Archive for the ‘Healthy eating’ Category

Drinking your calories

Friday, September 10th, 2010

We have a close friend who always says, "No dessert for me; I'd rather drink my calories." Now she's fairly slender and doesn't drink to excess, but today I heard a story from another writer about a visiting relative and her drinking and eating patterns that made me look up data on calories in alcoholic beverages.

I do drink, almost always wine and very rarely more than two to three standard-sized glasses a week. I've had reaction to Cabernet in the past and don't like dry white wines, so these days I usually prefer sweet Riesling or, if I'm elsewhere and the only white wine offered is Chardonnay, I'll have a glass of Merlot or Shiraz.

There are some medical data I've read in the past few years that talk of health benefits from wine, especially red wine. The term "in moderation" is always attached; there are obviously lots of medical concerns with excess alcohol consumption.

The story I heard today is of a woman who typically has at least two or three drinks, gets a little tipsy and then starts munching on snacks. She's not going to be driving, so that at least is something positive, but I wondered about her calorie intake.

Let's start with wine. Five ounces of Chablis is 120 calories, according to several references I found. A dessert wine, sweeter by a considerable measure, may weigh in at 165 calories. Twelve ounces of a light beer gives you 100 calories; a regular beer 150 calories.

Then there are rum, vodka, tequila and gin, all offering at 80 proof (40% alcohol), 100 calories per ounce and a half shot. Mixed drinks up the ante. A frozen margarita is 246 calories and a Daiquiri 314 calories.

In one of my posts I talked about cutting your calorie intake by 50 calories per day. That adds up, over the course of a year, to losing five pounds. If you add 50 calories of exercise (and don't eat extra) you can lose ten pounds in a year. Those numbers are approximates, as 3,500 calories is the equivalent of a pound. So 100/day x 365 days equals 36,500 calories or somewhat over ten pounds.

Now go the other direction. If you eat the same amount as usual, but add a glass of wine a day, you can gain ten pounds or more in a year. If  you typically have a mixed drink or two, we're talking weight gains of twenty pounds or more. And that's before the snacks. No wonder some people who think they eat a fairly healthy diet and complain they can't lose weight, turn out to be "drinking their calories" and still eating dessert as well.

Now many Army recruits are overweight and out of shape

Tuesday, August 31st, 2010

I was setting up Lynnette's new Kindle (we are now a two-Kindle family) and in doing so looked at the one newspaper I subscribe to on what is now our old Kindle. I get the "New York Times" breaking news, updated three or four times a day. I scanned through the article list quickly, then I stopped and read one article carefully.

In the last few years the military has come to grips with our obesity epidemic. In 2010 the

optimal Army recruit

Optimal Army Recruit

Army has had to change its recruit physical training program. They aren't having the newbies do situps anymore; now they do yoga and Pilates. The underly rationale is partially to cut down on injuries and get soldiers ready for challenging terrain, actually it's because so many more of the youngsters who enter the service are overweight and out of shape.

I guess with all I've studied and read on the area that shouldn't have been surprising, but it still was. An Army report, "Too Fat to Fight" said the proportion of possible new recruits who couldn't pass the application physical went up by 70% between 1995 and 2008. Many of those who passed that exam still can't "cut the mustard" in physical activity like their predecessors. All this is being attributed to junk food, video games replacing outdoors sports and less time spent in physical education classes in schools.

Kids are drinking sugar-filled sodas and more sports drinks and not getting enough calcium and iron according to the three-star general who is in charge of Army recruit training. That plus the lack of serious exercise in their teens leads to a markedly increased percentage failing fitness testing and suffering injuries along the way.

I remember when one of my Air Force dieticians came up with a heart-healthy recruit diet trial; that was about 1995 or 1996. The youngsters actually liked the fruit "pizza" and other food items she substituted for what one senior officer on our base termed "the same old slop." We didn't totally change the worldwide menu for what we termed "chow halls," but we did add 300 heart-healthy items to the list of choices.

