Archive for the ‘medically-oriented background info’ Category

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More on the E. coli front

Tuesday, June 7th, 2011

This week the focus appears to have shifted. I saw a photo in The Wall Street Journal of the German Health Minister and the local Hamburg Health Minister donning surgical gloves and wearing masks and gowns while they plan to visit an isolation ward.

Are these the culprits?

Now the most likely culprit appears to be bean sprouts in the food-borne illness that has affected well over 1,500 in Germany alone with 627 developing Hemolytic Uremic Syndrome (HUS). The article I read said that's an abnormally high percentage for this dire complication which has killed 22 people thus far.

Hamburg was the epicenter of the epidemic, i.e., most cases of the illness and of HUS-related complications have occurred relatively close to that city. There's lots more epidemiological work to be done, but a farm in the German state of Lower Saxony has been implicated, closed, and its produce is under a general recall.

The World Health Organization (WHO) has an online fact sheet that mentions people in 12 other countries have developed the disease termed hemorrhagic colitis (so you may see the unusual strain of E. coli called EHEC for Enterohemorrhagic E. coli). All but one person in that cohort had travel links to, or residence in, Germany.

The E. coli strain, called O104:H4, is rare, but has been seen in humans before. This is the first time its been linked to an EHEC outbreaks, this time with more than 2,200 people affected. There have been EHEC outbreaks every year, in varying parts of the globe, but almost always those have been small (the largest was in Japan in 1996 and affected more than 10,000 people).

The most recent update I found said that the first 23 samples (of 40) from the farm in question, tested negative, but more tests and more samples are pending.

Of course the economic impact on farmers has already been huge with estimates of $44 million in loses per week in Germany alone. Spain, whose cucumbers were initially blamed for the EHEC outbreak, is thinking of suing.

As of May 7th the European agriculture commissioner proposed paying farmers 30%of the cost of the vegetables they've been unable to sell, 150 million Euros. The source is still unclear and may never be known, but bean sprouts are still felt the most likely culprit, even if the ongoing tests come back negative. They've been implicated in previous US and Japanese outbreaks and are grown in heated water setting up an ideal culture media.

US scientists suggest that children, the elderly and those with weakened immune systems should not consume them raw.

This is what I'm buying

And it may be unfair, but yesterday when I shopped for groceries, I looked for "grown in the US" labels.

Posted in Food producers and less-healthy foods, Food-related disease, Governmental Efforts, medically-oriented background info, Publications | No Comments »

Sodium and Iodine intake

Friday, May 27th, 2011

You can get iodine from salt and from food

My wife subscribes to a healthy cooking magazine and I sometimes read parts. Last week I was puzzled by their piece regarding appropriate dietary sodium intake. There were three column, one for younger adult women, one for "older" women (starting at 51) and one for all adult men.

The levels were 2,300 mg per day for young women and all men and 1,500 mg a day for men. Yet sodium recommendations (in various publications) for older adults of both genders as well as African Americans of any adult age, and those of us with high blood pressure, diabetes or kidney disease (a total of perhaps 70% of our total population) range from 1,300 to 1,500 mg per day . The American Heart Association now recommends all of us limit our sodium intake to 1,500 mg/day.  http://circ.ahajournals.org/cgi/content/full/123/10/1138.

I decided to write an email to the magazine and mentioned that they were behind the power curve. I got a prompt answer from their senior dietitian; in their June edition they'll be listing a lower figure for older men. I thought. 'It's a start, at least."

Then I received the June 2011 edition of the Harvard Heart Letter. One question that arises when we're told to cut back on salt, is will we stinting on iodine? The title of the lead article gave a direct answer: "Cut salt--it won't affect your iodine intake." The subtitle continued in the same theme: "Iodized salt provides only a small fraction of daily iodine intake."

Those of us over the age of 19 should get 150 micrograms of iodine per day (The senior vitamin/mineral supplement we take contains 150 micrograms/tablet). The recommendations are higher for women who are pregnant or breast-feeding (220 and 290 micrograms respectively).

