I wrote this post on May 20 -21, 2016 after the FDA announced new labeling requirements for packaged food manufacturers. The manufacturers will be required to provide additional information and modified information on the Nutrition Facts Panel (NFP). This applies to all companies, but smaller ones have longer to comply. The FDA announced July 2018 as the official effective date, but we know from past FDA associated labeling initiatives that this date could change.
The FDA press release - which you can access here - offers highlights of the changes, and many news sources have covered the story. What I want to do is put the changes in the context of my blog re: nutrition disclosures that help us consume fewer calories across venues.
So does this change help? Probably - or to some extent. First, the revised labels have an increased 'reference serving size'. The noted serving size may merely be a declaration to allow the nutrient content to be calculated, because people rarely (if ever) dole out cups, ounces, or grams and even if they did, it would be more cups, ounces, or grams than the label suggests. The update, a slightly larger serving size, appears to be a compromise between what people are actually eating and what they are supposed to be eating. In other words, it is probably still not realistic. One example of a serving size change involves ice cream. Instead of a 1/2 cup, a label will say 2/3 cup. I imagine most people scoop out more than 2/3 a cup of ice cream for themselves, therefore, if a person wanted to know the actual calories or sugar they consumed, they'd have to do the math (just as before). Also people may think that the label refers to an actual cup of some sort, not a measuring cup.
A similar issue with serving sizes is unchanged. They are not exactly uniform across similar products - the serving sizes may all be a 1/2 cup but the weight - the precise measurement - will vary. Boxes of cereal and cartons of ice cream, as opposed to say, a can of soda, are actually figured by weight, grams usually. So a serving size might be 2/3 cup on five cartons of ice cream but the weight of each 2/3 cup could be different. So to be frugal with our calories like we are with our dollars, we need to know the calories per unit. You don't get to see an orange shelf tag with this information but you can do the math, e.g. calories per serving divided by grams in a serving gives you the calories/gram.
Another change on the NFP is that sugar grams will come with a % DV. I've never been much of a fan of the % daily value disclosure on a label. It is based on a 2000 calorie/day diet and the majority of women, myself included, require less, say 1500 to 1800, so again, math is required. There is a trick that can make the percentages useful. If the item on the label is a nutrient of concern (meaning we get too much of it, like calories, sugar and sodium), look for a low %DV. Low is 10% or less. There are very few nutrients that Americans lack, but for those, look for high %DV. For example, it would be great to have products with vitamin D and calcium at 20% or higher.
Small packages, ones that people are likely to consume all at once even if they 'technically' contain 2 or 3 servings, will now have dual labels. There will be a column with the serving size nutrient information and a column with the whole package nutrient information. For items like a 20 ounce soda, where the expectation or custom is to drink the entire bottle in one 'sitting' the nutrient and calorie content will only be for the entire package (who drinks 8 ounces of a 20 ounce soda and saves the rest for tomorrow?). BTW, that is why I go for diet sodas in 12 ounce cans, I do not need 20 ounces, its too much; and for some diet sodas, the trace calories will become meaningful beyond 12 ounces.
There are a couple more changes, which are not as relevant to the theme of my blog. You can review them by clicking on the above link.
I'll end with two important things the new labels do not address. The information is still on the back of the package and the rule doesn't amend the new vending machine law to include sugar grams with the point of purchase calorie disclosure. Because the Nutrition Facts Panel is still on the back of the package the prospective buyer has to pick up and turn each product around (the new rule does not mandate or standardize front of pack labels and this is a disappointment). And consequently, this rule won't help us purchase low 'added sugar' snacks from vending machines because we can't see the back of the package at the time of purchase.
Showing posts with label weight. Show all posts
Showing posts with label weight. Show all posts
Monday, May 23, 2016
Tuesday, May 3, 2016
Why we focus on food deserts and not food swamps
Most people have heard the term food desert. A food desert is a place where people live and do not have reasonable access to whole foods, or fresh produce. Often this is measured by some distance to a grocery store. For example, in some places people live close to convenience stores and fast food restaurants, but would have to travel several miles, sometimes 10 or 20, to get to a grocery store. In these same areas, there may be high rates of obesity - however, there are high rates of overweight and obesity across the USA. Some speculate that not living close to a grocery store where one can access produce is a 'cause' of obesity (i.e., they associate food deserts with obesity). And it is not just availability, it's affordability, too. If the fresh produce costs more than processed foods, they are less accessible. If children have to try foods several times to like them, and a parent is on budget, it makes it hard to buy more expensive items that might not be eaten.
Access and affordability are things that public health advocates work to change AND that the electorate/society supports. Right? Of course we should make sure everyone has access to nutritious foods that are often low in calories. YAY! Let's do it.
Research has not always supported the intuitive, however, and sometimes people who have access to fruits and vegetables still don't purchase or consume them. Why not? Well, my educated/informed opinion is because a good many people live in food swamps. I am not sure where I first heard or read the phrase, but I describe a food swamp as an area where high calorie foods - often low in nutrients - are in abundance, are cheap, easy to locate, highly advertised, branded (e.g., KFC, Doritos, Pepsi) and popular among children, adolescents and adults. Actually, these foods and their promotions (e.g., all you can eat buffets, $1 hamburgers, 3 for 1 honeybuns, 32 ounce sodas) are hard to avoid.
As noted above, the popular strategy for dealing with a food desert is to bring more fresh foods in - build a grocery store or a farmers market, add produce to the convenience store checkout, send in a mobile produce truck - and hope people will purchase, prepare wisely and eat more nutritious foods. Oh and here is the most important part... eat them instead of the high calorie non-nutritious foods they have been eating. Every one agrees, yes - those are all good strategies... yay, lets fund them! [They don't work so well, but they seem smart and non-paternalistic, therefore, it must be right.]
The strategy for food swamps (which is as unpopular as the food desert strategy is popular) is policy and regulation. I believe that food swamps are the bigger problem and that regulation and policy are our best bet at trying to reduce over consumption of calories (often occurring passively, i.e., not intentionally eating extra calories). Examples include, limiting the number of fast food/quick casual restaurants that can surround neighborhoods, schools, and worksites (zoning laws), putting a sales tax on high calorie, low nutrient items, like sugar sweetened beverages (specifically I say a sales tax because consumers are more likely to notice a sales tax than an excise tax and sales taxes cannot be 'eaten' by the manufacturer unless they literally lower the prices of their products), putting calorie counts out in front on everything, everywhere (menu boards, front of packages, sodas) and educating people on what is considered a 'high' amount of calories (e.g, a dinner entree over 500 calories is high, if it is part of a days worth of meals), portion caps - like suggested in NYC might work, and limiting ads for high calorie foods or ad space (e.g., TV, public transit, magazines, websites, social media). I think our grocery stores should have makeovers as well. The cheap, high calorie foods should not get prominence and promotion. This is one of the main reasons I believe that strategies to add fruits and vegetables to neighborhood stores or whole grocery stores to neighborhoods, fail. It is hard to get through the mire of junk - physically, emotionally, socially, parentally - to the better for you items.
And before anyone points out that the food swamp policies I mentioned are regressive (i.e., they will have a bigger impact on persons of lower income) I say YES, and obesity and its related disease conditions is also regressive and has a greater impact on persons of lower income.
My point is, that though it might sound good (especially politically) to make fruits and vegetables and other nutritious foods available and accessible, what we really need is to make low nutrient (junk) foods and drinks LESS available and accessible (less cheap, less popular, less in our face). And as that annoying prince on the TV show Outlander says, "mark me" I am right about this.
Access and affordability are things that public health advocates work to change AND that the electorate/society supports. Right? Of course we should make sure everyone has access to nutritious foods that are often low in calories. YAY! Let's do it.
Research has not always supported the intuitive, however, and sometimes people who have access to fruits and vegetables still don't purchase or consume them. Why not? Well, my educated/informed opinion is because a good many people live in food swamps. I am not sure where I first heard or read the phrase, but I describe a food swamp as an area where high calorie foods - often low in nutrients - are in abundance, are cheap, easy to locate, highly advertised, branded (e.g., KFC, Doritos, Pepsi) and popular among children, adolescents and adults. Actually, these foods and their promotions (e.g., all you can eat buffets, $1 hamburgers, 3 for 1 honeybuns, 32 ounce sodas) are hard to avoid.
As noted above, the popular strategy for dealing with a food desert is to bring more fresh foods in - build a grocery store or a farmers market, add produce to the convenience store checkout, send in a mobile produce truck - and hope people will purchase, prepare wisely and eat more nutritious foods. Oh and here is the most important part... eat them instead of the high calorie non-nutritious foods they have been eating. Every one agrees, yes - those are all good strategies... yay, lets fund them! [They don't work so well, but they seem smart and non-paternalistic, therefore, it must be right.]
The strategy for food swamps (which is as unpopular as the food desert strategy is popular) is policy and regulation. I believe that food swamps are the bigger problem and that regulation and policy are our best bet at trying to reduce over consumption of calories (often occurring passively, i.e., not intentionally eating extra calories). Examples include, limiting the number of fast food/quick casual restaurants that can surround neighborhoods, schools, and worksites (zoning laws), putting a sales tax on high calorie, low nutrient items, like sugar sweetened beverages (specifically I say a sales tax because consumers are more likely to notice a sales tax than an excise tax and sales taxes cannot be 'eaten' by the manufacturer unless they literally lower the prices of their products), putting calorie counts out in front on everything, everywhere (menu boards, front of packages, sodas) and educating people on what is considered a 'high' amount of calories (e.g, a dinner entree over 500 calories is high, if it is part of a days worth of meals), portion caps - like suggested in NYC might work, and limiting ads for high calorie foods or ad space (e.g., TV, public transit, magazines, websites, social media). I think our grocery stores should have makeovers as well. The cheap, high calorie foods should not get prominence and promotion. This is one of the main reasons I believe that strategies to add fruits and vegetables to neighborhood stores or whole grocery stores to neighborhoods, fail. It is hard to get through the mire of junk - physically, emotionally, socially, parentally - to the better for you items.
And before anyone points out that the food swamp policies I mentioned are regressive (i.e., they will have a bigger impact on persons of lower income) I say YES, and obesity and its related disease conditions is also regressive and has a greater impact on persons of lower income.
My point is, that though it might sound good (especially politically) to make fruits and vegetables and other nutritious foods available and accessible, what we really need is to make low nutrient (junk) foods and drinks LESS available and accessible (less cheap, less popular, less in our face). And as that annoying prince on the TV show Outlander says, "mark me" I am right about this.
Monday, February 15, 2016
February Reminder: You said you would eat 'better' this year!
It's the middle of February, how are you doing with your goals to eat healthier in 2016?
I hope this post has helped get you back on track or keep you on track and given you some new information for meeting your goals.
Here are a few reminders and helpful hints:
Remember that calories still count and there are plenty of ways to eat delicious, full plates of food if you make some clever choices. For example, when eating out you can order your fish or meat with little to no oil, butter, glaze or sauce and ask for your vegetables to be steamed without butter. (note, pasta is never low calorie and bottomless bowls of it are a mistake) At home, you can prepare your food the same way - without lots of sauces, breading or butter.
Remember that calories still count and there are plenty of ways to eat delicious, full plates of food if you make some clever choices. For example, when eating out you can order your fish or meat with little to no oil, butter, glaze or sauce and ask for your vegetables to be steamed without butter. (note, pasta is never low calorie and bottomless bowls of it are a mistake) At home, you can prepare your food the same way - without lots of sauces, breading or butter.
Some vegetables are more nutritious than others - high in nutrients but not high in calories, as long as you do not bread, fry or coat them in butter. For example, summer squashes, spaghetti squash, eggplant, cauliflower, broccoli, asparagus, butternut squash, Brussels sprouts, green beans, greens (kale, broccoli rabe, etc). Use this link to find other low calorie foods, and remember just because they start out low calorie doesn't mean they end up low calorie (how you or the chef prepares them is a crucial factor).
