men to take the online survey. I understand that they advertised in some newspapers, but they also had a link to the survey in a blog from a condom sales website. Which condom company might that be? Trojan is the one we all know... does it have a blog? Too funny.
And the conclusion the researchers make is equally amusing and yet understandable. They suggest that people like ME<>quality, which will in turn promote greater satisfaction, thus use, thus protection.
Let me just end with - Safe Sex is Good Sex............ :)
Tuesday, February 16, 2010
An Absence of Conscience
I can think of no scenario in which this practice could be considered unbiased and for that reason, I can think of no situation where it should be allowed.
I read yesterday about a growing number of instances where pharmaceutical companies are farming out their clinical drug trials. (outsourcing) That part sounds like a very good idea - except when that outsourcing goes to other countries (another outrage - as we can't buy from other countries but we can rely on them to tell us our meds are safe? what is that?).
The FDA requires (what we have been led to believe is) rigorous testing of new medications in order to show that they are firstly safe, secondly that they are effective in a statistically significant way and lastly, that the benefits of the drug are greater than the risk. We are also becoming, as consumers, more privy to the research trials, not just the ones that showed what the drug companies hoped, but all of them. Having access to the studies can allow for comparative research from I hope, neutral third parties who want to to see which drugs work best in head to head competition. But what I read yesterday...
A company that does work for one of the major drug companies has, some time ago, bought stock in that company. In the article I read and did not bookmark (dang it) the CEO of the research company (it started with a G) talked about the need for the drug makers to have cash flow to develop new drugs. The CEO also mentioned using the money from his company to market the drug once it was FDA approved. The research company spokesperson presented this as a win-win situation for all involved. In my opinion, it is a big LOSE for us - the people who become guinea pigs en masse.
I do think independent testing of drugs needs to be the rule and that those doing the research need to have NO , I mean NO, vested interested in the approval and use of said drug.
I read yesterday about a growing number of instances where pharmaceutical companies are farming out their clinical drug trials. (outsourcing) That part sounds like a very good idea - except when that outsourcing goes to other countries (another outrage - as we can't buy from other countries but we can rely on them to tell us our meds are safe? what is that?).
The FDA requires (what we have been led to believe is) rigorous testing of new medications in order to show that they are firstly safe, secondly that they are effective in a statistically significant way and lastly, that the benefits of the drug are greater than the risk. We are also becoming, as consumers, more privy to the research trials, not just the ones that showed what the drug companies hoped, but all of them. Having access to the studies can allow for comparative research from I hope, neutral third parties who want to to see which drugs work best in head to head competition. But what I read yesterday...
A company that does work for one of the major drug companies has, some time ago, bought stock in that company. In the article I read and did not bookmark (dang it) the CEO of the research company (it started with a G) talked about the need for the drug makers to have cash flow to develop new drugs. The CEO also mentioned using the money from his company to market the drug once it was FDA approved. The research company spokesperson presented this as a win-win situation for all involved. In my opinion, it is a big LOSE for us - the people who become guinea pigs en masse.
I do think independent testing of drugs needs to be the rule and that those doing the research need to have NO , I mean NO, vested interested in the approval and use of said drug.
Monday, February 15, 2010
Another "Eight" Myth
As you may know by now, eight 8 ounce glasses of water a day is more an old adage than medical advice. This is largely due to the fact that we do not all weigh the same, and thus don't all need 64 ounces of fluid. Also we don't all do the same things with our bodies, so some need more and some need less.
Today I am writing about a research study on the sleep needs of person's over age 65.
The study was mentioned and explained in a USA Today article by Kim Painter. Her article was good, but it did not explain one issue that I thought was relevant. Being the curious girl I am, I contacted the lead author, Derk-Jan Dijk-Professor of Sleep and Physiology -Director, Surrey Sleep Research Centre in the UK. He forwarded the actual research article to me.
My post today comes from Ms. Painter's article, Dr. Dijk's study and the experts interviewed by Ms. Painter. Of note, no group in the study is getting eight hours of sleep and according to a side bar in the article, the most sleep - in the 20-30 year olds, was just over seven hours and the other two groups, 40-55 and 66 and above were getting six plus hours.
The study explored whether or not the less hours of sleep in the older group was truly a deficit that led to functioning problems during the day or over time. The research indicates that it does not. However, it was a small study and is not conclusive.
The scientists did require that the volunteers be healthy. That was my issue - what defines healthy? Dr. Dijk sent me the article so that I could look at the criteria and he said that I could email him again if I needed more information, but I felt that he had already been generous.
The volunteers did under go a medical and psychological screen at the first visit. They were not to have any sleep disorders and they could not be on any mood or conscious altering drugs (think of any meds for mental illness, many pain meds, and meds for insomnia). The paper did not indicate if weight or chronic disease was a factor. Thus, I am making an educated assumption that the people in the study could have a chronic illness (how many over age 60 do not have one ?) but that the illness had to be controlled.
So the study was cool. The older persons did take longer to fall asleep and historically, older persons do also have sleep disturbance. In the experiment, they did interrupt the sleep of the younger and older subjects, so that everyone had less SWS (slow wave sleep) time. The researchers tested for day time sleep and also for functioning, alertness, energy and relaxation. Most persons who had their sleep disrupted would fall asleep during a designated nap period the next day. What the researchers found was that the older persons did not have that daytime sleep propensity when their sleep was disrupted or shallow - on its own, or when they slept on average, 40+ minutes less than younger persons.
All this meaning, it could just be possible that our sleep needs DO change over time and that we can function well with less sleep. This is far from an agreed upon theory however. Sleep is restorative and effects many different levels of our functioning, from our immune system to our memories. If one lacks hours of sleep or has restive sleep, the replenishment may not occur.
Of note, under normal conditions, it does not appear that six to seven hours of sleep lead to daytime drowsiness, thus - it is NOT normal and should be reported to a physician.
Another thing I liked in Ms. Painters article was a statement by the director of sleep research at the National Institutes of Aging. He introduced the idea of sleep ability vs sleep need. That is interesting. If one's need is greater than one's ability than certainly a sleep disorder may be at hand. However, if need and ability are equal, even at six hours, than one does not need to "fret" over not getting that 8 hours. Certainly, that would be counterproductive and interrupt the sleep more.
I still wonder about the differences that might occur if we compared older persons that are fit and active vs those who are sedentary, overweight and who have diabetes, HTN, or other cardiovascular problems.
Today I am writing about a research study on the sleep needs of person's over age 65.