We also get iodine from dairy products including cheese and yogurt, eggs, marine fish and vegetables that come from regions where the soil contains lots of iodine. Essentially all iodine ingested in food and liquids is absorbed and bio-available (This is not true for iodine in thyroid hormones taken for therapeutic purposes). So I searched to see if we might be getting too much iodine. The data is vague, but an old World Health Organization recommendation I found stated that 1,000 micrograms/day was felt to be safe.

Thyroid check in pregnant woman

We need iodine to enable our thyroid glands to synthesize thyroid hormone. Too little iodine intake leads to hypothyroidism and enlargement of the thyroid gland (goiter). That's bad enough for adults, but worse for fetuses, infants and children where too little iodine can seriously affect brain development.

Most Americans, especially those who eat lots of processed food, take in excess sodium. But the majority of the food-producing companies in adding salt to their products, don't use iodized salt.

You can get all your needed iodine from the AHA-recommended sodium intake (NB. not all salt is iodized) and from "natural" foods Processed foods just add sodium you don't need.

But if you're pregnant (or might be), ask your own doctor.

 

 

Posted in additives, Healthy eating, medically-oriented background info, Publications, Vitamins and Minerals | No Comments »

Brian Wansink's "Mindless Eating" concept

Tuesday, May 24th, 2011

Don't fill your plate this way

I just read Brian Wansink's book, Mindless Eating: Why We Eat More Than We Think. Wansink got a PhD in Consumer Behavior from Stanford and from 2007 to 2009 was the USDA's Executive Director for Nutrition Policy and Promotion. He's currently in an Endowed Chair at Cornell and won the humorous Ig Nobel Prize in 2007.

If you've never heard of the Ig Nobel Prizes, Google the term. They started in 1991 and were originally given for discoveries "that cannot, or should not be, reproduced." They are presented by Nobel laureates in a ceremony  sponsored by three Harvard groups, broadcast on NPR, on the Internet and on Science Friday the day after Thanksgiving. Some are thinly veiled criticism (BP was a co-winner in 2010 for disproving the old belief that oil and water don't mix). Most are for serious work that has a humorous slant (malaria-carrying mosquitoes are equally attracted to the smell of Camembert cheese and human feet; this led to insect traps in Africa being baited with that cheese).

In Wansink's case, his award was given in the Nutrition category for studying people's appetite for mindless eating by secretly feeding them a self-refilling bowl of soup.

His work has focused on how our environment influences our eating habits. Wansink says we all make well over 200 food choices a day (what to eat, what to drink, how much of each) and we rarely know why we make those decisions or if they are helpful/healthy choices.

For instance, one of his experiments showed using smaller plates can help you serve and eat less. Another concerned fat-free foods, which may have nearly as many calories (and sometimes more) than the standard version of the same food item. In one of his studies, normal-weight subjects given low-fat foods actually consumer one-sixth more calories and overweight subjects took in nearly 50% more calories.

Wansink says low-fat foods have a "health halo;" we think they're better for us and therefore, in a sense, give ourselves permission to eat more of them.

Container size is another of his "food trap" areas. When presented with a larger package, a larger bottle of a soda or a short, fat glass to pour a drink into, we end up eating or drinking more.

He suggests a series of food trade-offs and food policies (if I want that doughnut, I need to spend an hour walking; I'll only eat snacks when I'm sitting at the table).

Try eating with these instead of a knife and fork

I liked Wansink's books, already had been using many of his strategies, but found others I can adopt. I think his studies and concepts are valid and his ~300-page publication well worth reading.If you do so, you may find yourself using chopsticks the next time you eat Chinese food. You'll likely eat less per bite and eat slower.

I may try them for American food.