Now, roughly fifteen years later, the Army recruit diet is changing with milk vs. sodas, more green vegetables and lots less fried foods. It's about time, was my first thought. My second was, we've got to start earlier than the 18 to 24 year-old group.

It's time to set an example for your kids and grandkids and to pay attention to what they get to eat when they're first starting out. I suspect too many parents are letting very young children make bad choices in their diets and not setting limits on their sedentary activities. We need to steer our next generations for healthy eating habits and more physical activity.

Kids don't always listen to what you say, but they will notice what you do.

Before it's too late.

Living to 100; I tried some of Harvard Medical School's ideas

Monday, August 30th, 2010

We've purchased a number of Harvard Medical School's short publications; as expected they're excellent. I just was re-reading on on "living to 100." Most of the concepts, e.g., don't smoke, exercise regularly and eat a healthy diet, are well known to almost all of us but less commonly followed than I'd like to see. Some of the others, like take care of your teeth, establish a social network that lasts and kept your brain working hard, are also fairly obvious, but less well-publicized.
But then there was an idea that I really liked: keep an optimistic viewpoint on life. I tend to be cheerful, like puns (that's a "two-fer," optimism and brain play) and view the cup as mostly full, rather than partially empty.

My wife isn't hiking this summer as one knee has been bothering her; she goes to the gym for Pilates and/or yoga two or three times a week and is still in her "Strong Women, Strong Bones" class twice a week. She has a group of friends who attend one class and sit and converse afterwards; she has a close friend in the Strong,Stong class and has a snack with her afterwards.

I've noticed her social network and thought I needed one myself. So this past weekend I went for a hike in the mountains with a close friend of ours. I'm ten weeks out from back surgery and have been walking, but not going to the gym. In the week before the hike I walked further, three and a half hours without pause one day (actually I stopped to pet a dog for a moment) and two hours up and down hills another day.

My legs weren't as strong as usual going up the mountain to 11,440 feet and I had to stop twice, but made it to the summit. Then, on the way down, something extraordinary happened. We had seen a couple hiking up and later heard the man had stopped with Acute Mountain Sickness. Someone called 911 when they got to a point where they had cellphone reception and ten of us gathered around the couple and, in one way or another, contributed to getting the man down the slope.

The National Park medics arrived with oxygen and another group brought a stretcher with a single huge wheel. When my friend and I got to the trail-head I thought, "What a great day; exercise, a superb group effort and lots of positive approaches to solving a problem."

Then to top thing off, our friend came back with me, and joined my wife and I in celebrating our anniversary. With days like that I may live to 100.

To Overeat or not to Overeat, now that is THE question

Monday, August 23rd, 2010

I read an article in "The Wall Street Journal" recently (WSJ July 13, 2001) that gave me clues for my own eating "Hot Spots," those times when I tend to go on eating autopilot, switching from being a fairly lean, healthy eater to my late 1960s pattern of consuming anything in sight. As usual, I also looked for source material, and found an article in "Applied Psychology" that was published two years ago and another in the June 21010 issue of the "American Journal of Clinical Nutrition."

Swiss researchers used the "Power of Food Scale" to measure three groups' vulnerability to so-called hedonic/hedonistic eating. Obese patients tended to react much more to the sight, smell and, in other studies, even the names of "attractive" foods. Several recent studies have shown brain activity in the amygdala, a primitive area of our brains thought to be connected to emotion, to differ in lean vs. obese subject, in response to the smell and taste of milkshakes. Scientists are exploring, via functional MRIs and measurements of hormone levels, how and when we decide to quit eating.

So what does that mean for you and me? Many of us tend to eat on impulse, reacting to sight, smell, sound, and taste of foods we really like. People who are obese seem to have less/little control over this reaction. Successful dieters have the ability to pause, to have second thoughts before launching into an eating frenzy.

When I look back at how I once ate, it's clear to me that I was, at times, a hedonistic eater. Now I'm almost always a homeostatic eater, eating to satisfy hunger, rather than eating impulsively.

Yet there are still times when I can switch patterns. That's when I need to adopt the "one bite only" method, eat prior to parties, try my own method of cutting off a portion of each food item, avoid even the sight of high-calorie foods or just pause for a moment.