The study was mentioned and explained in a USA Today article by Kim Painter. Her article was good, but it did not explain one issue that I thought was relevant. Being the curious girl I am, I contacted the lead author, Derk-Jan Dijk-Professor of Sleep and Physiology -Director, Surrey Sleep Research Centre in the UK. He forwarded the actual research article to me.
My post today comes from Ms. Painter's article, Dr. Dijk's study and the experts interviewed by Ms. Painter. Of note, no group in the study is getting eight hours of sleep and according to a side bar in the article, the most sleep - in the 20-30 year olds, was just over seven hours and the other two groups, 40-55 and 66 and above were getting six plus hours.
The study explored whether or not the less hours of sleep in the older group was truly a deficit that led to functioning problems during the day or over time. The research indicates that it does not. However, it was a small study and is not conclusive.
The scientists did require that the volunteers be healthy. That was my issue - what defines healthy? Dr. Dijk sent me the article so that I could look at the criteria and he said that I could email him again if I needed more information, but I felt that he had already been generous.
The volunteers did under go a medical and psychological screen at the first visit. They were not to have any sleep disorders and they could not be on any mood or conscious altering drugs (think of any meds for mental illness, many pain meds, and meds for insomnia). The paper did not indicate if weight or chronic disease was a factor. Thus, I am making an educated assumption that the people in the study could have a chronic illness (how many over age 60 do not have one ?) but that the illness had to be controlled.
So the study was cool. The older persons did take longer to fall asleep and historically, older persons do also have sleep disturbance. In the experiment, they did interrupt the sleep of the younger and older subjects, so that everyone had less SWS (slow wave sleep) time. The researchers tested for day time sleep and also for functioning, alertness, energy and relaxation. Most persons who had their sleep disrupted would fall asleep during a designated nap period the next day. What the researchers found was that the older persons did not have that daytime sleep propensity when their sleep was disrupted or shallow - on its own, or when they slept on average, 40+ minutes less than younger persons.
All this meaning, it could just be possible that our sleep needs DO change over time and that we can function well with less sleep. This is far from an agreed upon theory however. Sleep is restorative and effects many different levels of our functioning, from our immune system to our memories. If one lacks hours of sleep or has restive sleep, the replenishment may not occur.
Of note, under normal conditions, it does not appear that six to seven hours of sleep lead to daytime drowsiness, thus - it is NOT normal and should be reported to a physician.
Another thing I liked in Ms. Painters article was a statement by the director of sleep research at the National Institutes of Aging. He introduced the idea of sleep ability vs sleep need. That is interesting. If one's need is greater than one's ability than certainly a sleep disorder may be at hand. However, if need and ability are equal, even at six hours, than one does not need to "fret" over not getting that 8 hours. Certainly, that would be counterproductive and interrupt the sleep more.
I still wonder about the differences that might occur if we compared older persons that are fit and active vs those who are sedentary, overweight and who have diabetes, HTN, or other cardiovascular problems.
Sunday, February 14, 2010
Odds and Ends
Groceries: It is a simple fact that I pay more attention to other people and their food choices than the average person does. I like to think that this is because I am always thinking of improving health and writing a blog. Earlier this week I spoke of the obesity problem and Michelle Obama's drive to make a change. I thought about her yesterday when I was in line waiting to check out with my groceries. In the lane across from me, I was drawn first to the over flowing shopping cart and then to the two tall men and a woman unloading it. It could have been that she was the Mom of one and the partner of the other, or the Mom of both - I was unable to determine age - but all were over age 16. On the conveyor belt I noticed multiple boxes of frozen pizza, hamburger helper and those prepackaged flavored noodles as well as gallons of HiC fruit punch. There were a lot of other things, but I was struck by those processed, high calorie foods and thought with a sigh, "That stuff is cheap and it is so so so wrong that people eat it without realizing the health consequences that accompany it."
Olympics: Last night I watched some of the games. I was particularly intrigued during the women's ski event. When the athletes were on deck to compete, the commentators were noting all the injuries and surgeries that they had experienced. One was jumping with a torn meniscus and another had had three or more surgeries in EACH knee. The women were between ages 18 and 35. I was stunned. Though I should not have been. Knees, hips, ankles - and heads - all at risk in extreme training and competition. Today I watched cross country skiing and realized that just finishing wasn't the end these men were striving for, they had to be in the top three. I consider this and think of my very active and determined self. I set goals too, usually distance goals, but I just want to finish - not to beat another person - well, I don't want to be last! I run or exercise as much as I do for the day to day benefit, the self esteem, the productivity, the sense of efficacy it gives me daily. And my family scowls at me, quite verbally at times, for running when I have a pulled muscle. Watching these events my jaw just sort of dropped. These courageous, powerful, dedicated persons are at high risk for debilitating arthritis in their 50s - and yet they push and push to be on those podiums and to receive those medals. Isn't that a contrast to the high number of sedentary adults there are in the world?
Snacks: I continue my hope for a sugar free, low calorie pop tart, but today I found something near as good. My also ran is the Newton Crisps, but the winner is Kellogg's Special K blueberry crisps. Oh so yummy, it is almost as good as a pop tart. And, I just realized that Kellogg's makes the pop tart. These snacks have 100 calories, but there are two pieces in each pouch.
New Drug Woes: I was really surprised to read about this blood thinning drug from Lilly that appears to not be doing well - with sales. I keep thinking that drugs have to be better or have less side effects to be on the market, but there are so many duplicates that I am doubting my beliefs. This drug is similar to Plavix - which will soon be generic. In this NY Times article three different medicines were said to prevent blood clots after angioplasty and stent placement. However, this one from Lilly, Effient seemed to increase bleeding and got itself a black box warning. In reading about this, I see that the drugs they use for thinning blood need to be short acting in case the patient needs surgery again. I remember my aunt talking about having to go off her blood thinner, wafarin, if she were going to have cataract surgery. Any way, I am getting distracted. In the NY Times article, written by Duff Wilson, I was most struck by this comment,
Olympics: Last night I watched some of the games. I was particularly intrigued during the women's ski event. When the athletes were on deck to compete, the commentators were noting all the injuries and surgeries that they had experienced. One was jumping with a torn meniscus and another had had three or more surgeries in EACH knee. The women were between ages 18 and 35. I was stunned. Though I should not have been. Knees, hips, ankles - and heads - all at risk in extreme training and competition. Today I watched cross country skiing and realized that just finishing wasn't the end these men were striving for, they had to be in the top three. I consider this and think of my very active and determined self. I set goals too, usually distance goals, but I just want to finish - not to beat another person - well, I don't want to be last! I run or exercise as much as I do for the day to day benefit, the self esteem, the productivity, the sense of efficacy it gives me daily. And my family scowls at me, quite verbally at times, for running when I have a pulled muscle. Watching these events my jaw just sort of dropped. These courageous, powerful, dedicated persons are at high risk for debilitating arthritis in their 50s - and yet they push and push to be on those podiums and to receive those medals. Isn't that a contrast to the high number of sedentary adults there are in the world?