Alcohol and caffeine(particularly in coffee) can be a part of a health promoting diet, but be mindful of two things: 1) excess alcohol and caffeine can have adverse effects on your health (excess is more than one or two drinks a day depending on your sex and size, and probably 3 to 4 8-ounce cups of coffee); 2) both alcoholic beverages and coffee that is flavored with cream and sugar, bring in calories and those calories count towards your individual daily requirements.
I enjoy a good cup of arabica coffee, black no sugar in the morning (okay 2) and decaffeinated, almond milk infused cappuccino in the evening. (sugar free milk ~ 30 cals a cup). For alcohol, I stick to one 12 ounce light beer, one 4 to 6 ounce glass of wine OR one shot of liquor mixed with a no calorie beverage. I recently made a batch of limoncello which I am enjoying several nights a week! Pictured above.
I hope this post has helped get you back on track or keep you on track and given you some new information for meeting your goals.
Tuesday, August 4, 2015
Calorie Awareness While Traveling
I recently spent a week at a Residence Inn in Alabama. I attended a research methods workshop for obesity prevention and treatment. On several occasions, I was aware of the 'conspicuous' absence of calorie disclosures. The biggest one... the hotel 'free breakfast.' Except for the cartons of yogurt and milk, nothing was labeled. Considering that a slice of bread can have as little as 40 calories (if you search hard) and as many as 100+, that's a big deal. I imagine the range for the available muffins, bagels and waffles make them equally hard to 'estimate.' Sure a day or two of incidental over consumption should't have lasting effects on your health, but if you travel - and eat away from home - often, the information will come in handy.
When I travel, attend workshops, meetings and just go to work, I try to keep within the bounds of what is healthy for me. That is another observation I had while at the workshop. It is not enough for the planners to serve 'healthy' food, because healthy, especially these days, is a relevant term and a moving target. Healthy for me mostly meets with the updated recommendations from the Dietary Guidelines Advisory Committee:
So for me, healthy is not about organic or 'all natural,' and healthy doesn't mean no artificial sweeteners, but that is exactly how some others might define healthy for themselves. My healthy diet includes mostly whole foods, minimally processed; no meats, lots of vegetables, soy based lean protein, fish, almond milk and no or low fat dairy (yogurt, cheese, ice cream), fruit, coffee, plenty of whole grains, like popcorn!, fiber and yup, alcohol and diet soda. So to eat the way I like, I usually bring my own food, and in Alabama, though I ate out a few nights, I went to the grocery store and prepared my lunch and dinner in the nice hotel room kitchen. (The reason the workshop lunches weren't 'healthy' to me is because they were often sandwiches, pasta, or meat based. I did enjoy the fruit and diet soda though!)
Interestingly, my friends and I were out walking one evening and one or two got very excited when we passed the Insomnia Cookies store. (remember this was an obesity prevention workshop, and cookies can be part of a calorie controlled diet). So, my friend was more than a little excited as she went into the store - there was quite a line at the counter - but she came right back out, with a brochure (for me) and disgust. WHY? THEY POSTED THE CALORIE CONTENT! HAHAHAHA, she said that seeing the calories took all the fun out of it. Hilarious. (BTW, we have one of these Insomnia Cookie food trucks at Temple University, and the shop in Alabama was within a mile of the UAB campus. Sense a theme?)
When I travel, attend workshops, meetings and just go to work, I try to keep within the bounds of what is healthy for me. That is another observation I had while at the workshop. It is not enough for the planners to serve 'healthy' food, because healthy, especially these days, is a relevant term and a moving target. Healthy for me mostly meets with the updated recommendations from the Dietary Guidelines Advisory Committee:
The overall body of evidence examined by the 2015 DGAC identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat;i and low in sugar-sweetened foods and drinks and refined grains. Vegetables and fruit are the only characteristics of the diet that were consistently identified in every conclusion statement across the health outcomes.*The fruits and vegetables are highlighted as being prepared with spices and without adding salt and saturated fat. See the full report here.
So for me, healthy is not about organic or 'all natural,' and healthy doesn't mean no artificial sweeteners, but that is exactly how some others might define healthy for themselves. My healthy diet includes mostly whole foods, minimally processed; no meats, lots of vegetables, soy based lean protein, fish, almond milk and no or low fat dairy (yogurt, cheese, ice cream), fruit, coffee, plenty of whole grains, like popcorn!, fiber and yup, alcohol and diet soda. So to eat the way I like, I usually bring my own food, and in Alabama, though I ate out a few nights, I went to the grocery store and prepared my lunch and dinner in the nice hotel room kitchen. (The reason the workshop lunches weren't 'healthy' to me is because they were often sandwiches, pasta, or meat based. I did enjoy the fruit and diet soda though!)
Interestingly, my friends and I were out walking one evening and one or two got very excited when we passed the Insomnia Cookies store. (remember this was an obesity prevention workshop, and cookies can be part of a calorie controlled diet). So, my friend was more than a little excited as she went into the store - there was quite a line at the counter - but she came right back out, with a brochure (for me) and disgust. WHY? THEY POSTED THE CALORIE CONTENT! HAHAHAHA, she said that seeing the calories took all the fun out of it. Hilarious. (BTW, we have one of these Insomnia Cookie food trucks at Temple University, and the shop in Alabama was within a mile of the UAB campus. Sense a theme?)
 |
| Notice the ranges, also on the right is ice cream |
Monday, June 1, 2015
Calorie Mindful or Drunkorexia
I recently came across a research article discussing a phenomena (possible 'disorder') called drunkorexia. The term and what it means caught me off guard and to be honest, disturbed me. It disturbs me for a couple reasons. The first is that I am loathe to think that my advising persons - as a public health educator - to consider how they spend their calories in a given day might in some way suggest that I think people should drastically cut their calories in order to 'fit in' highly caloric (and dangerous) binge drinking. Of course, I expect that the primary audience for my blog and YouTube channel are not mostly college aged females - the group that engages in this behavior the most - and is instead, people doing their best to consume the right amount of calories to keep themselves at a health promoting weight. So when I say that I personally consider the 1 beer, glass of wine or alcoholic beverage (~ 100 cals) in my daily total, and thus have a smaller lunch or breakfast in order to have that drink, I am NOT advocating skipping meals or 'starving' in order to 1) drink on an empty stomach for a quicker high or 2) or to consume 500 or more calories in alcohol and not gain weight.
I am also concerned when people medicalize/diagnose behaviors, like the dumb one I just described, into psychological problems - at least too quickly. Labeling people, in my experience as a social worker (not a psychiatrist/psychologist or nutritionist), too soon or maybe at all, can cement the problem; the person becomes the problem - the illness manifests because someone said it was there.
My area of expertise and research is not eating disorders. The main point of this post, and the point I will reiterate and end with is: being smart about the calories you consume does not include - never includes - not eating. It is easy to reduce a breakfast and or lunch by 50 to 100 calories by changing its ingredients. I do not advocate any of the behaviors associated with this 'drunkorexia.'
Saturday, January 3, 2015
Calories as Currency
The reason I appreciate, support and take advantage of calorie disclosures on pre packaged, ready to eat, and bulk food items (see e.g., the USDA nutrient data base) and prepare 90% of my meals - over the course of a year - is because I LOVE to eat and want to stay thin.
Exercise is important - it is vital to health - but unless one can do moderate to vigorous physical activity for more than an hour a day every day - or be in some other way unusual (e.g., have genetically, hyper metabolism), exercise is not going to keep you thin - at best, it will allow you to eat a 100 or so more calories than you could eat without exercising, and maintain a certain weight.
So to meet my goals, I monitor - stay aware of - my calorie intake. Calories are currency and I do not spend them lightly. In other words, I would rather have a plateful of 200 calories than a tablespoonful. To be truthful, it took me years of self education - reading and research - to understand what 200 calories means in relation to my daily needs. I eat 5 or 6 meals a day and consume between 1500 and 1800 calories a day depending on my current level of physical activity and fitness.
For all of us, calories have always mattered and up until recently, the calorie content for most of our foods has been hard to access. With new nutritional labeling requirements for away from home foods (e.g., snacks in vending machines and movie theatres, restaurant meals), existing labeling on packaged foods, emerging but imperfect front of pack labeling and unprecedented access to legitimate calorie information on line, people have a real opportunity to consume the right amount of calories for their bodies. The information is there, but the understanding of calorie moderation and the desire to moderate are both lacking.
Now more than ever, we need health educators and promoters to:
The way I eat, this calorie as currency approach, is possible because I choose foods with low energy density - Dr. Barbara Rolls at Penn State terms it Volumetrics and has written books on the style - it is not a diet, it is a way of choosing and preparing foods - all the time. I know January is diet focused but I encourage you to think instead about calories and nutritious foods on which to spend them.
[I did not discuss carbs, protein, fats and sugar - you understand there is a current debate and the evidence is contradictory, but calories have not changed - too many of them from any source is a cause of weight gain. Most will agree that salty, sugary and fried foods should be substantially reduced if not eliminated from the diet, and that complex carbs and fat are important dietary components.]
Exercise is important - it is vital to health - but unless one can do moderate to vigorous physical activity for more than an hour a day every day - or be in some other way unusual (e.g., have genetically, hyper metabolism), exercise is not going to keep you thin - at best, it will allow you to eat a 100 or so more calories than you could eat without exercising, and maintain a certain weight.
So to meet my goals, I monitor - stay aware of - my calorie intake. Calories are currency and I do not spend them lightly. In other words, I would rather have a plateful of 200 calories than a tablespoonful. To be truthful, it took me years of self education - reading and research - to understand what 200 calories means in relation to my daily needs. I eat 5 or 6 meals a day and consume between 1500 and 1800 calories a day depending on my current level of physical activity and fitness.
For all of us, calories have always mattered and up until recently, the calorie content for most of our foods has been hard to access. With new nutritional labeling requirements for away from home foods (e.g., snacks in vending machines and movie theatres, restaurant meals), existing labeling on packaged foods, emerging but imperfect front of pack labeling and unprecedented access to legitimate calorie information on line, people have a real opportunity to consume the right amount of calories for their bodies. The information is there, but the understanding of calorie moderation and the desire to moderate are both lacking.
Now more than ever, we need health educators and promoters to:
- assure the public that calories do count,
- educate the public on the amount of calories most people need in a day,
- provide the public with the reasons the amount of calories needed may vary, per person and per day, and
- note that food volume alone does not signify calorie amount - for example a CUP of kale and a TEASPOON of oil or butter have about the same amount of calories (30 to 40), such that more can sometimes be less and less can certainly and often is quite more..
The way I eat, this calorie as currency approach, is possible because I choose foods with low energy density - Dr. Barbara Rolls at Penn State terms it Volumetrics and has written books on the style - it is not a diet, it is a way of choosing and preparing foods - all the time. I know January is diet focused but I encourage you to think instead about calories and nutritious foods on which to spend them.
[I did not discuss carbs, protein, fats and sugar - you understand there is a current debate and the evidence is contradictory, but calories have not changed - too many of them from any source is a cause of weight gain. Most will agree that salty, sugary and fried foods should be substantially reduced if not eliminated from the diet, and that complex carbs and fat are important dietary components.]
Sunday, September 9, 2012
Let's Make Prevention the Priority
At the end of August, the World Cancer Congress 2012 was held in Canada. The congress is a meeting of professionals - research and practice - that occurs every two years. The purpose is to share experience and knowledge to impact change in cancer occurrence and outcomes (death).
Once again, but with growing unity and urgency, people who study cancer in labs, communities and patients and those who treat patients, tell us that at the very least 50% of cancer can be prevented.
Prevented by what we do, what we are exposed to, whether or not we are immune to viruses (HPV, HCV, HBV) and the screenings we complete (PAP, sigmoidoscopy).