We ate a wonderful Australian dinner with our small gourmet group last night. There were lots of unusual food items, some of which were potentially high in calories. I ate very well, but only gained two tenths of a pound. This morning I walked for three and a half hours, doing some hill work in preparation for a mountain hike this coming weekend. Today is a mostly vegetable day. I think I understand the hedonistic eating pattern better and, in doing so, find myself much better able to withstand tempting foods.

Think about your own eating patterns, especially those times when you tend to overeat without thinking. How can you avoid or minimize this happening?. How can you spend as much of your life as possible as homeostatic eater?

Slow Food, farmer's markets and more

Wednesday, August 18th, 2010

I had heard of the "Slow Food" movement, begun in the late 60s after McDonald's got to Rome. I didn't know much about it until I read Michael Pollan's June 10, 2010 online article in "The New York Review of Books." His six-page piece is exceptionally well worth reading; I just got back to it via Google without any difficulty. Now I'll attempt to articulate some of its points and add a few of my own views.

Pollan covers some far-flung aspects of the recent history and current trends of "food in America" (and elsewhere). Early on he mentions that our citizens now spend less of their money and time preparing and cleaning up from meals than any other group in history. There has, however, been a secondary, but crucial cost, the decline of meals eaten together as a family. The impact of this is visible: our kids are growing up with meals eaten in front of the TV with an absence of family conversations; our food industry has had an enormous sway in what we eat and where, e.g., "Fast Food;" our diet with all its emphasis on ease and speed of preparation has led to the epidemic of obesity and its related diseases.

Pollan notes the variegated segments of the food movement, distinct as they have been over the past thirty years or so, have now appeared to have a common focus on high-level problems: we cannot sustain our present food/farming patterns longterm without major environmental and economic consequences. Climate change issues are at the heart of this shift, as is the realization that cheap fossil fuel enabled the huge post WW II increases in farm/food system productivity via the pesticides and fertilizers they spawned. In order to solve our global warming and water issues, we will almost certainly have to alter our farming/food patterns.

Our current diet, centered for many on meat-eating, consumes huge amounts of our increasingly valuable water supply. Our habits of wanting produce grown around the globe to be available on our tables year-round consumes fuel in enormous quantities.

The new health care reform legislation, Pollan feels, may lead to health insurance firms having a keen interest in the prevention of chronic diseases. We appear to be at a cusp where food-related businesses, locovores, food movement organizations, health insurers and even our government may agree on the need for change.

I'm tentatively hopeful that the next twenty years will see progressive shifts in our dietary patterns, our food sources, our use of fossil fuels and the longterm health of our kids and grandkids. Maybe that's asking for a lot, but the alternative is truly frightening. It's time and past time for a whole series of interlocking changes.

Help your baby; gain less during pregnancy

Friday, August 13th, 2010

A health-conscious blogger friend from Australia, Liana Werner-Gray, was gracious enough to feature this post recently on her own blog, The Earth Diet. Liana's blog was suggested to me by my local friend, Pat Stoltey, an author of two wonderful mystery novels.

Original post Aug 13,2010:
I read an article in "The Wall Street Journal" on August 6th that was a long ways away from my usual areas of interest. But in this case, it caught my attention enough to track back to an article published in "The Lancet" the day befores week and another one an Epidemiology journal from nine years ago.The synopsis of the two articles is that women who gain large amounts of weight during pregnancy have large babies. No surprise there. But large babies often end up as large teenagers.

Why did I do that legwork? Well I'm really concerned about our upcoming generation's weight. Lots of youngsters are overweight; too many are obese and heading for trouble, medical-problem-type trouble, down the line. We can blame TV, lack of exercise, fast foods, fat and sugar-laden processed foods, families that let kids decide what they'll eat from early on...all the usual suspects. But here was an idea I hadn't paid much attention to, do some kids start life with an obesity strike or two against them.

My caveat is this really isn't my turf; I'm an Internal Medicine subspecialist. I've delivered fifty babies, but that's old history. Nonetheless, I wanted to see the data and decide if it stood the test of time.