Snacks: I continue my hope for a sugar free, low calorie pop tart, but today I found something near as good. My also ran is the Newton Crisps, but the winner is Kellogg's Special K blueberry crisps. Oh so yummy, it is almost as good as a pop tart. And, I just realized that Kellogg's makes the pop tart. These snacks have 100 calories, but there are two pieces in each pouch.
New Drug Woes: I was really surprised to read about this blood thinning drug from Lilly that appears to not be doing well - with sales. I keep thinking that drugs have to be better or have less side effects to be on the market, but there are so many duplicates that I am doubting my beliefs. This drug is similar to Plavix - which will soon be generic. In this NY Times article three different medicines were said to prevent blood clots after angioplasty and stent placement. However, this one from Lilly, Effient seemed to increase bleeding and got itself a black box warning. In reading about this, I see that the drugs they use for thinning blood need to be short acting in case the patient needs surgery again. I remember my aunt talking about having to go off her blood thinner, wafarin, if she were going to have cataract surgery. Any way, I am getting distracted. In the NY Times article, written by Duff Wilson, I was most struck by this comment,
"Javan Collins, vice president of Lilly’s United States cardiovascular business,
said the company was using office visits, promotional speakers, new sales
materials and journal advertising to bolster Effient. “It’s a challenge to sell
to doctors satisfied with Plavix,” he added."
I am starting to think that if clinicians prescribe a medication that turns out to be harmful on a global scale, that they too should be named in the lawsuits against the drug companies. Based on the article however, many doctor's are avoiding the medicine and that is what has Lilly and investors worried.
Saturday, February 13, 2010
gestational diabetes
I chose this topic today because a woman I care a great deal about has recently learned that she has gestational diabetes.
So what is that and what does it mean?
Diabetes is defined as having a blood sugar level over 130 if fasting and 180 if after a meal. When blood sugar levels run high after one becomes pregnant but not before, then it is gestational diabetes. (there are some instances of gestational diabetes however, that fall into the category of previous diabetes that was undiagnosed). There are not always symptoms, but increased thirst, light headedness and frequent urination are a few. A blood glucose test is usually performed during pregnancy.
Gestational diabetes can cause problems and it is important to get blood sugar levels under control and to treat the condition with the utmost respect. Gestational Diabetes affects about 4% of pregnant women. It usually occurs and is diagnosed between the second and third trimester. Though only around 30% of women with gestational diabetes develop diabetes beyond pregnancy, there is a 60% chance that this will occur for each woman who has gestational diabetes. There is also increased risk of the infant becoming obese and also developing type 2 diabetes. What this really tells us is that the recommendations to maintain a healthy weight, to eat frequent, consistent, small meals and to exercise are universal and paramount.
Women who are diagnosed with this condition, often because of screening during their sixth month, must control their blood sugars. When diagnosed, the mother should receive a referral to a certified diabetes educator who will assist in meal planning. How one eats can do a lot to prevent blood sugar spikes and thus less need for insulin to be secreted. Exercise can also reduce blood sugar, however, there may be a need for exogenous insulin and if so, special education on how to use the medicine is needed as well. No other diabetes medication is considered safe during pregnancy.
Insulin and exercise are both known to lower blood sugar levels. Pregnant women should not start new vigorous exercise, but are usually able to continue with the same physical activity level they had before they become pregnant, unless of course they were sedentary. Walking is usually considered a safe activity. All women who are pregnant and especially those with these risks, should maintain regular prenatal care and get direction from their provider on what exercise is best and how often it should be done.
With regard to controlling blood sugar through nutrition; frequent, small meals are suggested. Complex carbohydrates, whole grains, fruits and vegetables as well as lean proteins are recommended. It is also noted that saturated fat, fried and greasy foods should be avoided. Pregnant women are also encouraged to consume 20+ grams of fiber each day, and to drink plenty of water.
As you can see, these suggestions are pretty much the same as those for the general population. These guidelines can reduce weight gain and prevent chronic disease. Women with gestational diabetes are also encouraged to monitor their weights. I cannot emphasize enough that this is not a disease to tackle on your own. The baby and the mother are at risk for problems - birth problems, growth problems and still birth. The risk is greatest if the diabetes is not controlled. This is different than being diagnosed with DM2 and twenty years later having a heart attack from it - the adverse outcome can happen within months if the condition is not taken seriously.
Risk factors and etiology:
There are some risk factors, but please note, many cases of gestational diabetes are in women who did not have the named risk factors. If you are curious, they include - being overweight prior to pregnancy, being over age 25, having had gestational diabetes during a previous pregnancy, having a family history of diabetes, and being a person of color.
The disease develops (etiology) during the course of a normal pregnancy phenomena. When pregnant, the placenta itself makes hormones. The hormones have many effects but one is to reduce the impact of the mothers insulin on her blood sugar level. The idea is to increase nutrient flow from the mom to the baby and in so doing the mom might be at risk for low blood sugar, so the body is trying to prevent that outcome by interfering with natural insulin response. However, sometimes that back fires and the mothers blood sugar is too high. Usually the mother will begin to produce extra insulin (from the pancreas) to account for this change, but in gestational diabetes this extra insulin does not move the blood sugar out of the blood stream. The infant's pancreas is also working so that when the infant has too much blood glucose, it will release insulin. The glucose passes through to the baby but the mom's insulin doesn't. Glucose or blood sugar that cannot be used is stored as fat. The baby is at risk for a condition in which it has too much fat (macrosomia) at birth and it will continue to be at risk for obesity and diabetes after birth.