Graham Colditz, PhD, DrPH was one of the presenters. He notes smoking as the cause of 30% of all cancer and said that reducing smoking rates to 11% (like in Utah) would reduce smoking related cancers by 75%. He also noted that being overweight accounts for about 20% of cancers (and that to prevent cancer the BMI range should be between 21 to 23). Physical inactivity and poor diet ( defined as a diet that does not include the better foods in adequate amounts and does not limit others (salt, trans fat, sat fat, sugar) each cause about 5% of cancer and if improved would reduce the new cases of cancer substantially.
I have no doubt that this is true. Therefore, I have strong reservations on spending my money (donations) or the governments money to explore treatment/cures when we are doing nothing to stop the cases from coming. It is like this familiar health care story. Do we keep training EMTs, buying ambulances and expanding hospital ER rooms to treat drowning victims - or do we fix the hole in the bridge. Public health folks, like me, want to fix the bridge. {some people would do neither and just educate people to stop falling into the hole!}
I would like money to be spent on improving our environment so that eating well, moving more, consuming the right amount of calories, getting appropriate and evidence based health screenings and vaccinations is EASY. (even if this means some kind of regulation)
We are fools to keep treating things that we can prevent. (I in no way place blame on cancer or heart disease patients and I am not suggesting that we not treat their illnesses. [the pharmaceutical industry would never have that!] I just want to point out the futility on a population level. I see the environment and health care system as places to intervene, and when situations are truly conducive to good health, then I view personal responsibility as a possible nationwide focus.)
See more about the World Cancer Congress and the UICC here.
{note when looking at studies or speeches like this - there are two sets of numbers to explore - the percent of cancer that is accounted for by a factor and the amount that can be prevented if that factor is addressed}
Once again, but with growing unity and urgency, people who study cancer in labs, communities and patients and those who treat patients, tell us that at the very least 50% of cancer can be prevented.
Prevented by what we do, what we are exposed to, whether or not we are immune to viruses (HPV, HCV, HBV) and the screenings we complete (PAP, sigmoidoscopy).
Graham Colditz, PhD, DrPH was one of the presenters. He notes smoking as the cause of 30% of all cancer and said that reducing smoking rates to 11% (like in Utah) would reduce smoking related cancers by 75%. He also noted that being overweight accounts for about 20% of cancers (and that to prevent cancer the BMI range should be between 21 to 23). Physical inactivity and poor diet ( defined as a diet that does not include the better foods in adequate amounts and does not limit others (salt, trans fat, sat fat, sugar) each cause about 5% of cancer and if improved would reduce the new cases of cancer substantially.
I have no doubt that this is true. Therefore, I have strong reservations on spending my money (donations) or the governments money to explore treatment/cures when we are doing nothing to stop the cases from coming. It is like this familiar health care story. Do we keep training EMTs, buying ambulances and expanding hospital ER rooms to treat drowning victims - or do we fix the hole in the bridge. Public health folks, like me, want to fix the bridge. {some people would do neither and just educate people to stop falling into the hole!}
I would like money to be spent on improving our environment so that eating well, moving more, consuming the right amount of calories, getting appropriate and evidence based health screenings and vaccinations is EASY. (even if this means some kind of regulation)
We are fools to keep treating things that we can prevent. (I in no way place blame on cancer or heart disease patients and I am not suggesting that we not treat their illnesses. [the pharmaceutical industry would never have that!] I just want to point out the futility on a population level. I see the environment and health care system as places to intervene, and when situations are truly conducive to good health, then I view personal responsibility as a possible nationwide focus.)
See more about the World Cancer Congress and the UICC here.
{note when looking at studies or speeches like this - there are two sets of numbers to explore - the percent of cancer that is accounted for by a factor and the amount that can be prevented if that factor is addressed}
Sunday, August 12, 2012
Odds and Ends
Water Conservation - Beverage Heroes? A story from the Associated Press (AP) caught my attention yesterday. It was published in many papers so you might have caught it. The largest beverage companies are spending millions of dollars to assure that certain land areas are NOT developed and that the proper care of watersheds is administered. The conservation efforts are intended to protect the companies bottom lines - the products they sell. Beverages are predominately water. I understand that their motive is self satisfying but the outcome is beneficial to everyone and I applaud the efforts. Here is a link to the story from one of many sources.
Weight Control Success You are probably aware that individual research experiments and the National Weight Control Registry support the assertion that people who are successful at maintaining weight loss use self monitoring techniques. They keep track of their intake of calories. The level of monitoring (every calorie or just general daily calories) is not as important as the awareness of what one is eating. Because we spend almost 50% of our food budgets on away from home meals and calorie monitoring is a successful weight control technique, it is vital that we have calorie content available on menus and menu boards. Lets get the final rule written and the numbers on our menus! (FDA delay)
Eye Drop Application Here is another thing you may know, but just in case you don't I will share it. Actually there are two things. As noted previously, I have sun damage to my eyes. The condition is called pinquela. My whites are discolored (this makes me sad). The eye doctor suggests that I use drops every day. He told me this two years ago, so I got some Visine. When I saw him in July he said "NO! That is the opposite of what you need." Ooops. So for dry, damaged, scratchy eyes, lubricant drops are helpful. I bought the store brand after I used up the sample he gave me. (But only after I compared the ingredients labels). Anyways, I also told him that I had trouble administering the drops. I would blink before the drop reached my eye. So - here is the technique. With your eye closed, squeeze a drop in the corner (where your tear ducts are) then tilt back and open your eye, lean sideways, and the drop rolls right in!
NFL and Disease Prevention Somewhere along the line, I signed up to receive occasional emails from the NFL. This would be precipitated by my love of the NYG - whom I shall see play in person next month! In July, I received one of the emails and it was announcing a new Wellness Initiative for current and former players, coaches, team members and families. The main focus appears to be mental health. This may be a response to suicides and family conflict that plagues some of the players. Though it includes physical health - that may be related more to injuries (including concussions) that can turn in to disabilities than chronic disease prevention. The program includes a 24 hour hot line for members in crisis. You can learn about it by clicking here. I can't imagine this being a bad thing. I hope that it helps.
Lastly my weekly exercise chart. I didn't share it last week, but I add it today to highlight the near absence of any red columns! That is running. I did manage 15 minutes, but clearly I am not healed so I stopped. I hope for more red next time. BTW, for those who have followed my swimming trials and tribulations.. just once a week, okay just this semester, Oh, if the pool is closed, its not my fault, YAY!, okay twice a week, okay three times a week.. Well, the whole Rec Center is closed this week and I am thinking of paying to swim at the Y. Clearly I made it past the six months (now two years) time that makes something a habit.
Weight Control Success You are probably aware that individual research experiments and the National Weight Control Registry support the assertion that people who are successful at maintaining weight loss use self monitoring techniques. They keep track of their intake of calories. The level of monitoring (every calorie or just general daily calories) is not as important as the awareness of what one is eating. Because we spend almost 50% of our food budgets on away from home meals and calorie monitoring is a successful weight control technique, it is vital that we have calorie content available on menus and menu boards. Lets get the final rule written and the numbers on our menus! (FDA delay)
Eye Drop Application Here is another thing you may know, but just in case you don't I will share it. Actually there are two things. As noted previously, I have sun damage to my eyes. The condition is called pinquela. My whites are discolored (this makes me sad). The eye doctor suggests that I use drops every day. He told me this two years ago, so I got some Visine. When I saw him in July he said "NO! That is the opposite of what you need." Ooops. So for dry, damaged, scratchy eyes, lubricant drops are helpful. I bought the store brand after I used up the sample he gave me. (But only after I compared the ingredients labels). Anyways, I also told him that I had trouble administering the drops. I would blink before the drop reached my eye. So - here is the technique. With your eye closed, squeeze a drop in the corner (where your tear ducts are) then tilt back and open your eye, lean sideways, and the drop rolls right in!
NFL and Disease Prevention Somewhere along the line, I signed up to receive occasional emails from the NFL. This would be precipitated by my love of the NYG - whom I shall see play in person next month! In July, I received one of the emails and it was announcing a new Wellness Initiative for current and former players, coaches, team members and families. The main focus appears to be mental health. This may be a response to suicides and family conflict that plagues some of the players. Though it includes physical health - that may be related more to injuries (including concussions) that can turn in to disabilities than chronic disease prevention. The program includes a 24 hour hot line for members in crisis. You can learn about it by clicking here. I can't imagine this being a bad thing. I hope that it helps.
Lastly my weekly exercise chart. I didn't share it last week, but I add it today to highlight the near absence of any red columns! That is running. I did manage 15 minutes, but clearly I am not healed so I stopped. I hope for more red next time. BTW, for those who have followed my swimming trials and tribulations.. just once a week, okay just this semester, Oh, if the pool is closed, its not my fault, YAY!, okay twice a week, okay three times a week.. Well, the whole Rec Center is closed this week and I am thinking of paying to swim at the Y. Clearly I made it past the six months (now two years) time that makes something a habit.
Friday, August 10, 2012
The Calories You Burn
Part Two
Here is a way to get a (very) rough estimate of the amount of calories you are burning in a day. This is for people who have been weight stable for at least a year. If you are currently at a steady weight, write down everything (remember the Micky Mantra - every bite, lick and taste) you ate yesterday and the day before. Write down everything for today and do the same thing tomorrow. That should give you four days to average. Do NOT change your normal behavior - this includes eating out. If you usually eat out, then you need to capture those meals in your average.
There are many tools available on line (and perhaps in print) that can help you determine the calorie amounts for all of the foods on your list, if you have the serving sizes. [You might have to go four days forward instead of two days backwards for accuracy. The reason I suggested that you start with past days (even though you may forget something) is so you won't change your pattern because you are thinking about it.]
If you purchase foods away from home, you can usually get calorie information from the restaurant's website, but it may be slightly or largely inaccurate. If you prepare your own meals, you can get info on the ingredients from the USDA website. When you feel pretty confident that you have the four days individual totals, add them together, divide by four and that is your average. Remember this is only going to work if you are tracking what you normally eat.
If you are stable, the number you came up with should be the same number that you burn. TEI total energy intake = TEE total energy expenditure in weight stable people.
I will tell you that this type of estimate is closer than any you can get by trying to track your energy burn, outside of a clinical, laboratory setting. The machines at your gym are NOT accurate. Your GPS systems and sports watches are not either (but they are a good measure of consistency and changes - in other words they are reliable even if they are not valid)
I want to be very clear that what I just told you is offered as a way for you to assess in general terms, the amount of energy you use in a day. It is not meant to suggest how many calories you need to maintain or lose weight. The only qualified nutrition guidance that applies to individuals is provided by licensed/registered dieticians. Remember that even if you forget everything else you read. Your personal trainer at the gym is NOT qualified to give you diet advice, unless of course, he or she is an RD.
Nutritional science continues to grow and to challenge our assumptions about food and weight. We are learning that a calorie is not a calorie. What you eat can have an impact on your metabolic processes. Again, that is a discussion to have with a nutrition expert.
Ah, but let me get back to the conversation started with the Lowe article. We will use me as an example. I am very confident that my calorie intake varies from 1600 to 1680 calories a day (higher if I am running more). This keeps me, a very active person who is short and thin, at a stable weight. If I shift that range by even 70 calories, to between 1750 and 1830 a day, I will gain several pounds in a year. Seems like nothing, but of course, we have shifted our normal calorie intake by as many as 300 calories a day and gained many pounds. This can be reversed, in general and at the population level, by a 500 calorie reduction (some say). Sounds like a lot, but if you are one of the people eating 3000 calories a day and switch to low energy dense foods, its a piece of ......... its not that hard.
Here is a way to get a (very) rough estimate of the amount of calories you are burning in a day. This is for people who have been weight stable for at least a year. If you are currently at a steady weight, write down everything (remember the Micky Mantra - every bite, lick and taste) you ate yesterday and the day before. Write down everything for today and do the same thing tomorrow. That should give you four days to average. Do NOT change your normal behavior - this includes eating out. If you usually eat out, then you need to capture those meals in your average.