The 2001 piece was a Finnish study that looked at nearly 4,400 sixteen-year-old twins and tracked their progress from birth. Not surprisingly, adolescents who were tall at birth and had tall parents, were often tall at age sixteen. The group I focused on were those who were of normal birth length, but high birth weight.

That group was much more likely to be overweight at age 16. That fits with a number of other studies that didn't focus on twins.

So there's been some good data indicating high birth weight increases chances of high adolescent weight; the same is true for high adolescent weight foreshadowing high adult weight.

Now how much is nature and how much is nurture isn't clear to me. What makes sense if to re-emphasize to young women that gaining average amounts of weight during pregnancy is important. Too much gained increases the chance of heavy babies, heavy teenagers and, eventually heavy adults.

Our youngsters have enough factors that can contribute to their becoming obese adults; why add one more?

If you're a young person planning to have a baby, discuss this one with your own doctor. The life you improve may be your child's.

Pea Pod Soup and Pea Pod Soup++

Tuesday, August 10th, 2010

This has been our first closeup and personal experience with a CSA (community supported agriculture) organization. Every Monday we drive about a mile and a half to one of the 20+ delivery sites for Grant Family farms and pick up our Couples Veggie Share and a Single Fruit Share. This was week eight and thus far we've been extremely pleased at the quality and variety of produce we've been receiving.

Our only issue was what to do with it all; we've gotten six to eight different veggies a week. We have friends who split their Couples Veggie Share with neighbors, and we've given our next-door couple a few things. And when we travel we've either donated to the Larimer County Food Bank or, as will happen over the next ten days, while we're up in the mountains at the Y camp with our grandson and then flying him back to his folks in the DC area, a friend will make two pickups for us. She'll keep one for her family and split the second with us when we return.

The real discovery was the recipes. Our CSA sends out a newsletter each week and it took me a week or two to catch on to the sidebars. There are fascinating thins to do with the kale, beets, romaine lettuce, and cabbage we're getting at this time in the veggie season.

Then there were the English peas. The first time we got a large batch of them we just shelled them and added the pods to our kitchen compost bucket. They eventually were transferred to our vermiculture compost bin in a sheltered location just outside our garage.

The following week I spotted a recipe for pea pod soup. I gathered up the ingredients: olive oil, an onion, two cloves of garlic, chicken stock, fresh thyme, zest of one lemon and the pea pods and followed the instructions. I thought the resulting soup was delicious, if a little bland; Lynnette really wanted considerably more kick to it.

Having been local parents to two graduate students from India, we've been introduced to garam masala, a wonderful spice mix. We had a second day's worth of soup left over and heated that up for lunch, adding a couple of tablespoonfuls of garam masala and a teaspoon of minced garlic.

Both of us tried the new recipe and agreed we had made an enormous improvement. I plan to send our suggested alterations back to the CSA. Some may like the "souped up" soup; some may not. We'll probably never make it any other way.

We've stopped taking supplemental Calcium

Tuesday, August 3rd, 2010

For some years now, as we've gotten older and my wife's bone density studies moved into the borderline arena (osteopenia but not frank osteoporosis), we've been taking calcium tablets. We settled on a mix of calcium citrate (supposedly better absorbed than calcium carbonate) and Vitamin D. I took two of the caplets in the morning and two in the evening, giving me 1,260 mg of calcium and 1000 IU of Vitamin D. She took two in the morning and three in the evening.

This week we stopped taking that supplement and I bought some dried figs instead.

What's going on here? Well, the British Medical Journal (29 July 2010) published a very well-done meta-analysis (a review of a number of medical research studies) of 12,000 patients over the age of forty who were given calcium supplements in randomized, placebo-controlled research studies. The study's goal was to look at the risk of heart attacks in patients given at least 500 mg of calcium per day. The article concluded there was an increased incidence of heart attacks, about 30% more than in the control subjects and therefore the management of osteoporosis through by the use of non-food calcium should be re-evaluated.