All this being said, controlling the blood sugar of the mother, through smart eating and exercise can prevent these adverse outcomes. A woman with this condition should take advantage of any and all resources made available to them by their OBGYN. To control the blood sugar, testing is required. Certified Diabetes Educators, both nurses and dietitians can educate on how to test blood sugar and use insulin if needed. Blood testing cannot be avoided. The baby may also undergo fetal monitoring, ultrasound and other tests as the pregnancy progresses. At birth the baby will undergo some testing to make sure his or her blood sugars are normal. Again, the baby will be at risk for obesity which is a big factor in diabetes - parents should provide the child with the same healthful diet the mother was encouraged to consume. After birth, the mother will also be tested for some time to see if her blood sugar and insulin response returns to normal. It should because the placenta is no longer there to cause hormone challenges, but again about one third of women will develop diabetes, or may have had undiagnosed diabetes prior to pregnancy.
If you have this condition you should read more, as the links below were my resources. Start here: http://www.cdc.gov/ncbddd/bd/diabetespregnancyfaqs.htm#willmybaby
and here:
http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html
and here:
http://www.webmd.com/baby/tc/gestational-diabetes-topic-overview
So what is that and what does it mean?
Diabetes is defined as having a blood sugar level over 130 if fasting and 180 if after a meal. When blood sugar levels run high after one becomes pregnant but not before, then it is gestational diabetes. (there are some instances of gestational diabetes however, that fall into the category of previous diabetes that was undiagnosed). There are not always symptoms, but increased thirst, light headedness and frequent urination are a few. A blood glucose test is usually performed during pregnancy.
Gestational diabetes can cause problems and it is important to get blood sugar levels under control and to treat the condition with the utmost respect. Gestational Diabetes affects about 4% of pregnant women. It usually occurs and is diagnosed between the second and third trimester. Though only around 30% of women with gestational diabetes develop diabetes beyond pregnancy, there is a 60% chance that this will occur for each woman who has gestational diabetes. There is also increased risk of the infant becoming obese and also developing type 2 diabetes. What this really tells us is that the recommendations to maintain a healthy weight, to eat frequent, consistent, small meals and to exercise are universal and paramount.
Women who are diagnosed with this condition, often because of screening during their sixth month, must control their blood sugars. When diagnosed, the mother should receive a referral to a certified diabetes educator who will assist in meal planning. How one eats can do a lot to prevent blood sugar spikes and thus less need for insulin to be secreted. Exercise can also reduce blood sugar, however, there may be a need for exogenous insulin and if so, special education on how to use the medicine is needed as well. No other diabetes medication is considered safe during pregnancy.
Insulin and exercise are both known to lower blood sugar levels. Pregnant women should not start new vigorous exercise, but are usually able to continue with the same physical activity level they had before they become pregnant, unless of course they were sedentary. Walking is usually considered a safe activity. All women who are pregnant and especially those with these risks, should maintain regular prenatal care and get direction from their provider on what exercise is best and how often it should be done.
With regard to controlling blood sugar through nutrition; frequent, small meals are suggested. Complex carbohydrates, whole grains, fruits and vegetables as well as lean proteins are recommended. It is also noted that saturated fat, fried and greasy foods should be avoided. Pregnant women are also encouraged to consume 20+ grams of fiber each day, and to drink plenty of water.
As you can see, these suggestions are pretty much the same as those for the general population. These guidelines can reduce weight gain and prevent chronic disease. Women with gestational diabetes are also encouraged to monitor their weights. I cannot emphasize enough that this is not a disease to tackle on your own. The baby and the mother are at risk for problems - birth problems, growth problems and still birth. The risk is greatest if the diabetes is not controlled. This is different than being diagnosed with DM2 and twenty years later having a heart attack from it - the adverse outcome can happen within months if the condition is not taken seriously.
Risk factors and etiology:
There are some risk factors, but please note, many cases of gestational diabetes are in women who did not have the named risk factors. If you are curious, they include - being overweight prior to pregnancy, being over age 25, having had gestational diabetes during a previous pregnancy, having a family history of diabetes, and being a person of color.
The disease develops (etiology) during the course of a normal pregnancy phenomena. When pregnant, the placenta itself makes hormones. The hormones have many effects but one is to reduce the impact of the mothers insulin on her blood sugar level. The idea is to increase nutrient flow from the mom to the baby and in so doing the mom might be at risk for low blood sugar, so the body is trying to prevent that outcome by interfering with natural insulin response. However, sometimes that back fires and the mothers blood sugar is too high. Usually the mother will begin to produce extra insulin (from the pancreas) to account for this change, but in gestational diabetes this extra insulin does not move the blood sugar out of the blood stream. The infant's pancreas is also working so that when the infant has too much blood glucose, it will release insulin. The glucose passes through to the baby but the mom's insulin doesn't. Glucose or blood sugar that cannot be used is stored as fat. The baby is at risk for a condition in which it has too much fat (macrosomia) at birth and it will continue to be at risk for obesity and diabetes after birth.
All this being said, controlling the blood sugar of the mother, through smart eating and exercise can prevent these adverse outcomes. A woman with this condition should take advantage of any and all resources made available to them by their OBGYN. To control the blood sugar, testing is required. Certified Diabetes Educators, both nurses and dietitians can educate on how to test blood sugar and use insulin if needed. Blood testing cannot be avoided. The baby may also undergo fetal monitoring, ultrasound and other tests as the pregnancy progresses. At birth the baby will undergo some testing to make sure his or her blood sugars are normal. Again, the baby will be at risk for obesity which is a big factor in diabetes - parents should provide the child with the same healthful diet the mother was encouraged to consume. After birth, the mother will also be tested for some time to see if her blood sugar and insulin response returns to normal. It should because the placenta is no longer there to cause hormone challenges, but again about one third of women will develop diabetes, or may have had undiagnosed diabetes prior to pregnancy.
If you have this condition you should read more, as the links below were my resources. Start here: http://www.cdc.gov/ncbddd/bd/diabetespregnancyfaqs.htm#willmybaby
and here:
http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html
and here:
http://www.webmd.com/baby/tc/gestational-diabetes-topic-overview
Friday, February 12, 2010
Eat More While Aging
Oh that sounds cool now doesn't it? And how about eat more and don't gain weight! That sounds even better. Well that is exactly what happens with Masters athletes. These are people, usually over the age of 35 who are still training and competing at intense levels. We had a few Masters athletes in the Summer Olympics and the recent Super Bowl. Many "regular" Masters athletes compete in triathlons and marathons every weekend.
As you can imagine, this group of persons is often studied by gerontologists, exercise and sports scientists and epidemiologists. An article in the current issue of ACSM's Health and Fitness journal by nutritionist Stella Volpe PhD discusses the nutrition needs of these older athletes. Also, an article in Nutrition Today from 2006 explains the many benefits of continuing to train and compete as one ages. The advantages include having better lipid profiles, waist to hip ratios, aerobic fitness and blood sugar control then their sedentary counterparts. Masters athletes do not have to make the same caloric adjustments as less active persons do in order to prevent middle age weight gain.