There are many tools available on line (and perhaps in print) that can help you determine the calorie amounts for all of the foods on your list, if you have the serving sizes. [You might have to go four days forward instead of two days backwards for accuracy. The reason I suggested that you start with past days (even though you may forget something) is so you won't change your pattern because you are thinking about it.]
If you purchase foods away from home, you can usually get calorie information from the restaurant's website, but it may be slightly or largely inaccurate. If you prepare your own meals, you can get info on the ingredients from the USDA website. When you feel pretty confident that you have the four days individual totals, add them together, divide by four and that is your average. Remember this is only going to work if you are tracking what you normally eat.
If you are stable, the number you came up with should be the same number that you burn. TEI total energy intake = TEE total energy expenditure in weight stable people.
I will tell you that this type of estimate is closer than any you can get by trying to track your energy burn, outside of a clinical, laboratory setting. The machines at your gym are NOT accurate. Your GPS systems and sports watches are not either (but they are a good measure of consistency and changes - in other words they are reliable even if they are not valid)
I want to be very clear that what I just told you is offered as a way for you to assess in general terms, the amount of energy you use in a day. It is not meant to suggest how many calories you need to maintain or lose weight. The only qualified nutrition guidance that applies to individuals is provided by licensed/registered dieticians. Remember that even if you forget everything else you read. Your personal trainer at the gym is NOT qualified to give you diet advice, unless of course, he or she is an RD.
Nutritional science continues to grow and to challenge our assumptions about food and weight. We are learning that a calorie is not a calorie. What you eat can have an impact on your metabolic processes. Again, that is a discussion to have with a nutrition expert.
Ah, but let me get back to the conversation started with the Lowe article. We will use me as an example. I am very confident that my calorie intake varies from 1600 to 1680 calories a day (higher if I am running more). This keeps me, a very active person who is short and thin, at a stable weight. If I shift that range by even 70 calories, to between 1750 and 1830 a day, I will gain several pounds in a year. Seems like nothing, but of course, we have shifted our normal calorie intake by as many as 300 calories a day and gained many pounds. This can be reversed, in general and at the population level, by a 500 calorie reduction (some say). Sounds like a lot, but if you are one of the people eating 3000 calories a day and switch to low energy dense foods, its a piece of ......... its not that hard.
Wednesday, June 24, 2009
Physical Fitness
I am working on today’s blog from my seat on the plane. I do not think I am supposed to try and go on line, so I will write about some things that I just read in the Wall St Journal and not add any additional research points.
Yesterday’s post mentioned the need to lower energy intake to lose weight and suggested eating low calorie foods to do so.
In the paper today there were side by side articles referencing a physical activity routine and a calorie expenditure gadget. The routine was interesting and note worthy as it was that of New York Police Commissioner Ray Kelly. He notes that since his time as a marine many years ago he has made weight training a significant part of his life. In fact, it has been said that his commitment to his routine borders on addiction. It is something that he has to do to feel right. Amen to that. He does work out for about an hour a day four days a week. He spends about 30 minutes of that time in cardio activity. He walks and runs, on a treadmill. He certainly dedicates a lot of time to his weight lifting and does many more sets than I would ever do, but he does vary the number of repetitions based on the pounds he is lifting. He made a good point, an iteration of one made here, that there is a difference between lifting to build and lifting to maintain. It is his current goal to maintain and to also to do functional exercises. Functional exercises help you do the activities of daily living, or ADLS. Working your legs to maintain your ability to take the stairs, doing core work so that your back and abs are strong and perhaps most importantly, adding balancing exercises to prevent falls.
He also eats a low fat high produce diet.
I have never watched the TV show the Biggest Loser but a certain device was used on the show that is supposed to help people track their calorie expenditure. These devices are somewhat less accurate than ones used in research studies and could cost you up to 200 dollars, but are certainly more on target than ones embedded in say, a treadmill or elliptical machine. Laura Johannes mentioned a few of these accelerometers in the paper today. The one used on the TV show has been involved in several studies. The studies were small and that certainly dilutes their validity but interestingly the gadget underestimated calorie burn, only slightly, which is far better than over estimating it. We do that without the help of an accelerometer! Anyways, it would be consistent in it’s under estimation and could still be a helpful tool for a person.
My Garmin Forerunner GPS tells me time, distance, pace and calories too and I can see when I run further I burn more, but it does not take into account when I sweat or shiver more, so I don’t think it is high in accuracy for calories. I do not wear it for that, so it is okay.
Lastly, there was a small note that got my attention. A large research study is to begin soon which will track users of vitamin D and fish oil capsules over time, to see if the purported health benefits, Drs. Willett and Cooper, will prove true and also to see if these benefits hold with blacks who will make up 25% of the study population. As you know I take Vitamin D and recently began the fish oil, so this is very exciting stuff!
Okay, that is enough I think. I am freezing to death on this plane.. and I am not alone, many people are digging out their jackets. That is just dumb.
Yesterday’s post mentioned the need to lower energy intake to lose weight and suggested eating low calorie foods to do so.
In the paper today there were side by side articles referencing a physical activity routine and a calorie expenditure gadget. The routine was interesting and note worthy as it was that of New York Police Commissioner Ray Kelly. He notes that since his time as a marine many years ago he has made weight training a significant part of his life. In fact, it has been said that his commitment to his routine borders on addiction. It is something that he has to do to feel right. Amen to that. He does work out for about an hour a day four days a week. He spends about 30 minutes of that time in cardio activity. He walks and runs, on a treadmill. He certainly dedicates a lot of time to his weight lifting and does many more sets than I would ever do, but he does vary the number of repetitions based on the pounds he is lifting. He made a good point, an iteration of one made here, that there is a difference between lifting to build and lifting to maintain. It is his current goal to maintain and to also to do functional exercises. Functional exercises help you do the activities of daily living, or ADLS. Working your legs to maintain your ability to take the stairs, doing core work so that your back and abs are strong and perhaps most importantly, adding balancing exercises to prevent falls.
He also eats a low fat high produce diet.
I have never watched the TV show the Biggest Loser but a certain device was used on the show that is supposed to help people track their calorie expenditure. These devices are somewhat less accurate than ones used in research studies and could cost you up to 200 dollars, but are certainly more on target than ones embedded in say, a treadmill or elliptical machine. Laura Johannes mentioned a few of these accelerometers in the paper today. The one used on the TV show has been involved in several studies. The studies were small and that certainly dilutes their validity but interestingly the gadget underestimated calorie burn, only slightly, which is far better than over estimating it. We do that without the help of an accelerometer! Anyways, it would be consistent in it’s under estimation and could still be a helpful tool for a person.
My Garmin Forerunner GPS tells me time, distance, pace and calories too and I can see when I run further I burn more, but it does not take into account when I sweat or shiver more, so I don’t think it is high in accuracy for calories. I do not wear it for that, so it is okay.
Lastly, there was a small note that got my attention. A large research study is to begin soon which will track users of vitamin D and fish oil capsules over time, to see if the purported health benefits, Drs. Willett and Cooper, will prove true and also to see if these benefits hold with blacks who will make up 25% of the study population. As you know I take Vitamin D and recently began the fish oil, so this is very exciting stuff!
Okay, that is enough I think. I am freezing to death on this plane.. and I am not alone, many people are digging out their jackets. That is just dumb.
Monday, June 15, 2009
Recommended Daily Intake
Due to some conversations I have had with friends of late, I wanted to write a few words (HAHAHA ) about caloric intake in the context of the nutrients that the body needs. I shuffled through some old files and found my notes from a simple nutrition course that I had taken some years ago.
My purpose today is not to tell you how many calories you need nor what percent of carbs, fat or protein... the gold standard for that kind of personal input is a licensed nutritionist. I do want you to be able to access credible Internet resources that can give you a general idea of how many calories you may need. Remember, the energy you need is based on the size you are now, the size you want to be and what you require of your body. I.e. , a football player versus an office receptionist who walks after work.
I also believe that if you limit saturated fat and sugar you will get the right amount of protein and carbs. (actually it is like the saying my Mom is fond of, "if you take care of the pennies the dollars will take care of themselves". If you watch the fat and sugar, and sodium as well, then chances are you will also cut the calories) To survive, to function, our body needs protein, fat (mono and poly unsaturated), carbohydrates (specifically complex ones), water, vitamins and minerals.
According to my study notes, which are several years old, a person needs about 60% complex carbs, zero refined sugar and about 25 grams of fiber a day. Protein, carbs and monounsaturated fats are key. I do not have my Cooper Institute notebook at home with me, but I recall one of the professors telling us not to get caught up in percent breakdowns.
Please consider this food guide pyramid by Walter Willett, MD and the Harvard School of Public Health.
Copyright © 2008. For more information about The Healthy Eating Pyramid, please see The Nutrition Source, Department of Nutrition, Harvard School of Public Health, , and Eat, Drink, and Be Healthy, by Walter C. Willett, M.D. and Patrick J. Skerrett (2005), Free Press/Simon & Schuster Inc.
I believe if you follow these recommendations within
your own caloric requirements you would get the right amount of carbs and protein, etc. If you are underweight, recovering from illness, have wounds or injuries, a special recommendation will be made for you by a medical professional and or nutritionist.
Also use this website to get an idea of how many calories a day you may need.
Go to the bottom left and there is a link called Calorie Needs, click there:
http://www.standupandeat.org/
Continue to explore the above link and you will learn much to get yourself on the way to a healthy active life. Remember we want to extend healthy years not debilitating ones.
My purpose today is not to tell you how many calories you need nor what percent of carbs, fat or protein... the gold standard for that kind of personal input is a licensed nutritionist. I do want you to be able to access credible Internet resources that can give you a general idea of how many calories you may need. Remember, the energy you need is based on the size you are now, the size you want to be and what you require of your body. I.e. , a football player versus an office receptionist who walks after work.
I also believe that if you limit saturated fat and sugar you will get the right amount of protein and carbs. (actually it is like the saying my Mom is fond of, "if you take care of the pennies the dollars will take care of themselves". If you watch the fat and sugar, and sodium as well, then chances are you will also cut the calories) To survive, to function, our body needs protein, fat (mono and poly unsaturated), carbohydrates (specifically complex ones), water, vitamins and minerals.
According to my study notes, which are several years old, a person needs about 60% complex carbs, zero refined sugar and about 25 grams of fiber a day. Protein, carbs and monounsaturated fats are key. I do not have my Cooper Institute notebook at home with me, but I recall one of the professors telling us not to get caught up in percent breakdowns.
Please consider this food guide pyramid by Walter Willett, MD and the Harvard School of Public Health.
Copyright © 2008. For more information about The Healthy Eating Pyramid, please see The Nutrition Source, Department of Nutrition, Harvard School of Public Health, , and Eat, Drink, and Be Healthy, by Walter C. Willett, M.D. and Patrick J. Skerrett (2005), Free Press/Simon & Schuster Inc.
I believe if you follow these recommendations within
your own caloric requirements you would get the right amount of carbs and protein, etc. If you are underweight, recovering from illness, have wounds or injuries, a special recommendation will be made for you by a medical professional and or nutritionist.
Also use this website to get an idea of how many calories a day you may need.
Go to the bottom left and there is a link called Calorie Needs, click there:
http://www.standupandeat.org/
Continue to explore the above link and you will learn much to get yourself on the way to a healthy active life. Remember we want to extend healthy years not debilitating ones.