 

Posted in Complications of Obesity, Life Expectancy, medically-oriented background info, Obesity, Publications, strategies for healthy aging, Unhealthy eating, Weight Loss | No Comments »

Today's trail led back nearly five years

Tuesday, May 3rd, 2011

It's time to eat less and do more

There was an interesting article in the Wall Street Journal this morning titled "The Bigger the Belly, the Bigger the Risk." It cited an article published online yesterday in the Journal of the American College of Cardiology with the lead author being a Mayo Clinic (Rochester branch) physician named Francisco Lopez-Jimenez.

I followed the paper trail (that's not exactly correct since it's an online publication) and read the abstract, then another of Dr. Lopez-Jimenez's articles, then a commentary and followed those concepts back to a long article written in 2006 by a Yale staffer, Dr. David L. Katz.

Dr. Katz's article in the Harvard Health Policy Review (Vol. 7, No. 2, Fall 2006, pp.135-151) is one of the best I've ever read and I'll concentrate on it today and then move up to 2011.

Katz gives statistics (remember these are almost five years old) showing at least 15% of kids ages 6 to 19 are overweight with higher percentages for Hispanic and Black children. Then he notes that more than two thirds of kids over 10 who are obese will turn out to be obese as adults. They will then be subject to the big three obesity-relayed diseases, diabetes, heart disease and cancer. And while they are children, their quality of life is less, for many reasons.

What I didn't realize was even those who lose weight as adults, but were obese as kids, are at increased risk.

Not the right choice for weight loss

He goes on to explain that as a species, we ate, historically, when we could, stored fat for times when food was scarce, and exercised a lot. All that has changed, but we still tend to eat more than we should, given the fact that for many of us food is abundant. And our modern labor-saving devices mean we usually exercise far less than we should. We also eat the wrong things. The end result is weight gain, to the point of frank obesity for many.

Today's article said where you carry excess weight is more important than the sheer fact of being overweight. I read several of Dr. Lopez-Jimenez' publications, and their main thrust is that central obesity, i.e., having a large roll around your waistline, is much more detrimental than simply having a higher than usual weight or BMI.

Lopez-Jimenez and his co-authors looked at studies following patients with heart disease, but other papers support their basic theme. The NIH's director of cardiovascular sciences, Dr. Michael Laurer, who wasn't involved in the Lopez-Jimenez study, is quoted as saying, "Fat is not created equal and where fat is located makes a difference."

The other comment that was somewhat new also came from Dr. Laurer who said, "Fat isn't an inert substance." Apparently scientists have found a number of toxic chemicals can be released from fat.

I'm heading to the gym next where I'll see a number of men in the locker room who have built up their upper body muscles, but have a considerable roll around their mid-section. They need to adopt a new exercise, pushing away from the dinner table.

 

Posted in Complications of Obesity, medically-oriented background info, Obesity | No Comments »

exercise and eating as you get older

Friday, April 22nd, 2011

you may not want to try this much weight

I was reading a food and exercise article this morning in a Nutrition Action Healthletter, a publication from the Center for Science in the Public Interest, a group whose watchdog goals I often support. CSPI has been around for forty years and when I looked at its board member list I saw the familiar name of David A. Kessler, MD, JD, the former FDA head and ex-dean of two medical school.

The April 2011 article my wife showed me was titled "Staying Strong: How exercise and diet can help preserve your muscles." Well I'm two days shy of my 70th birthday and a gym rat, there six days a week. And I eat well or so I thought. What's there for me to learn from this article?

I agreed with the opening quote from Dr. Miriam Nelson, the director of Tuft's Center on Physical Activity, Nutrition and Obesity Prevention, "Muscle is the absolute centerpiece for being healthy, vital and independent as we grow older." Of course, having a functioning brain helps. But I wasn't about to quibble with a distinguished figure like Dr. Nelson, who is a Fellow of the American College of Sports Medicine, an Assocatiate Professor at Tufts and founder of the Strong Women program.