Dr. Volpe's article notes that the athletic older person should be mindful of WHAT calories they are eating and should be especially careful to include complex carbohydrates and deep colored fruits and vegetables. The fruits and vegetables will contain antioxidants that help speed recovery and even improve performance. This is the same advice given to young athletes! Indeed, the article goes on to recommend lean proteins and more monounsaturated fats. The diet is the same for all of us, but the amount of calories is based on one's level of activity and body composition. (BTW, this PhD level nutritionist did not recommend ANY supplements, protein powders or energy drinks- only nutrient and antioxidant rich FOODS)
In several research studies referenced in the two articles and available through a web search, one finds that Masters athletes are much more likely to have biometrics similar to young athletes and far superior to their own age peers who do not engage in regular physical activity. The latter are much more likely to be overweight as well. In fact, the Nutrition Today article notes that only 13% of those over age 65 engage in vigorous activity three or more days a week. Vigorous physical activity is that which increases your heart rate for an extended period of time; running, swimming, cycling at speed - are considered vigorous. People who do not exercise regularly have much higher rates of chronic disease.
Some decline in muscle mass and aerobic capacity with age is inevitable, but not all of it is. It is absolutely possible to slow these changes down - don't let age determine your activity level - let your activity level determine your age!
As you can imagine, this group of persons is often studied by gerontologists, exercise and sports scientists and epidemiologists. An article in the current issue of ACSM's Health and Fitness journal by nutritionist Stella Volpe PhD discusses the nutrition needs of these older athletes. Also, an article in Nutrition Today from 2006 explains the many benefits of continuing to train and compete as one ages. The advantages include having better lipid profiles, waist to hip ratios, aerobic fitness and blood sugar control then their sedentary counterparts. Masters athletes do not have to make the same caloric adjustments as less active persons do in order to prevent middle age weight gain.
Dr. Volpe's article notes that the athletic older person should be mindful of WHAT calories they are eating and should be especially careful to include complex carbohydrates and deep colored fruits and vegetables. The fruits and vegetables will contain antioxidants that help speed recovery and even improve performance. This is the same advice given to young athletes! Indeed, the article goes on to recommend lean proteins and more monounsaturated fats. The diet is the same for all of us, but the amount of calories is based on one's level of activity and body composition. (BTW, this PhD level nutritionist did not recommend ANY supplements, protein powders or energy drinks- only nutrient and antioxidant rich FOODS)
In several research studies referenced in the two articles and available through a web search, one finds that Masters athletes are much more likely to have biometrics similar to young athletes and far superior to their own age peers who do not engage in regular physical activity. The latter are much more likely to be overweight as well. In fact, the Nutrition Today article notes that only 13% of those over age 65 engage in vigorous activity three or more days a week. Vigorous physical activity is that which increases your heart rate for an extended period of time; running, swimming, cycling at speed - are considered vigorous. People who do not exercise regularly have much higher rates of chronic disease.
Some decline in muscle mass and aerobic capacity with age is inevitable, but not all of it is. It is absolutely possible to slow these changes down - don't let age determine your activity level - let your activity level determine your age!
Thursday, February 11, 2010
Best Way to Beat the Stigma?
In a lively radio show debate this afternoon, health experts argued the outcomes of the new initiative to be led by First Lady Michelle Obama . Most agree that this is a good thing and that the CDC generated statistic - 17% of children are obese - is too high. Most also agree with the data that suggests obese children will become obese adults. Add to that overweight children and it is about double.
There is also substantial scientific evidence that being overweight and inactive can lead to chronic disease conditions such as diabetes and heart disease.
Unfortunately, I cannot find the show on line to see who was speaking this afternoon and I apologize for not being able to credit everyone. However, an educated guest, perhaps a scientist or physician, stated two things about the current initiative that I wished to comment on. One of the things he said made sense to me, I felt it was true and I understood the rationale. The other - NO , not at all.
The obesity prevention campaign is titled Let's Move and it involves providing healthy foods to our children in school and in their neighborhoods, getting kids moving and active and limiting advertising of unhealthy foods to them.
What the gentleman said that I agree with is this:
The program will not make children thin. And he may be right. If the strategy doesn't involve reducing caloric intake, the kids may indeed be healthier, but not lighter.
He denied however, that being overweight was detrimental and that flies in the face of all the current science we have. In aggregate, being overweight and obese triggers inflammation, insulin resistance and joint problems. If individually an overweight person does not have an adverse outcome, that does not mean that being over weight is not harmful. (Think smoking if you will. If your granddad smoked all his life and did not get lung cancer that does not mean that smoking doesn't cause lung cancer.)
So, I find NO debate there. The caller/guest then said that the problem was not being overweight or obese but that people were stigmatized for it. He felt that calling attention to the fact that 30+% of our kids had a weight problem would only cause them psychological harm. I wanted to tell him and so will tell you - the psychological damage can be avoided, not by changing other peoples perceptions or by denying that obesity causes disease, but by preventing the disease. I would wager a significant bet that an overweight child would MUCH rather be trim and fit, agile and energetic than to be sluggish and uncomfortable and accepted for it.
This doesn't even touch the fact that the children who start with cholesterol, blood pressure and diabetes medicine in their teens are going to have quite a lot of blood draws for the rest of their life making sure those meds don't destroy their kidneys before the diseases do.
The most important things that we as a country can do for our children is to 1) educate them, 2) prevent tobacco use and 3) prevent obesity. Ok, let me rephrase, some of the most important things, because they need a lot from us and we better start doing our jobs.
Foot note: A few years ago Bill Clinton became involved with obesity prevention as well. He is a partner with the Alliance for a Healthier Generation program. In his speaking engagements, he has noted that he was an overweight kid and how hard that was. He has also spoken about being overweight as an adult and having to be careful on campaigns and such because of high calorie foods. Today he is in the hospital recuperating from a serious heart surgery, not his first if I remember correctly. And this is WHY we need to follow Mrs. Obama's lead and address obesity head on and full force.
If we do our best to stop the epidemic then the stigma will take care of itself.
There is also substantial scientific evidence that being overweight and inactive can lead to chronic disease conditions such as diabetes and heart disease.