Friday, April 10, 2009
wellness weekly
The News:
Triglycerides: Having high triglycerides can be an independent risk factor for heart disease. Heart disease can of course lead to premature death. Unfortunately, there is a growing prevalence of this condition in America which is associated with the obesity problem that we have. There has been a push by some, I am guessing the pharmaceutical industry, to use statin therapy to lower triglycerides, but a recent study does not support that recommendation. Instead, when a person’s level of this blood fat is between 150 and 500, known as hypertriglyceridemia, changes in diet and activity level should be recommended by the treating physician. This is a serious issue. I have not had blood work since 2005, but I had it today! So stay tuned for the present. My last level was in the 80s.
What? With sales slumping at most clothing stores, eclectic boutiques are looking for ways to get customers in and to keep them around for a while. I read in the WSJ last week that several were offering beer, wine and cocktails. My first and continued reaction is this, the LAST thing I want to do before I try on a pair of jeans is drink a beer!
High or Low Fat,Carbs,Protein: Instead of a randomized clinical drug trial, researchers who published their study in a peer reviewed journal, Cardiosource, placed over 800 overweight and obese persons into 3 separate diet groups. What they found was weight loss occurs when less calories are consumed (everyone sure hates to hear that), but cholesterol levels were lower in the group that ate less saturated fat.
Garadasil: One of my list serves contained an article on recommendations for this vaccine. Because Gardasil is new and in my opinion controversial, I read the article. There were a few points that I would like to iterate. There are 4 strains of HPV addressed by this vaccine. Two of them are responsible for 70% of the HPV that can lead to cervical cancer and two are responsible for 90% of the strain that may lead to genital warts. If a person has been exposed to part of these four strains (there are many more strains) but not all, there may be some therapeutic benefit from getting the vaccine. There is no benefit if a person has been exposed to all four. Thus the vaccine is best for persons not yet sexually active. HPV is the most common of the sexually transmitted diseases with current prevalence at about 26%. The article that I read was written by pharmacist Laurie Briceland. BTW, vaccine or no, Pap Smears can prevent cervical cancer.
Readmissions: The Government and it’s Centers for Medicare Services or CMS, did some research into costs of care for its Medicare recipients. Of concern is readmission to the hospital within 30 days of discharge. The study found that billions of dollars could be saved if this rate of readmissions could be lowered from the current 20%. What is considered the main cause of these unplanned readmissions is lack of adequate follow up care. Discharge planning was one of my roles in a past career and at my hospital every patient had to be scheduled with their PCP after discharge. Many patients did not keep their appointment and the cause of that warrants further investigation. Some issues of which I am aware is availability of doctors, long wait times, transportation issues, and Medicare visit costs. I must add that at many hospitals there is pressure to “get the patient out of there.”
Obesity Epidemics Main Cause: I have seen this before but when I saw it on Sunday I thought, you know, that is it right there. Electric Bicycles. No not mopeds, bicycles with engines. Now General Motors, whom I thought could not make any more mistakes, wants to expand its relationship with Segway Co. A new vehicle is being produced that can pretty much obviate walking. This new rideable device will be called PUMA. That stands for Personal Urban Mobility and Accessibility. I cannot swallow this. We are overweight and our environment is polluted for one very significant reason… we do not walk anywhere. So for those of us who are able to walk, i.e. not paralyzed, here is the personal mobility device I would like to promote; LEGS.
Okay, let’s do some cooking.
Whole Wheat Pancakes:
Spices: cinnamon and sugar free vanilla syrup
Grains: 56 g of whole wheat flour, ¾ cup of loose oat bran
Liquid: ¼ cup no sugar added apple sauce, eighth cup egg beaters, ¼ cup skim milk
Sweetener: ¼ c splenda
Other: Baking Powder
Topping: Walden’s Farms Sugar/Calorie Free Syrup
(this recipe has 420 calories, on the video i mistakenly say 400 at one point)
Non fat spray and water is also needed.
Calorie content explained in video. BTW, whole wheat flour is a protein source!
Live Well
Deirdre
Triglycerides: Having high triglycerides can be an independent risk factor for heart disease. Heart disease can of course lead to premature death. Unfortunately, there is a growing prevalence of this condition in America which is associated with the obesity problem that we have. There has been a push by some, I am guessing the pharmaceutical industry, to use statin therapy to lower triglycerides, but a recent study does not support that recommendation. Instead, when a person’s level of this blood fat is between 150 and 500, known as hypertriglyceridemia, changes in diet and activity level should be recommended by the treating physician. This is a serious issue. I have not had blood work since 2005, but I had it today! So stay tuned for the present. My last level was in the 80s.
What? With sales slumping at most clothing stores, eclectic boutiques are looking for ways to get customers in and to keep them around for a while. I read in the WSJ last week that several were offering beer, wine and cocktails. My first and continued reaction is this, the LAST thing I want to do before I try on a pair of jeans is drink a beer!
High or Low Fat,Carbs,Protein: Instead of a randomized clinical drug trial, researchers who published their study in a peer reviewed journal, Cardiosource, placed over 800 overweight and obese persons into 3 separate diet groups. What they found was weight loss occurs when less calories are consumed (everyone sure hates to hear that), but cholesterol levels were lower in the group that ate less saturated fat.
Garadasil: One of my list serves contained an article on recommendations for this vaccine. Because Gardasil is new and in my opinion controversial, I read the article. There were a few points that I would like to iterate. There are 4 strains of HPV addressed by this vaccine. Two of them are responsible for 70% of the HPV that can lead to cervical cancer and two are responsible for 90% of the strain that may lead to genital warts. If a person has been exposed to part of these four strains (there are many more strains) but not all, there may be some therapeutic benefit from getting the vaccine. There is no benefit if a person has been exposed to all four. Thus the vaccine is best for persons not yet sexually active. HPV is the most common of the sexually transmitted diseases with current prevalence at about 26%. The article that I read was written by pharmacist Laurie Briceland. BTW, vaccine or no, Pap Smears can prevent cervical cancer.
Readmissions: The Government and it’s Centers for Medicare Services or CMS, did some research into costs of care for its Medicare recipients. Of concern is readmission to the hospital within 30 days of discharge. The study found that billions of dollars could be saved if this rate of readmissions could be lowered from the current 20%. What is considered the main cause of these unplanned readmissions is lack of adequate follow up care. Discharge planning was one of my roles in a past career and at my hospital every patient had to be scheduled with their PCP after discharge. Many patients did not keep their appointment and the cause of that warrants further investigation. Some issues of which I am aware is availability of doctors, long wait times, transportation issues, and Medicare visit costs. I must add that at many hospitals there is pressure to “get the patient out of there.”
Obesity Epidemics Main Cause: I have seen this before but when I saw it on Sunday I thought, you know, that is it right there. Electric Bicycles. No not mopeds, bicycles with engines. Now General Motors, whom I thought could not make any more mistakes, wants to expand its relationship with Segway Co. A new vehicle is being produced that can pretty much obviate walking. This new rideable device will be called PUMA. That stands for Personal Urban Mobility and Accessibility. I cannot swallow this. We are overweight and our environment is polluted for one very significant reason… we do not walk anywhere. So for those of us who are able to walk, i.e. not paralyzed, here is the personal mobility device I would like to promote; LEGS.
Okay, let’s do some cooking.
Whole Wheat Pancakes:
Spices: cinnamon and sugar free vanilla syrup
Grains: 56 g of whole wheat flour, ¾ cup of loose oat bran
Liquid: ¼ cup no sugar added apple sauce, eighth cup egg beaters, ¼ cup skim milk
Sweetener: ¼ c splenda
Other: Baking Powder
Topping: Walden’s Farms Sugar/Calorie Free Syrup
(this recipe has 420 calories, on the video i mistakenly say 400 at one point)
Non fat spray and water is also needed.
Calorie content explained in video. BTW, whole wheat flour is a protein source!
Live Well
Deirdre
Friday, March 27, 2009
Wellness Weekly
The News:
Supplements: A study that compared the results of over 70,000 persons who completed food frequency questionnaires (FFQ) between 2000 and 2002 which recalled a decade of their lives, found a disturbing trend. The people in the group, who took certain supplements daily over time, had more cases of the most common type of lung cancer than those who did not take these supplements. In the past it was learned that smokers who took beta carotene supplements had high incidence of lung cancer, so this adds to that research. In this case, the supplements included beta carotene, lutein and retinol. People may take these supplements as they hope to increase the amount of antioxidants available in their bodies. Antioxidants are meant to clean up damage that is left behind after some cellular interactions. The scientists point out a few things. One is that no harm was found when people took a multivitamin with these compounds, only when taking more than the recommended dose. Also it is advised that people not take these three supplements to prevent lung cancer as it appears to increase that risk and more so in smokers. Finally, I would like to suggest that when epidemiologists point out a health promoting behavior, such as they do when they talk about the long lives of people in the Mediterranean, that you try to copy the life style and not fall victim to the sensationalism. I mean, do not believe that a long life is achieved through anything but diet, exercise and the avoidance of high risk activities and maybe a little luck.
HPV: The human papillomavirus has gotten a lot of attention in recent years. I believe that is due to Merck’s creating a vaccine that can prevent the contraction of some of the strains of HPV. I have also been vocal about my concern that Merck calls its’ vaccine a cervical cancer vaccine at least when they market it to women. It is important that women continue to receive PAP smears whether they have had that vaccine or not and because the vaccine is really meant for children… well.. that just opens up a whole new issue.. in regards to safety. Now another method of possible HPV reduction has been discovered. Circumcision. This week it was reported that circumcised men had less incidence of both HPV and herpes. It is said that having herpes makes one more susceptible to HIV but I am not sure if that is because of the illness or the frequency of unprotected sex. I don’t know that I have more to say about this issue. STDs are a big part of public health, but my area of expertise is obesity prevention. I do encourage the use of condoms… of course.
Meat Meat Meat: Too much red meat is bad for you. It has been said before and I have noticed that meat eaters are VERY sensitive about this issue. In fact, people often say that they think I should eat meat… I guess meat eaters like company. I am not against anyone else eating meat.. just so you know. The evidence to support a link between colon cancer and red meat is strong. What is new this week is a study that looked at all cause mortality and found that for any disease, the more red and processed meat a person eats, the more likely they are to die of that disease. For instance, if the no-excess risk is 2 three ounce servings a week (and I am NOT saying it is) then anyone who eats four ounces 2 x a week is at greater risk for heart disease death than the person who ate three ounces, and the person who eats more is at even greater risk. Get it? The study involved six states and includes NC, PA and Fl. No clear recommendations were given but the healthiest ate less than a ½ an ounce per 1000 calories per day. There is no need for processed meat and it should be avoided as much as possible.
Fiber for Men: I wanted to spotlight this new ad campaign because I think it is a great idea. The makers of Grape Nuts and the marketing firm they hired are targeting men in these new ads even though women will probably do the shopping. Of course, I am still an All Bran girl and think my cereal bars are the way to get your fiber.. but this is clever. The spots involve a discussion of some challenging endeavor and the slogan, “Now that takes Grape Nuts.” Too funny.