The Healthletter said most of us lose muscle mass starting in our late 30s and early 40s. I had certainly noticed that a few years back, in spite of being physically active. To reverse the process, or at least keep a decent amount of muscle, resistance training is advocated, I've been doing lower body exercise mostly (an hour+ on a recumbent bike), but recently added back some weight training for both upper and lower body.  Ben Hurley, a PhD Exercise Physiologist at the University of Alabama, feels muscle power is the key to fall prevention, a critical factor in the elderly.

Even if you fall and break a bone, like the oldest member of my wife's Strong Women, Strong Bones class, did, your chances of having a rapid recovery are considerably increased. Her docs were amazed at how she bounced back. Strength training, in several studies, has been shown to increase bone density.

What else did I need to do? The new information in this Healthletter was of the amount of protein we need as we age. I read the article and added a hunk (~4 ounces) of leftover beef to my cereal, milk and fruit breakfast. That advice came from researchers at UT Galveston (and numerous other universities), especially a PhD Associate professor, Dr. Douglas Paddon-Jones, who's worked with NASA on usingartificial gravity and amino acids to preserve muscle mass in astronauts.

Is leucine the key?

The bottom line was to eat more protein and to add some to your breakfasts and lunches as you age. One particular amino acid, leucine, appears to be most crucial. it's found in whey (in milk and cheese) and in fish, poultry, eggs and meat. I'll write more about timing of amino acid intake another time.

 

Posted in Healthly lifestyle, Healthy eating, medically-oriented background info, Publications, strategies for healthy aging | 2 Comments »

grass-fed (and grass-finished) vs. grain-finished beef

Wednesday, April 20th, 2011

What's your beef?

We've been buying meat (a bison we split four ways, a young sheep we shared with another couple and, most recent a quarter beef) that's been grass-fed and grass-finished. I always thought it was a healthier way to eat red meat, even though overall we're eating smaller meat portions, more fish and chicken, lots more fruit and veggies all the time and an occasional meat-free main meal.

Now I found a very well done (no pun intended) examination of the issue at the CNN.com website. CNN discussed the Cooking Light Test Kitchen. We have a subscription to that magazine and enjoy its recipes, but I didn't know much about its test kitchen. They had a complete article on the grass-finished vs. grain finished beef controversy. I say grass-finished since essentially all cows eat grass to start with, but some eat only grass and perhaps some hay for six months to a year. Others, those who end up in those huge feedlots like the ones we see when we drive east in Colorado, eat corn mixed with soy and other edibles and are given hormones and lots of antibiotics, whether they are ill or not.

I won't even get into the subject of drug-resistent bacteria in this post, but instead I'll stick to the question of "Can a grass-finished ruminant taste good and can I afford to buy grass-finished beef?" I should mention bison as well, but that meat wasn't tested in CNN's study.

In short, the answer is going to be yes for almost all of us. I know the meat will be less fatty (there's always going to be some fat, of course), but cooked properly, anyone other than those who are specially "trained to evaluate sensory characteristics in beef" won't know the difference. I have a friend who raised beef cattle in Nebraska and disagrees with me on the subject, but the Nutrition Journal article I just quoted (I printed the entire journal article that was mentioned in passing in the CNN piece), basically said it's what you grew up eating. Consumer "sensory panels", that represent the vast majority of us, they felt, were more of an art than a science.

So what are the advanatges and disadvantages of grass-finished beef. It's got fewer calories, roughly four and a half pounds worth per year if you eat as much beef as the average American. Its fat is yellower than the grass-finished cow's, representing more beta-carotene, a significant antioxidant. And it contains more omega-3s as well as more Vitamin A & E.

Disadvantages? It may cost more, if you buy it at the supermarket, but try your area's CSA or look for a local farmer who raises beef and buy it in bulk. CNN got 243 pounds of meat for $5.32 per pound, just a tad higher than they would have paid in supermarkets. We paid <$3 per pound for the quarter cow we bought recently. I'll finish the Chico State article + one from Tufts in another post.