Unfortunately, I cannot find the show on line to see who was speaking this afternoon and I apologize for not being able to credit everyone. However, an educated guest, perhaps a scientist or physician, stated two things about the current initiative that I wished to comment on. One of the things he said made sense to me, I felt it was true and I understood the rationale. The other - NO , not at all.
The obesity prevention campaign is titled Let's Move and it involves providing healthy foods to our children in school and in their neighborhoods, getting kids moving and active and limiting advertising of unhealthy foods to them.
What the gentleman said that I agree with is this:
The program will not make children thin. And he may be right. If the strategy doesn't involve reducing caloric intake, the kids may indeed be healthier, but not lighter.
He denied however, that being overweight was detrimental and that flies in the face of all the current science we have. In aggregate, being overweight and obese triggers inflammation, insulin resistance and joint problems. If individually an overweight person does not have an adverse outcome, that does not mean that being over weight is not harmful. (Think smoking if you will. If your granddad smoked all his life and did not get lung cancer that does not mean that smoking doesn't cause lung cancer.)
So, I find NO debate there. The caller/guest then said that the problem was not being overweight or obese but that people were stigmatized for it. He felt that calling attention to the fact that 30+% of our kids had a weight problem would only cause them psychological harm. I wanted to tell him and so will tell you - the psychological damage can be avoided, not by changing other peoples perceptions or by denying that obesity causes disease, but by preventing the disease. I would wager a significant bet that an overweight child would MUCH rather be trim and fit, agile and energetic than to be sluggish and uncomfortable and accepted for it.
This doesn't even touch the fact that the children who start with cholesterol, blood pressure and diabetes medicine in their teens are going to have quite a lot of blood draws for the rest of their life making sure those meds don't destroy their kidneys before the diseases do.
The most important things that we as a country can do for our children is to 1) educate them, 2) prevent tobacco use and 3) prevent obesity. Ok, let me rephrase, some of the most important things, because they need a lot from us and we better start doing our jobs.
Foot note: A few years ago Bill Clinton became involved with obesity prevention as well. He is a partner with the Alliance for a Healthier Generation program. In his speaking engagements, he has noted that he was an overweight kid and how hard that was. He has also spoken about being overweight as an adult and having to be careful on campaigns and such because of high calorie foods. Today he is in the hospital recuperating from a serious heart surgery, not his first if I remember correctly. And this is WHY we need to follow Mrs. Obama's lead and address obesity head on and full force.
If we do our best to stop the epidemic then the stigma will take care of itself.
Wednesday, February 10, 2010
Menu Math - Choose Your Numbers
Today I would like to teach you a little bit about reading the nutrition info from a restaurant's website and making that information work for you. Remember, this blog is intended to empower YOU, the reader, to make decisions and choices based on the most current information and tools available - so that you have the best chance for an active, long life.
So we are going to use the chart featured here. I realize it may be hard to see. You can go straight to the source and view this, however, it will not have my highlights there.
So let me explain. This is the nutrition information that Panera Bread offers for its Mediterranean Salmon Salad. (we just talked about the Mediterranean Diet so this was a good example! It is also what I am having for lunch tomorrow)
Most health experts now recommend that we eat small, but frequent meals, as many as six a day - according to the Cleveland Clinic. I will let you see what they have to say as well, click here. Note their words - small, frequent meals mean JUST THAT. The USA Today Weight Loss challenge notes that most of the dieters are consuming 1500 to 1800 cals a day, so divide that number by six and if all the meals were even, all would be UNDER that 480 calorie Salmon Salad. There is no hard and fast rule about that however. Breakfast might be 200-400 calories with plenty of fiber and some meals may instead be 100 calorie snacks, but the best thing about the chart printed here is that you can use it to see which of the calories are BENEFICIAl and which bring along things you could do without - like extra sodium. Hence, my highlights.
Let me explain - as by the time I was done picking my choices, I had a 180 calorie salad!
Things to look for in a food label, good and bad, are fats (saturated, trans and unsaturated), protein, sodium, fiber, sugar and maybe cholesterol, but that is usually not as important as saturated and trans fats.
In this entree we can see that protein is good overall. Sodium is too high and for that reason I would leave out those poor olives, only 35 calories but almost 600 mg of sodium. Salmon does have some sodium naturally, but not this much - they must glaze the fillet. Saturated fat is only concerning for the cheese, but if you are watching saturated fat, that might be something to leave off. Notice that the almonds and salmon are high in poly or monounsaturated fats - (subtract the saturated fat from the total fat and that is how you know) . The remaining are the fats that give us the health promoting Omega 3s! There is too much sugar in this salad. A total of 19 grams. A food is considered a healthy choice if it has less than 8 g of added sugar. Now some of the sugar comes from oranges but a lot comes from the dressing. The dressing by the way is high in calories as well. I am going to use my own dressing.
I like that this chart has caffeine content included. There is none in this meal. I like that the meal does not have any TFAs! I am looking forward to my lunch tomorrow.
If you have the opportunity to look at a food this thoroughly you can certainly order your meal without items that don't meet your best health needs. Of course, a recent review of online and restaurant menus showed some significant under reporting in calorie content, so this is all to be taken as a "more or less" figure.
Bon Appetit!
Tuesday, February 9, 2010
Does it Matter Why?
On the radio today, I heard a discussion regarding the Mediterranean Diet. Another study supports the health benefits of consuming plant based foods, fish and olive oil, and an occasional glass of wine. The study that was highlighted today was not an experiment but an observation made after comparing two large groups of persons of later age. One group ate more fruits, vegetables, whole grains, fish, and used olive oil while another ate foods considered to be Western - a lot of meat and fried foods. The first group had a significant and substantially lower rate of dementia than the second.
Science has already suggested that the Mediterranean Diet is protective for the heart. It is expected that the diet helps to reduce inflammation or just creates less inflammation. It also seems that people who eat this way have lower weights.
One person interviewed today said that at this time we don't know if it is something particular in one or more of the foods eaten that is helpful or if the combination of the foods is helpful - or even that the persons are thinner and have less cases of diabetes (diabetes is a risk factor for impaired blood flow which effects the heart and brain).
For instance, it could be the antioxidants in the fruits and vegetables, or the PUFA in the fish or the fiber that reduces bad cholesterol or even the resveratrol in the red wine, that promote better health.
I do want to make this one point to be safe. When our health experts suggest that we eat more fruits ,vegetables, fish, and get more monounsaturated fats, they do not mean ON TOP OFF or IN ADDITION TO the red meats and sugars and other fats that we consume, they mean in PLACE OF.