GERD: This is the signature piece for today. Gastroesophageal Reflux Disease. My father had GERD and I remember some of what he said about it, mostly that it was very uncomfortable for him. More over, my well liked coworker also has GERD and she has mentioned a few things. If I remember correctly she has said that she is trying to get off the medications she has been taking for this condition. Of course, any reader of this blog will know that I am in much support of her efforts. This week however, she asked me to look into that a little more, not just for her, but for anyone who reads the blog and has GERD or has wondered about it. Let me tell you the first thing that I realized. If you do not yourself have GERD nor have researched GERD.. you DO NOT KNOW GERD. I went to several sources and have some technical information that I would like to try to repeat in plain English. First, heart burn can be a symptom of GERD but that you have had heart burn does not mean you have GERD. (People should be mindful of heartburn however because 20 to 40% of persons who experience that DO have GERD). After reading the description, I am not sure I have even had heartburn. I have had indigestion.. a stomach ache… but not a burning behind my breast bone that might be similar to angina or a heart attack. Second, GERD involves repeated episodes of this burning, a taste of bile in the throat and the need to avoid certain foods. In fact, it disrupts ones lifestyle .There are tests to diagnose this disease. (a small number of people are asymptomatic) and there are medications to treat it. Surgery is another option and there are several types. The surgery has significant risks, including that one has to continue to take the medicine anyway. The most important thing to know, I think, is the mechanics. There is a flap at the end of the esophageal tube, it is called the lower esophageal sphincter or LES and it has to have normal length and pressure and episodes. The tube must also be located at a junction in the abdomen just so, clearance and neutralization of gastric juice must occur and the stomach must empty properly. If all this is correct, the digestive juices stay where they belong and the esophagus is protected. It is hard to determine what causes GERD though there is data on what aggravates it, including certain foods and obesity. [there are some medications that also make one more susceptible to this disease, instead of rewriting all that I have learned, I am going to include a link at the end of this blurb to the best website I found]. The goal of treatment is to stop the gastric juice (which contains not only acid, but also bile and pancreatic secretions) from entering the esophagus. Remember, this is a digestive juice, it is meant to break down food for processing and eliminating.. it is caustic. For this reason, medication treatment is nearly always a chronic and life long necessity. It breaks my heart to say that. There is research ongoing of course and there may in time be a surgical option that has a minimal risk of complication or failure. The adverse outcomes of untreated GERD include stricture, Barrett Esophagus and adenocarcinoma.. or cancer. Medications that are used are of two popular types and the concern has been that stopping the acid from being secreted or neutralizing it once secreted over the long term is dangerous. The acids have a job to do. Though most people have to return to meds that does not mean it isn’t worth trying the lifestyle modifications. That includes avoiding tomato based foods as well as citrus juices and coffee, not caffeine, but coffee and also chocolate. Losing weight can help as well as eating small meals.. It is important to not overfill the stomach as that puts pressure on the LES. Right now I am just hitting myself for making my friend that spaghetti squash parmesan.. ugh. Also, for people with GERD it is best not to eat within three hours of bed time. The best link I have found is this:
http://www.gerdcare.org/Default.htm
I realize that some of the foods that are to be avoided are well liked by many of us.. However, if avoiding them and eating smaller meals in general reduces the acid backflow it is a small price to pay, in my opinion because that back flow is extremely damaging.
That will bring us to today’s cooking video. The point of these videos is to assist you in eating food, lots of food really, without adding non nutritive and even disease promoting extras.. like saturated FAT and sugar.
Today’s video is on snacks….
Supplements: A study that compared the results of over 70,000 persons who completed food frequency questionnaires (FFQ) between 2000 and 2002 which recalled a decade of their lives, found a disturbing trend. The people in the group, who took certain supplements daily over time, had more cases of the most common type of lung cancer than those who did not take these supplements. In the past it was learned that smokers who took beta carotene supplements had high incidence of lung cancer, so this adds to that research. In this case, the supplements included beta carotene, lutein and retinol. People may take these supplements as they hope to increase the amount of antioxidants available in their bodies. Antioxidants are meant to clean up damage that is left behind after some cellular interactions. The scientists point out a few things. One is that no harm was found when people took a multivitamin with these compounds, only when taking more than the recommended dose. Also it is advised that people not take these three supplements to prevent lung cancer as it appears to increase that risk and more so in smokers. Finally, I would like to suggest that when epidemiologists point out a health promoting behavior, such as they do when they talk about the long lives of people in the Mediterranean, that you try to copy the life style and not fall victim to the sensationalism. I mean, do not believe that a long life is achieved through anything but diet, exercise and the avoidance of high risk activities and maybe a little luck.
HPV: The human papillomavirus has gotten a lot of attention in recent years. I believe that is due to Merck’s creating a vaccine that can prevent the contraction of some of the strains of HPV. I have also been vocal about my concern that Merck calls its’ vaccine a cervical cancer vaccine at least when they market it to women. It is important that women continue to receive PAP smears whether they have had that vaccine or not and because the vaccine is really meant for children… well.. that just opens up a whole new issue.. in regards to safety. Now another method of possible HPV reduction has been discovered. Circumcision. This week it was reported that circumcised men had less incidence of both HPV and herpes. It is said that having herpes makes one more susceptible to HIV but I am not sure if that is because of the illness or the frequency of unprotected sex. I don’t know that I have more to say about this issue. STDs are a big part of public health, but my area of expertise is obesity prevention. I do encourage the use of condoms… of course.
Meat Meat Meat: Too much red meat is bad for you. It has been said before and I have noticed that meat eaters are VERY sensitive about this issue. In fact, people often say that they think I should eat meat… I guess meat eaters like company. I am not against anyone else eating meat.. just so you know. The evidence to support a link between colon cancer and red meat is strong. What is new this week is a study that looked at all cause mortality and found that for any disease, the more red and processed meat a person eats, the more likely they are to die of that disease. For instance, if the no-excess risk is 2 three ounce servings a week (and I am NOT saying it is) then anyone who eats four ounces 2 x a week is at greater risk for heart disease death than the person who ate three ounces, and the person who eats more is at even greater risk. Get it? The study involved six states and includes NC, PA and Fl. No clear recommendations were given but the healthiest ate less than a ½ an ounce per 1000 calories per day. There is no need for processed meat and it should be avoided as much as possible.
Fiber for Men: I wanted to spotlight this new ad campaign because I think it is a great idea. The makers of Grape Nuts and the marketing firm they hired are targeting men in these new ads even though women will probably do the shopping. Of course, I am still an All Bran girl and think my cereal bars are the way to get your fiber.. but this is clever. The spots involve a discussion of some challenging endeavor and the slogan, “Now that takes Grape Nuts.” Too funny.
GERD: This is the signature piece for today. Gastroesophageal Reflux Disease. My father had GERD and I remember some of what he said about it, mostly that it was very uncomfortable for him. More over, my well liked coworker also has GERD and she has mentioned a few things. If I remember correctly she has said that she is trying to get off the medications she has been taking for this condition. Of course, any reader of this blog will know that I am in much support of her efforts. This week however, she asked me to look into that a little more, not just for her, but for anyone who reads the blog and has GERD or has wondered about it. Let me tell you the first thing that I realized. If you do not yourself have GERD nor have researched GERD.. you DO NOT KNOW GERD. I went to several sources and have some technical information that I would like to try to repeat in plain English. First, heart burn can be a symptom of GERD but that you have had heart burn does not mean you have GERD. (People should be mindful of heartburn however because 20 to 40% of persons who experience that DO have GERD). After reading the description, I am not sure I have even had heartburn. I have had indigestion.. a stomach ache… but not a burning behind my breast bone that might be similar to angina or a heart attack. Second, GERD involves repeated episodes of this burning, a taste of bile in the throat and the need to avoid certain foods. In fact, it disrupts ones lifestyle .There are tests to diagnose this disease. (a small number of people are asymptomatic) and there are medications to treat it. Surgery is another option and there are several types. The surgery has significant risks, including that one has to continue to take the medicine anyway. The most important thing to know, I think, is the mechanics. There is a flap at the end of the esophageal tube, it is called the lower esophageal sphincter or LES and it has to have normal length and pressure and episodes. The tube must also be located at a junction in the abdomen just so, clearance and neutralization of gastric juice must occur and the stomach must empty properly. If all this is correct, the digestive juices stay where they belong and the esophagus is protected. It is hard to determine what causes GERD though there is data on what aggravates it, including certain foods and obesity. [there are some medications that also make one more susceptible to this disease, instead of rewriting all that I have learned, I am going to include a link at the end of this blurb to the best website I found]. The goal of treatment is to stop the gastric juice (which contains not only acid, but also bile and pancreatic secretions) from entering the esophagus. Remember, this is a digestive juice, it is meant to break down food for processing and eliminating.. it is caustic. For this reason, medication treatment is nearly always a chronic and life long necessity. It breaks my heart to say that. There is research ongoing of course and there may in time be a surgical option that has a minimal risk of complication or failure. The adverse outcomes of untreated GERD include stricture, Barrett Esophagus and adenocarcinoma.. or cancer. Medications that are used are of two popular types and the concern has been that stopping the acid from being secreted or neutralizing it once secreted over the long term is dangerous. The acids have a job to do. Though most people have to return to meds that does not mean it isn’t worth trying the lifestyle modifications. That includes avoiding tomato based foods as well as citrus juices and coffee, not caffeine, but coffee and also chocolate. Losing weight can help as well as eating small meals.. It is important to not overfill the stomach as that puts pressure on the LES. Right now I am just hitting myself for making my friend that spaghetti squash parmesan.. ugh. Also, for people with GERD it is best not to eat within three hours of bed time. The best link I have found is this:
http://www.gerdcare.org/Default.htm
I realize that some of the foods that are to be avoided are well liked by many of us.. However, if avoiding them and eating smaller meals in general reduces the acid backflow it is a small price to pay, in my opinion because that back flow is extremely damaging.
That will bring us to today’s cooking video. The point of these videos is to assist you in eating food, lots of food really, without adding non nutritive and even disease promoting extras.. like saturated FAT and sugar.
Today’s video is on snacks….
Saturday, February 7, 2009
Wellness Weekly - guest blog
This week I am proud to offer a guest entry from a dear and cherished friend who thinks I should take a rest. When I read her words I of course wanted to offer empathy and an action plan, that is who I am and what I do, but I didn't go past the empathy.. yet . Please reflect on her words and offer your thoughts, she and I would appreciate this.
I will be back soon with my usual opinionated opining.. Until then, I do want to note that I am extremely pleased with the federal tax increase on cigarettes believing that this measure will reduce the number of teens who begin using tobacco. The tax may save the life of someone you know.
Without further ado then, the words of my friend, Lee Ann Manning.
I have body image issues. I will say, not proudly, but very humbly, that I do not suffer from bulimia or anorexia, nor am I obese, or even overweight. The last time I calculated my body mass index using one of those nifty web sites, I was well within a normal range for my height and weight.
So why am I not happy with my body? Good question. Seems like lately, I’ve found myself pondering the mixed messages about my body that come from so many places, whether medical reports, advertisements, television shows, or even web diets.
I believe it’s important to eat a healthy, varied diet, with plenty of vegetables and fruits. I’m not vegetarian, so I eat my share of chicken, seafood, pork, and yes, even red beef! (Love me a good burger!) I understand the importance of fiber, protein, and calcium, so try to include lots of those in my daily intake. I don’t overeat. (Well, not usually.) And with full confession, I will tell you that I also love chocolate, French fries, and wine. In moderation.
So if I’m not overweight, is there a problem? Most people would say “no!” That I’m healthy, not too skinny, not fat. So, why complain?
The problem is in my perception. Let’s go back a couple of years, to a time in my life when I had too much going on … one full time job, one part time job, a budding romance, volunteer commitments, and increased training for a half-marathon. There was so much going on in my life, I couldn’t seem to eat enough to keep my body nourished. Not only was I physically pushing my body beyond what it had done to that point, my mental state kept me constantly moving and worrying.
My weight, which I thought was perfect at 115 pounds, fell to 112. I loved it! I loved the skinny me. I loved wearing the skinny clothes. I loved the feeling. Until one night, I almost passed out.
I wasn’t consciously starving myself; I just had too much going on in my life to realize the impact on my body.
Soon after that night, my body began to readjust itself. I fed it more to meet the demands of the training schedule; the stress of working two jobs began to ease, and as I became more comfortable in my personal life, the constant fidgeting and worrying went away. I gained some of the weight back. Life got back to normal.
Or so I thought. About the time life got back to normal, my body went to abnormal, as in perimenopausal. (Funny, my spell check thinks the word “perimenopausal” is abnormal, as well!)
So here I was, finally finished punishing my body with long runs every week, thinking now I could go back to gentle, 5-mile runs two or three times a week, and that I would stay in shape. Or even better, since I was pretty burned out on running by this point, I thought about swimming, biking, spin classes, Zumba classes, etc. It was time to try something new.