Posted in food and food-producing animals, Healthy eating, medically-oriented background info, Publications, Vitamins and Minerals | No Comments »

Saving $1T by losing pounds

Saturday, April 16th, 2011

whole-grain cereal and a banana

Mark Bittman's "Opinionator" column in the New York TImes April 12, 2011, was right on. He called the $36B that Congress has been haggling over (like two small boys) small potatoes compared to what could be saved if we ate less overall and ate more of the right things. He quoted a number of medical resources, so I went back to look at the originals.

In the January 24, 2011 online edition of the American Heart Association's journal Circulation, a panel headed by a Stanford Associate Professor, Paul Heidenreich, stated that cardiovascular disease (CVD) currently accounts for more than one sixth of all US health dollars spent. They went on to predict that by 2030 the direct costs of care for all forms of CVD would triple from a 2010 estimate of $273B to $818B .

CVD includes stroke, heart attacks, congestive heart failure and hypertension among other entities and they are often highly correlated. In fact the INTERHEART study which Bittman quotes (and I found in a seven-year-old copy of the journal Lancet), says lifestyle-related risk factors such as obesity, smoking and hypertension account for roughly 90+% of heart disease.

We haven't even started on Type 2 diabetes (DM) yet and Bittman noted that problem will cost roughly $500B per year  by 2020. And almost all of the cases of Type 2 DM are preventable.

If we want to reduce the deficit, one way would be to reduce our weights and trim our waistlines. Sure, we wouldn't get rid of all CVD and Type 2 DM, but a large share of the $1.3T per year we will be spending on them by 2020-2030 could be avoided.

We're spending over $2T a year now on healthcare and those costs are going up and up.

So how can we save a major chunk of that huge sum? How about Dr. David Ludwig's ideas? He's a Harvard doc who has worked with Marion Nestle, the PhD dietitian I've mentioned before. He published a very recent article in JAMA (the Journal of the American Medical Association) with both straightforward and complex/innovate modalities to improve our American diet.

I read something about Dr. Ludwig and his earlier concepts in his Harvard bio and a WebMD interview. He's a pediatric endocrinologist working at Children's Hospital in Boston, founding director of its Optimal Weight for Life (OWL) program and author of Ending the Food Fight:Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World.

In the JAMA article he talks about better funding for school lunch programs, making breads with whole grains (non-refined) and research needed to improve food preservatives that are healthier than the current ones. His own studies appear to show a correlation between lower calorie intake and eating whole grain products.

I see two difficult issues: getting people to make healthy foods choices and avoiding bureaucratic costs as the British experienced from their NHS shift toward paying physicians for preventive measures (NB. WSJ article from 4-16-2011 p. C3).

But what a great way to save us money that Congress might even agree on.

 

 

 

 

Posted in Complications of Obesity, Dieting, Healthy eating, Life extension, medically-oriented background info, Obesity, Weight Loss | No Comments »

Updated link

Thursday, April 14th, 2011

I had a link to a Mayo Clinic article in my last post that needs correcting.

It should be http://www.mayoclinic.com/health/healthy-diet/HQ01396

Posted in Healthy eating, medically-oriented background info | No Comments »

Snacking: fried has to goeth before a small (size)

Wednesday, April 13th, 2011

Healthy snacks

To snack or not to snack, now that is the question. I read two articles on the subject, one in the Wall Street Journal and the other in the Mayo Clinic's online comments. Then I thought about Wednesday evenings, my own downfall.

The newspaper article was titled "The Battle of the Office Candy Jar" and detailed the travails of people whose bosses and office mates think that the workplace should always be stocked with a dish of candy bars. Then there are the tempters who are forever bringing cookies and birthday cakes in to work or selling candy bars for their kid's baseball teams or school fundraisers.

The WSJ calculated the effects of eating two pieces of candy a day, five days a week, assuming one didn't cut down other foood intake or decide they needed to increase their exercise regime. Wow, it's over seven pounds added a year. It's even worse when the candy is presented in a clear jar, rather than a covered and opaque dish.