And if it matters to you, if it's the fish, fiber, fruits or wine - stay tuned because they will figure it out. However, your heart and brain will thank you if you just go ahead and make the recommended amendments to your "diet" today.
Science has already suggested that the Mediterranean Diet is protective for the heart. It is expected that the diet helps to reduce inflammation or just creates less inflammation. It also seems that people who eat this way have lower weights.
One person interviewed today said that at this time we don't know if it is something particular in one or more of the foods eaten that is helpful or if the combination of the foods is helpful - or even that the persons are thinner and have less cases of diabetes (diabetes is a risk factor for impaired blood flow which effects the heart and brain).
For instance, it could be the antioxidants in the fruits and vegetables, or the PUFA in the fish or the fiber that reduces bad cholesterol or even the resveratrol in the red wine, that promote better health.
I do want to make this one point to be safe. When our health experts suggest that we eat more fruits ,vegetables, fish, and get more monounsaturated fats, they do not mean ON TOP OFF or IN ADDITION TO the red meats and sugars and other fats that we consume, they mean in PLACE OF.
And if it matters to you, if it's the fish, fiber, fruits or wine - stay tuned because they will figure it out. However, your heart and brain will thank you if you just go ahead and make the recommended amendments to your "diet" today.
Monday, February 8, 2010
Myth Buster
Yes, I think I should rename myself and this blog - we have been taking on a lot of myth busting over the years, and there is no end in sight. I like it though. I like it when science is used to prove or disprove a concept, especially when I know that misinformed or misled persons are spending their money on products that will not help them and may harm them.
Today the story is protein- powders, shakes, bars and supplements.
The truth is that muscle's gain power, strength and endurance when they are pushed too far in a workout and then repair themselves during the rest or recovery phase. It is also truth that the rebuilding is only possible with the use of protein. What is also truth, but not well known, is that you have enough of that protein already. At least the persons that are reading this blog and the persons who are spending money on gym memberships, fitness equipment and work out gear - those, them, us, me - we are not starving and really only starving people lack protein.
Even someone who practices body building for competition is unlikely to need supplementation. The best source of protein is FOOD. Most persons need about half their body weight in pounds in grams of protein a day. I know that sounds confusing, but a 150 pound person needs 75 grams of protein.
Good sources of protein include dairy products (and nonfat products have just as much protein as full fat ones so don't even try that excuse!), lean meats, legumes (beans and nuts), some vegetables, whole grains and fish. Look at your labels tomorrow just for the heck of it. Track your protein. You are not deprived. Even vegetarians get ample protein.
Several studies have been conducted that show that even athletes do not need protein from nonfood sources and that most people who take them are doing so because a coach, personal trainer, or TV spokesperson suggested it. Most trainers do not know that the body does not need more protein than this .5g/lb of weight.
Two other things need to be said about this. One is that the protein bars, shakes and powders bring in a lot of calories and usually people do not take the protein as a replacement product but as a supplement or in addition to - their regular intake. Another point to consider is that too much protein can indeed harm the body because of the extra work the kidneys must do to process it.
The upshot, in my simple and blunt opinion, is that the protein push is a scam that costs you - at the least it costs you money and calories and at the most, -kidney damage. What we really need more of is the activity that challenges the muscles not the protein that repairs them.
(of course there are persons with specific medical conditions who would be advised by licensed nutritionists and physicians on supplementation - but the rest of us - when in doubt, leave it out)
Research: journal Nutrition January 2010
also, the Canadian Sport Centre Dietary Study
and
Journal of Strength and Conditioning Research 2008
More info: http://www.pcrm.org/health/veginfo/vsk/protein_myth.html
Today the story is protein- powders, shakes, bars and supplements.
The truth is that muscle's gain power, strength and endurance when they are pushed too far in a workout and then repair themselves during the rest or recovery phase. It is also truth that the rebuilding is only possible with the use of protein. What is also truth, but not well known, is that you have enough of that protein already. At least the persons that are reading this blog and the persons who are spending money on gym memberships, fitness equipment and work out gear - those, them, us, me - we are not starving and really only starving people lack protein.
Even someone who practices body building for competition is unlikely to need supplementation. The best source of protein is FOOD. Most persons need about half their body weight in pounds in grams of protein a day. I know that sounds confusing, but a 150 pound person needs 75 grams of protein.
Good sources of protein include dairy products (and nonfat products have just as much protein as full fat ones so don't even try that excuse!), lean meats, legumes (beans and nuts), some vegetables, whole grains and fish. Look at your labels tomorrow just for the heck of it. Track your protein. You are not deprived. Even vegetarians get ample protein.
Several studies have been conducted that show that even athletes do not need protein from nonfood sources and that most people who take them are doing so because a coach, personal trainer, or TV spokesperson suggested it. Most trainers do not know that the body does not need more protein than this .5g/lb of weight.
Two other things need to be said about this. One is that the protein bars, shakes and powders bring in a lot of calories and usually people do not take the protein as a replacement product but as a supplement or in addition to - their regular intake. Another point to consider is that too much protein can indeed harm the body because of the extra work the kidneys must do to process it.
The upshot, in my simple and blunt opinion, is that the protein push is a scam that costs you - at the least it costs you money and calories and at the most, -kidney damage. What we really need more of is the activity that challenges the muscles not the protein that repairs them.
(of course there are persons with specific medical conditions who would be advised by licensed nutritionists and physicians on supplementation - but the rest of us - when in doubt, leave it out)
Research: journal Nutrition January 2010
also, the Canadian Sport Centre Dietary Study
and
Journal of Strength and Conditioning Research 2008
More info: http://www.pcrm.org/health/veginfo/vsk/protein_myth.html
Sunday, February 7, 2010
Odds and Ends
Yes, I am blogging during the SuperBowl, but it is almost half time and of course, I have the TV on. Well, O&E are not supposed to require much thought anyways.
HFCS: Do you know what that stands for? Do you at least know that it is bad for you? AH - well. It is High Fructose Corn Syrup or highly concentrated sweetness. It came up twice for me this week. The first incident was a positive thing. I noticed on my Kraft 100 calorie chocolate covered pretzels (OH MY) that they did NOT contain any HFCS. It was written on the label. Pretty cool I thought. First we get rid of TFAs and now HFCS - awesome. The second incidence was in a recipe I was reading in a running magazine. It said, "choose tomato or spaghetti sauce with NO HFCS for a healthier option." WHAT?! I guess I never considered that there would be HFCS in pasta sauce, of course, I make my own. :) http://www.youtube.com/watch?v=6d6haqapyYE
Insane Workout: I was watching TV - no- the TV was on and I heard a commercial for some type of fitness product and the spokesperson claimed that results, muscle building results,would be seen with 11 minutes of training a day. The person claimed this was an "insane workout" and I thought, "yeah, and so are the claims." But you know what? It really isn't an insane claim. IF you spend 11 specific and intense minutes on ONE muscle group and you do that seven days a week, alternating muscles, I guess that could be the same as doing a full body workout twice a week (as I do). So I am going to give them there due on that one.