But the problem was -- my body wasn’t responding the way it used to. Suddenly, my once (almost) svelte thighs were ungainly and, horror of horrors, had the beginnings of cellulite! Around my waist, I could see the beginnings of … oh, no … a spare tire!
To make things worse, now when I run, I have hip and knee problems. So I don’t enjoy running like I once did. I cannot run for long distances (that’s now 3-5 miles!) without taking walk breaks. And running is the ONE THING that used to help me lose weight.
My weight is now at 130 pounds. It’s been that for almost a year, so it’s not really getting worse. It’s just sitting there. I absolutely hate thinking that I weigh 130 pounds. Everyone tells me I look fine. I don’t feel like I look fine.
What exactly is “fine?” Who decides?
About the time I started having these body image issues, I saw an advertising campaign that promotes “real” beauty. The campaign includes photos of women I consider overweight, but the entire campaign is directed at helping women feel good about themselves.
So here’s part of my confusion:
I applaud programs that help girls and young women feel good about themselves; that promote healthy body images and issues. There is nothing so sad as a pre-teen starving herself so she can look like a movie star, or to help her feel that controlling her hunger is the only issue in her life over which she has control. I believe that teaching good eating habits and healthy exercise are the best ways to promote the kind of self-esteem that makes everyone feel “good in their skin,” in other words, a healthy body image.
So why am I so frustrated about my own body image? Am I being stupid when I feel like suddenly I can’t (shouldn’t/wouldn’t/don’t want to) parade my 47-year old body down the beach in a bathing suit, simply because my thighs don’t look the way I’d like them to look?
I am healthy. I eat what I want. I exercise. Maybe I just need to grow up and realize that I’m not a teenager any more, that my body is going to change, but that as long as I’m healthy, it really doesn’t matter how I look?
I don’t have the answers. I’m simply sharing the questions. Probably because I hope someone else will give me the answers.
I will be back soon with my usual opinionated opining.. Until then, I do want to note that I am extremely pleased with the federal tax increase on cigarettes believing that this measure will reduce the number of teens who begin using tobacco. The tax may save the life of someone you know.
Without further ado then, the words of my friend, Lee Ann Manning.
I have body image issues. I will say, not proudly, but very humbly, that I do not suffer from bulimia or anorexia, nor am I obese, or even overweight. The last time I calculated my body mass index using one of those nifty web sites, I was well within a normal range for my height and weight.
So why am I not happy with my body? Good question. Seems like lately, I’ve found myself pondering the mixed messages about my body that come from so many places, whether medical reports, advertisements, television shows, or even web diets.
I believe it’s important to eat a healthy, varied diet, with plenty of vegetables and fruits. I’m not vegetarian, so I eat my share of chicken, seafood, pork, and yes, even red beef! (Love me a good burger!) I understand the importance of fiber, protein, and calcium, so try to include lots of those in my daily intake. I don’t overeat. (Well, not usually.) And with full confession, I will tell you that I also love chocolate, French fries, and wine. In moderation.
So if I’m not overweight, is there a problem? Most people would say “no!” That I’m healthy, not too skinny, not fat. So, why complain?
The problem is in my perception. Let’s go back a couple of years, to a time in my life when I had too much going on … one full time job, one part time job, a budding romance, volunteer commitments, and increased training for a half-marathon. There was so much going on in my life, I couldn’t seem to eat enough to keep my body nourished. Not only was I physically pushing my body beyond what it had done to that point, my mental state kept me constantly moving and worrying.
My weight, which I thought was perfect at 115 pounds, fell to 112. I loved it! I loved the skinny me. I loved wearing the skinny clothes. I loved the feeling. Until one night, I almost passed out.
I wasn’t consciously starving myself; I just had too much going on in my life to realize the impact on my body.
Soon after that night, my body began to readjust itself. I fed it more to meet the demands of the training schedule; the stress of working two jobs began to ease, and as I became more comfortable in my personal life, the constant fidgeting and worrying went away. I gained some of the weight back. Life got back to normal.
Or so I thought. About the time life got back to normal, my body went to abnormal, as in perimenopausal. (Funny, my spell check thinks the word “perimenopausal” is abnormal, as well!)
So here I was, finally finished punishing my body with long runs every week, thinking now I could go back to gentle, 5-mile runs two or three times a week, and that I would stay in shape. Or even better, since I was pretty burned out on running by this point, I thought about swimming, biking, spin classes, Zumba classes, etc. It was time to try something new.
But the problem was -- my body wasn’t responding the way it used to. Suddenly, my once (almost) svelte thighs were ungainly and, horror of horrors, had the beginnings of cellulite! Around my waist, I could see the beginnings of … oh, no … a spare tire!
To make things worse, now when I run, I have hip and knee problems. So I don’t enjoy running like I once did. I cannot run for long distances (that’s now 3-5 miles!) without taking walk breaks. And running is the ONE THING that used to help me lose weight.
My weight is now at 130 pounds. It’s been that for almost a year, so it’s not really getting worse. It’s just sitting there. I absolutely hate thinking that I weigh 130 pounds. Everyone tells me I look fine. I don’t feel like I look fine.
What exactly is “fine?” Who decides?
About the time I started having these body image issues, I saw an advertising campaign that promotes “real” beauty. The campaign includes photos of women I consider overweight, but the entire campaign is directed at helping women feel good about themselves.
So here’s part of my confusion:
I applaud programs that help girls and young women feel good about themselves; that promote healthy body images and issues. There is nothing so sad as a pre-teen starving herself so she can look like a movie star, or to help her feel that controlling her hunger is the only issue in her life over which she has control. I believe that teaching good eating habits and healthy exercise are the best ways to promote the kind of self-esteem that makes everyone feel “good in their skin,” in other words, a healthy body image.
So why am I so frustrated about my own body image? Am I being stupid when I feel like suddenly I can’t (shouldn’t/wouldn’t/don’t want to) parade my 47-year old body down the beach in a bathing suit, simply because my thighs don’t look the way I’d like them to look?
I am healthy. I eat what I want. I exercise. Maybe I just need to grow up and realize that I’m not a teenager any more, that my body is going to change, but that as long as I’m healthy, it really doesn’t matter how I look?
I don’t have the answers. I’m simply sharing the questions. Probably because I hope someone else will give me the answers.
Saturday, December 6, 2008
Wellness Weekly
The Brain: I took note of a researcher’s recommendation while reading an article about the aging brain. The study was in regards to loss of attention, distraction and remembering. The science community is a bit concerned about the depth of this problem when baby boomers, as they are now, start turning 65 and older. It is expected that in the year 2050 the largest age group will be those over 65. Interesting. If they age well this could be good, though it is not expected that the majority will. My notes were that the brain can be protected if its host stimulates it with mental challenges, like learning new things or doing cross word puzzles and by exercising and eating food that is nutrient but not calorie dense. Sounds like a hell of a motivator to me.
Alcohol: Quick regurgitation here. Research states that women who have more than two drinks a day significantly increase their chance of having the type of irregular heart beat that can lead to stroke. It did not say that drinking was bad, it said that too many drinks is bad. Please recall serving sizes for alcohol. Wine is 4 ounces, beer is 12 and liquor is 1.5. Measure your drinks if you have to. Your life may depend on it. (by the way, saving your one to two drinks a day for one or two weekend days, NOT RECOMMENDED)
Tobacco and Pregnancy: I read a few things on this topic in the past week, some new, some older. First, it is a fact according to our US Surgeon General’s reports, that maternal smoking and exposure to second hand smoke can lead to low birth weight babies. It is also true by research, that low birth weight babies are 20 to 25% more likely to die in the first years of life than normal weight babies. In regards to poor birth outcomes it is also said that the mother’s weight is a factor. An overweight or obese mother has twice the chance of an adverse pregnancy outcome than an underweight mother. In regards to tobacco use again, very new research which should be tested through repetition, has shown that the adult children of mothers who smoked or who were exposed to significant amounts of second hand smoke, have artery changes indicative of heart disease. When you add that to the fact that many of those children were sedentary and overweight as well, the assertion that the generation will not live longer than the one before seems to gain credence.
Assistive Devices: The WSJ had a feature this week on devices that may make it easier for those baby boomers to age in place, in their homes, even though they may have some physical limitations as they get older. There were some interesting items and appliances in the works, however, the note I wrote regarded Moen’s special grab bars that will hold the weight of a 350 pound person. Now they would not be spending the money to make these special grab bars if they did not think there was a market for them. Pretty much I don’t know of many people who could be considered at a healthy weight if they were more than 200 pounds at any height, so that pretty much sums up a lot of our problems doesn’t it.
5210: This was explained to me in passing (ok, it wasn’t really in passing, it was while I was having my two beers and I wasn’t taking notes) so I may not get it just right. There is a right way as it is a campaign by one of our respected health and wellness agencies. The gist is that we should strive, on a daily basis, to have 5 fruits and vegetables, no more than 2 hours of screen time, at least 1 hour of physical activity and 0 sugary drinks. Pretty neat.
Happy Weekend
Don’t smoke!
Eat Well
Move more
Alcohol: Quick regurgitation here. Research states that women who have more than two drinks a day significantly increase their chance of having the type of irregular heart beat that can lead to stroke. It did not say that drinking was bad, it said that too many drinks is bad. Please recall serving sizes for alcohol. Wine is 4 ounces, beer is 12 and liquor is 1.5. Measure your drinks if you have to. Your life may depend on it. (by the way, saving your one to two drinks a day for one or two weekend days, NOT RECOMMENDED)
Tobacco and Pregnancy: I read a few things on this topic in the past week, some new, some older. First, it is a fact according to our US Surgeon General’s reports, that maternal smoking and exposure to second hand smoke can lead to low birth weight babies. It is also true by research, that low birth weight babies are 20 to 25% more likely to die in the first years of life than normal weight babies. In regards to poor birth outcomes it is also said that the mother’s weight is a factor. An overweight or obese mother has twice the chance of an adverse pregnancy outcome than an underweight mother. In regards to tobacco use again, very new research which should be tested through repetition, has shown that the adult children of mothers who smoked or who were exposed to significant amounts of second hand smoke, have artery changes indicative of heart disease. When you add that to the fact that many of those children were sedentary and overweight as well, the assertion that the generation will not live longer than the one before seems to gain credence.
Assistive Devices: The WSJ had a feature this week on devices that may make it easier for those baby boomers to age in place, in their homes, even though they may have some physical limitations as they get older. There were some interesting items and appliances in the works, however, the note I wrote regarded Moen’s special grab bars that will hold the weight of a 350 pound person. Now they would not be spending the money to make these special grab bars if they did not think there was a market for them. Pretty much I don’t know of many people who could be considered at a healthy weight if they were more than 200 pounds at any height, so that pretty much sums up a lot of our problems doesn’t it.
5210: This was explained to me in passing (ok, it wasn’t really in passing, it was while I was having my two beers and I wasn’t taking notes) so I may not get it just right. There is a right way as it is a campaign by one of our respected health and wellness agencies. The gist is that we should strive, on a daily basis, to have 5 fruits and vegetables, no more than 2 hours of screen time, at least 1 hour of physical activity and 0 sugary drinks. Pretty neat.
Happy Weekend
Don’t smoke!
Eat Well
Move more
Thursday, June 5, 2008
Wellness Weekly
Youth Behavior: The CDC does a telephone survey of both youth and adults in two year intervals. Recently the report on youth behavior was released and though the news is that many health risk behaviors are trending down, the numbers can be startling to those not used to reviewing the literature. For example, less high school students report having sex now than they did in 1991. However, 48 percent are having sex and have had multiple partners. Less youth smoke, but on average the rate is 20%. Youth continue to drink and do drugs but on a positive note, they ARE using condoms!