I immediately thought, 'It's Wednesday!' That's when I go to a three-hour evening writers' critique group. My cohorts bring in stories to be read aloud and commented on (I have one for tonight on the Festival of Holi that our former graduate students from Mumbai brought us to recently). They also bring in cakes and cookies and I used to bring biscotti. Our leader always has a jar with Tootsie Pops and I invariably eat more than I intend.

The Mayo Clinic piece says snacks aren't always bad and their diet plan includes snacks that can help obviate hunger pangs and keep you from binge eating. But their choice of snacks is quite different: fruits and veggies make much more sense than doughnuts and candy.

Their website: http://www.mayoclinic.com/health/healthy-diet/HQ01396 can lead you to a healthy snack site which suggests 100-calorie snacks, e.g, 2 cups of carrots or, one of my favorites, air-popped popcorn.

I'd prefer to avoid snacking whenever possible, but I'm aware I need help in avoiding the tempting items I encounter on wednesdays or at parties. I've switched from bringing biscotti to fetching a sack of almonds. Mayo's cautions that even though nuts contain protein and thus can help you feel full for a longer time, they also contain calories, largely in the form of monosaturated fat (which is certainly a better variety than the polyunsaturated kind).

So I've made a game of it: I eat four almonds. No particular reason that I chose that number, but it works.

I also have a four by six card that says

My home-made snack barrier

Posted in Dieting, Food labeling, Healthy eating, medically-oriented background info, tricks and gimmicks, Unhealthy eating | No Comments »

So let's talk about supplements

Tuesday, April 12th, 2011

You don't need supplements to build muscles

I'm in the gym at least six times a week when we're in town and I've noticed the establishment sells very large containers of protein powders and other muscle building supplements. Well, unlike some of the young men who are constantly working on free weights building up their upper body musculature, I spend at least an hour on a recumbent bike and then do stretches and five machines at moderate weights. What I don't do is lift free weights or gulp down large quantities of strange looking liquids that supposedly help to make you look like Charles Atlas or some Olympic weight lifter.

But both The Redbook article I mentioned in my last post and the Tufts Health&Nutrition Letter (sic) I got in the mail and eventually subscribed to mentioned other supplements in some detail. Redbook, after discussing four newish diet pills and their pros and cons, moved on to "natural" weight-loss pills, powders and liquids. They quoted studies and experts from Harvard and UC San Diego and referred readers to WebMD.com, which appears to be a reasonable public-access website for medical information (though it also carries lots of advertisements).

One caution from Dr. Michael Steelman (I Googled him and he's the only weight loss specialist to receive the national society's Bariatrician of the Year award twice and is now the editor of a peer review journal in the field) is that "Dietary-supplement companies aren't required to show clinical data on the safety and efficacy to the FDA, which means we have no idea whether they work or if they're safe."

The Tufts article mentions a "voluntary recall" in 2009  of 14 diet-aid products sold as Hydrocut. This is a combination of several active components including caffeine and green tea plus at least three other ingredients. When I traced the history of the product I found the manufacturer had been reported by the New York Times in 2003 as burying studies showing it was ineffective and covering up evidence of cardiac side effects.

Later on there were 23 reports of major side effects with one person ending up with a liver transplant (and at least 17 cases of liver damage reported in the American Journal of Gastroenterology).

Yet when I Googled the drug I found ads for it online today. The company just reformulated the product and put it back on the market.

I went back to the Redbook which next mentioned bitter orange extract. I found university physician comments and reviews saying it doesn't help dieters lose weight and has significant side effects. But you can find lots of ads for the drug.

Brew tea leaves or drink milk; don't take supplement pills

The only two substances that may be effective and reasonably safe are green tea extract and CLA, conjugated linoleic acid (found in dairy products). But a Harvard medical school obesity specialist recommends that the best way to use them for weight loss is to drink some green tea and some skim milk, not to buy the unregulated and often costly supplements you can find advertised online or in magazines.

"Caveat emptor," the Romans used to say; let the buyer beware.

Posted in additives, Dieting, medically-oriented background info, supplements, Weight Loss | No Comments »

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