The Power of Thoughts: You know - it is OK to ask yourself, "Why in the world am I doing this?" And this could be any number of things - riding your bicycle 50 miles on a Saturday, getting up to walk every day at 6 a.m., swimming five days a week - training for a triathlon - lifting weights when it BURNS . It is okay to ask "WHY?" and of course, you know the answer - "To meet a challenge, to improve your health, to lose weight." It is however, NEVER okay to say, "I can't" I can't get up this early, I can't swim that far, I can't pedal anymore - the I Can'ts Must GO.
H1N1: I know I have already said this, but seriously, they can't give the vaccine away these days. Interestingly, I heard a story, an allegation, recently. It regarded the power of the companies that made the vaccines (I think there were four). What?? drug companies have power and influence???? SIGH. Apparently, there is some concern that they were telling the World Health Organization how bad a "pandemic" we were going to have and how imperative a multinational vaccine campaign was. I understand that these companies want to sell the drug they spent money and took risk to make, but they cannot control the universe... can they?
Mexican Children: I printed this story a week ago and never got a chance to really explore it. The article ran on Yahoo News and lamented the obesity problem with Mexican children. What stunned me really, was that the children were still living in Mexico. I had been under the impression that people moved here and became obese by eating our food. Though I must admit that Mexican food in America anyway, seems to be incredibly fat and calorie dense. And so it is in Mexico as well. In fact, the article states that Mexico's children have the highest obesity rates in the world. What a horrible distinction. It is indeed what they eat and what they fail to do - exercise or get active. The adults have the highest overweight rates as well. The president of the country states that the issue will be addressed by modeling a program out of France. That program, called EPODE, concentrates on physical activity, fruit, vegetable and water intake and monitoring the weights of the children.
Skateboarder: Yes, again, I was passed by a kid on a skateboard that was motorized. This time I actually said, "use your legs!" Out loud. He did turn back and look at me, but I am not sure he actually heard me. I think he was in his 20s.
Smoker: OK, so I was on a roll today. Along the same route (I was running) I came upon a man, a man who appeared to be 60-70 years old ( too old to still be smoking). He was stopped and had an unlit cigarette in his mouth. He was about to light it as I ran by.. I said, "Don't do it!" I imagine he did anyway, but I tried.
Ok, half time is over, thank goodness too - these commercials really are not worth the money this year, but the game is interesting.
HFCS: Do you know what that stands for? Do you at least know that it is bad for you? AH - well. It is High Fructose Corn Syrup or highly concentrated sweetness. It came up twice for me this week. The first incident was a positive thing. I noticed on my Kraft 100 calorie chocolate covered pretzels (OH MY) that they did NOT contain any HFCS. It was written on the label. Pretty cool I thought. First we get rid of TFAs and now HFCS - awesome. The second incidence was in a recipe I was reading in a running magazine. It said, "choose tomato or spaghetti sauce with NO HFCS for a healthier option." WHAT?! I guess I never considered that there would be HFCS in pasta sauce, of course, I make my own. :) http://www.youtube.com/watch?v=6d6haqapyYE
Insane Workout: I was watching TV - no- the TV was on and I heard a commercial for some type of fitness product and the spokesperson claimed that results, muscle building results,would be seen with 11 minutes of training a day. The person claimed this was an "insane workout" and I thought, "yeah, and so are the claims." But you know what? It really isn't an insane claim. IF you spend 11 specific and intense minutes on ONE muscle group and you do that seven days a week, alternating muscles, I guess that could be the same as doing a full body workout twice a week (as I do). So I am going to give them there due on that one.
The Power of Thoughts: You know - it is OK to ask yourself, "Why in the world am I doing this?" And this could be any number of things - riding your bicycle 50 miles on a Saturday, getting up to walk every day at 6 a.m., swimming five days a week - training for a triathlon - lifting weights when it BURNS . It is okay to ask "WHY?" and of course, you know the answer - "To meet a challenge, to improve your health, to lose weight." It is however, NEVER okay to say, "I can't" I can't get up this early, I can't swim that far, I can't pedal anymore - the I Can'ts Must GO.
H1N1: I know I have already said this, but seriously, they can't give the vaccine away these days. Interestingly, I heard a story, an allegation, recently. It regarded the power of the companies that made the vaccines (I think there were four). What?? drug companies have power and influence???? SIGH. Apparently, there is some concern that they were telling the World Health Organization how bad a "pandemic" we were going to have and how imperative a multinational vaccine campaign was. I understand that these companies want to sell the drug they spent money and took risk to make, but they cannot control the universe... can they?
Mexican Children: I printed this story a week ago and never got a chance to really explore it. The article ran on Yahoo News and lamented the obesity problem with Mexican children. What stunned me really, was that the children were still living in Mexico. I had been under the impression that people moved here and became obese by eating our food. Though I must admit that Mexican food in America anyway, seems to be incredibly fat and calorie dense. And so it is in Mexico as well. In fact, the article states that Mexico's children have the highest obesity rates in the world. What a horrible distinction. It is indeed what they eat and what they fail to do - exercise or get active. The adults have the highest overweight rates as well. The president of the country states that the issue will be addressed by modeling a program out of France. That program, called EPODE, concentrates on physical activity, fruit, vegetable and water intake and monitoring the weights of the children.
Skateboarder: Yes, again, I was passed by a kid on a skateboard that was motorized. This time I actually said, "use your legs!" Out loud. He did turn back and look at me, but I am not sure he actually heard me. I think he was in his 20s.
Smoker: OK, so I was on a roll today. Along the same route (I was running) I came upon a man, a man who appeared to be 60-70 years old ( too old to still be smoking). He was stopped and had an unlit cigarette in his mouth. He was about to light it as I ran by.. I said, "Don't do it!" I imagine he did anyway, but I tried.
Ok, half time is over, thank goodness too - these commercials really are not worth the money this year, but the game is interesting.
Subscribe to:
Posts (Atom)