Health Disparities: In reading about a grant program for certain geographical areas I was not surprised to find another correlation. The Robert Wood Johnson Foundation is hoping to address the needs of the medically underserved. ( race or regional disparities). Some points noted were under treatment of vascular disease and diabetes in black Medicare patients in Memphis or lack of screening tests for some women in Mississippi. In fact, the AP article by Kevin Freking noted that some states are particularly challenged by hospitalizations for heart failure and diabetes related exacerbations. These illnesses can be controlled with proper health care. These illnesses are also especially hard to control in smokers. The article doesn’t mention smoking, but out of curiosity I compared the super ill to the super healthy states, in this article to the rate of smoking in them. True enough, the states with poor outcomes in the research are West Virginia, Kentucky, Louisiana and Mississippi. The lowest complications for these illnesses are found in Washington, Hawaii and Utah. For the record then, the average rate of smoking is 19%. The lowest state is Utah, Hawaii is ranked 43 and Washington is 46. The number one highest rate of smoking goes to Kentucky, second is West Virginia, Mississippi is seventh and Louisiana 10th.
Vitamin D: The last few years have been good to this vitamin. If it were a stock it would be BUY BUY BUY. Vitamin D is needed for strong bones, both in development and integrity. It is also associated with prevention of many diseases. I take extra vitamin D along with my calcium and MVI and I choose a few minutes of sun a day to create that vitamin D. In America, we fortify many products with vitamin D including milk. Surprisingly then, Catherine Gordon, MD of Children’s Hospital in Boston reports a 40% deficiency rate in children ages 8 months to 2 years. One cause could be that breast milk, which is absolutely the better choice for an infant, does not have vitamin D. Vitamins seem to be recommended in the article and being overweight is not. In fact one cause of vitamin d deficiency may be excess fat because the vitamin will dissolve in it and perhaps not be absorbed.
Baby Boomer Demise: Well I did not like this article out of a meeting of the American College of Sports Medicine at ALL. At this meeting a podiatrist, a runner, spoke and had a few things to tell Reuters (M. Rauscher). He cautions that as we age and even in our FORTIES we might consider sports and physical activity that is less stressful on joints. He recommends less marathons if you run them and attention to flexibility as well. He notes wear and tear, biomechanics, and again, inflexibility as reasons for muscularskeletal problems that he sees in his practice. However, he also cautions us on the effects that intense sports, like tennis, soccer, baseball and ballet have on children. I know my family is wondering what I am going to do with his advice to slow it down, and well, I don’t know, I am letting it sink in. Anyways, I don’t run marathons!
Wishing you wellness
Health Disparities: In reading about a grant program for certain geographical areas I was not surprised to find another correlation. The Robert Wood Johnson Foundation is hoping to address the needs of the medically underserved. ( race or regional disparities). Some points noted were under treatment of vascular disease and diabetes in black Medicare patients in Memphis or lack of screening tests for some women in Mississippi. In fact, the AP article by Kevin Freking noted that some states are particularly challenged by hospitalizations for heart failure and diabetes related exacerbations. These illnesses can be controlled with proper health care. These illnesses are also especially hard to control in smokers. The article doesn’t mention smoking, but out of curiosity I compared the super ill to the super healthy states, in this article to the rate of smoking in them. True enough, the states with poor outcomes in the research are West Virginia, Kentucky, Louisiana and Mississippi. The lowest complications for these illnesses are found in Washington, Hawaii and Utah. For the record then, the average rate of smoking is 19%. The lowest state is Utah, Hawaii is ranked 43 and Washington is 46. The number one highest rate of smoking goes to Kentucky, second is West Virginia, Mississippi is seventh and Louisiana 10th.
Vitamin D: The last few years have been good to this vitamin. If it were a stock it would be BUY BUY BUY. Vitamin D is needed for strong bones, both in development and integrity. It is also associated with prevention of many diseases. I take extra vitamin D along with my calcium and MVI and I choose a few minutes of sun a day to create that vitamin D. In America, we fortify many products with vitamin D including milk. Surprisingly then, Catherine Gordon, MD of Children’s Hospital in Boston reports a 40% deficiency rate in children ages 8 months to 2 years. One cause could be that breast milk, which is absolutely the better choice for an infant, does not have vitamin D. Vitamins seem to be recommended in the article and being overweight is not. In fact one cause of vitamin d deficiency may be excess fat because the vitamin will dissolve in it and perhaps not be absorbed.
Baby Boomer Demise: Well I did not like this article out of a meeting of the American College of Sports Medicine at ALL. At this meeting a podiatrist, a runner, spoke and had a few things to tell Reuters (M. Rauscher). He cautions that as we age and even in our FORTIES we might consider sports and physical activity that is less stressful on joints. He recommends less marathons if you run them and attention to flexibility as well. He notes wear and tear, biomechanics, and again, inflexibility as reasons for muscularskeletal problems that he sees in his practice. However, he also cautions us on the effects that intense sports, like tennis, soccer, baseball and ballet have on children. I know my family is wondering what I am going to do with his advice to slow it down, and well, I don’t know, I am letting it sink in. Anyways, I don’t run marathons!
Wishing you wellness
Friday, May 16, 2008
wellness weekly
Less Weight Better Gas Mileage: MSN recently ran a story on line regarding the money that could be saved if Americans lost their excess weight. Though we are not all overweight and some are morbidly so, in the story by Shirley Steel, it was felt appropriate to say that the average American had twenty too many pounds. Losing the extra weight could improve gas mileage of cars and planes, reduce productivity losses and insurance and medical costs and save an estimated 4000 dollars per household.
Speaking of Productivity: Another article forwarded to me recently from Business Week, covers workplace wellness. The reason I received the email is because I am 100% for “junk food free” workplaces, fruit and water at meetings, higher prices for unhealthy food, and lower prices on insurance for those who modify their lifestyles based on a wellness profile. A point made in the story is one I feel quite strong about and that is – if the message is eat well move more, or some such variation, then the opportunity to do so must also be offered. And if we are encouraging our employees to eat less junk food than as employers we need to offer less of it or charge more for it. This is the same strategy that makes quit smoking programs more successful. Conversely, offering quit smoking programs and meds while also allowing employees to smoke at work sites isn’t only counterproductive, its counter intuitive. Now I realize that many people who smoke or eat junk food get upset by these kinds of policies. However, this is not about an infringement on the employee’s rights. I believe that companies that offer insurance as a benefit, or simply employ us, have a right to ask us to live as healthy as we can. You can smoke (as long as it is legal) and eat as you like, at your home, but the less opportunity you have to do so and the less acceptance you get for doing so, then the less you will do it. This may allow you the benefit of more healthy active productive life years. That will benefit you, the employer, and the general tax payer. Harsh, but research based truth.
Serving for One? Having seen a few commercials in print and on air, regarding certain frozen pizza’s sold in single serving packages, I reviewed one at the grocery store. The calories for this one serving were approximately the same as four slices of pizza hut cheese pizza. How crazy is that? If this is how the food industry plans to regulate itself, we are in trouble. The average person doesn’t know calorie and fat recommendations per meal or per day or per their own body. It is very likely that an average person would choose a product like this and believe that they were doing themselves some good. In fact they may end up eating MORE calories not less.
Fitness Test: Ah, something I like! Well, I should clarify. I did not like the fitness tests that we had to take in school and to hear that this new fitness test was inspired by the adults who miss those tests was a little surprising. None the less, the government is allowing us to test our fitness (children get to take the President’s Challenge and receive a certificate, not so for us!). We can however, see where we rank in fitness compared to others our same age. You do the test on your own and enter the data on line. The items or tests include running or walking (depending on your own baseline), push ups, sit ups and a stretch. You will also be asked to enter your weight and height. I haven’t done it yet, but probably will this weekend. The address is: http://www.adultfitnesstest.org/
Less Weight-Less Rx: Drugs are one of the things we can all spend less money on if we lose that average 20 pounds. Losing weight improves health and thus productivity. It also enables us to exercise more and more vigorously which can enhance our built in disease fighting capability as well as our antioxidant properties. We will age with less loss of function. We do have quite a way to go to make that happen. Research out this week and noted in an article by L. Johnson from AP provides these numbers. Over 50% of Americans who have insurance are taking a prescription medication for a chronic illness (diabetes, hypertension, high LDL) on a regular basis. Some of the more disconcerting points made in the article include that the biggest jump in chronic disease is in the age group that one might expect to be healthiest, 20-44, and worse, one in four children/teens, that is 25% of them, take a prescription medication for chronic disease control. The side effects related to long term use of these meds are far from understood and could be devastating. The physicians interviewed for the article stated that the problem stems from obesity and so, to come full circle, I don’t have a problem with workplace wellness programs that push low calorie foods.
Wishing you wellness
Speaking of Productivity: Another article forwarded to me recently from Business Week, covers workplace wellness. The reason I received the email is because I am 100% for “junk food free” workplaces, fruit and water at meetings, higher prices for unhealthy food, and lower prices on insurance for those who modify their lifestyles based on a wellness profile. A point made in the story is one I feel quite strong about and that is – if the message is eat well move more, or some such variation, then the opportunity to do so must also be offered. And if we are encouraging our employees to eat less junk food than as employers we need to offer less of it or charge more for it. This is the same strategy that makes quit smoking programs more successful. Conversely, offering quit smoking programs and meds while also allowing employees to smoke at work sites isn’t only counterproductive, its counter intuitive. Now I realize that many people who smoke or eat junk food get upset by these kinds of policies. However, this is not about an infringement on the employee’s rights. I believe that companies that offer insurance as a benefit, or simply employ us, have a right to ask us to live as healthy as we can. You can smoke (as long as it is legal) and eat as you like, at your home, but the less opportunity you have to do so and the less acceptance you get for doing so, then the less you will do it. This may allow you the benefit of more healthy active productive life years. That will benefit you, the employer, and the general tax payer. Harsh, but research based truth.
Serving for One? Having seen a few commercials in print and on air, regarding certain frozen pizza’s sold in single serving packages, I reviewed one at the grocery store. The calories for this one serving were approximately the same as four slices of pizza hut cheese pizza. How crazy is that? If this is how the food industry plans to regulate itself, we are in trouble. The average person doesn’t know calorie and fat recommendations per meal or per day or per their own body. It is very likely that an average person would choose a product like this and believe that they were doing themselves some good. In fact they may end up eating MORE calories not less.
Fitness Test: Ah, something I like! Well, I should clarify. I did not like the fitness tests that we had to take in school and to hear that this new fitness test was inspired by the adults who miss those tests was a little surprising. None the less, the government is allowing us to test our fitness (children get to take the President’s Challenge and receive a certificate, not so for us!). We can however, see where we rank in fitness compared to others our same age. You do the test on your own and enter the data on line. The items or tests include running or walking (depending on your own baseline), push ups, sit ups and a stretch. You will also be asked to enter your weight and height. I haven’t done it yet, but probably will this weekend. The address is: http://www.adultfitnesstest.org/
Less Weight-Less Rx: Drugs are one of the things we can all spend less money on if we lose that average 20 pounds. Losing weight improves health and thus productivity. It also enables us to exercise more and more vigorously which can enhance our built in disease fighting capability as well as our antioxidant properties. We will age with less loss of function. We do have quite a way to go to make that happen. Research out this week and noted in an article by L. Johnson from AP provides these numbers. Over 50% of Americans who have insurance are taking a prescription medication for a chronic illness (diabetes, hypertension, high LDL) on a regular basis. Some of the more disconcerting points made in the article include that the biggest jump in chronic disease is in the age group that one might expect to be healthiest, 20-44, and worse, one in four children/teens, that is 25% of them, take a prescription medication for chronic disease control. The side effects related to long term use of these meds are far from understood and could be devastating. The physicians interviewed for the article stated that the problem stems from obesity and so, to come full circle, I don’t have a problem with workplace wellness programs that push low calorie foods.
Wishing you wellness
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