There are a number of caveats here. The supplements used didn't contain Vitamin D, which in the accompanying editorial, is said to possibly reduce fall risk and even help cardiovascular function. And the mechanism for the increase in heart attacks in unclear, so the finding may even prove to be "incidental."

Today I read my copy of the ACP Internist, a publication from the American College of Physicians (I'm a Fellow of the ACP, an association of academically inclined Internal Medicine doctors). They reviewed the BMJ article, noted that its results didn't extend to supplements that include Vitamin D. They also mentioned that the editorial noted that positive effects of taking calcium supplements, a supposed health benefit for those having osteoporosis or at risk for developing it, aren't proven anyway, so why take the risk.

I crossed of my Ca++s from the mini-calendar I keep to record meds taken and events upcoming. We'll wait for this controversy to resolve, if it does. In the meantime I noted that figs were the top non-dairy source of calcium in a list compiled by a physician posting on a CBS News website (the others were sardines with bones, soybeans, salmon with bones and sesame seeds). Four figs contain 506 mg of calcium (but about 130 calories).

The figs were relatively expensive, but hospital stays for heart attacks are certainly more so, in a number of ways. I may get some sardines when I go buy a lemon and thyme to make pea pod soup later today. I normally drink soy milk, but had an eight ounce glass of non-fat regular milk this morning. Some studies I've been reviewing would have us not consuming any dairy either, but for now I'll continue having small amounts of non-fat milk, along with our usual generous helpings of fruits and vegetables..

High Fructose Corn Syrup: June 2004 Am. J. Clinical Nutrition article, 2008 editorial

Saturday, July 31st, 2010

I was reading an article in "the Wall Street Journal," (WSJ) in their Health and Wellness section for July 13th, 2010. The article discussed findings from two major medical conferences on obesity. The title of the piece was "Eating to Live or Living to Eat" with a subtitle "Why Some People Can Resist Dessert While Others Can't."

There was a lot of good material in the article, but as usual, I wanted to read the source material for myself. I've learned over the years that articles, books and presentations can often be written to fit the biases of the writer. So I'll almost always try to track down the original publications. One of the comments in the WSJ had to do with leptin, a hormone that normally helps you know when you're full.

That thread took me to an 2004 article published in the "American Journal of Clinical Nutrition." I view this as a seminal research study, one we're just catching up to. The authors, researchers at Loiusina State University and the University of North Carolina gave data showing the consumption of High Fructose Corn Syrup increased, in the U.S. population, ten-fold in a twenty-year period, forming 40% of caloric sweeteners added to foods and beverages.

Why is that important. Well, let's once more go back to the decision of our government to support the pesticide and fertilizer industries after WW II (I've mentioned this in prior posts) and therefore to support corn and soybean growers. That eventually led to the push for more HFCS use.

Why is that bad? The 2004 study shows the parallel increase in obesity, with a lag time of course, and discusses the problem of fructose, which is metabolized differently than ordinary sugar and therefore doesn't, via several mechanisms, including that of leptin, give you the "I've eaten enough signal."

More than that, HFCS is added to lots of foods, but especially to soft drinks. Some of the "food items" it's added to, and sodas are among those, are just "empty calories," with no real nutrient value.

The leader author of the 2004 study, Professor George A. Bray, published or co-published nine books on the subject in the last twenty years and a 2008 editiorial, in the same journal, on, "How bad is fructose?". He's also been attacked, in an online publication I just read, as someone who is paid by the pharmaceutical industry to help promote anti-obesity medications. My bet is the writer of this piece works for an non-academic concern and likely for the food industry. Dr. Bray's 2008 editorial on fructose in the same journal had the statement, "The author has no personal or financial conflict of interest."

My own take is the conclusions in his 2004 study, that HFCS is overused by our foods industries, that we should get soda machines out of our schools and reduce the portion size of sodas offered in other venues, made sense. As a nation, we're just now following some of those recommendations.

These days my wife and I read labels when we do buy processed foods and avoids foods that have HFCS. We're doing much less of this anyways, since we get farmers' market and CSA produce regularly and have our milk and eggs delivered from a local organic dairy.

What are your thoughts on this issue?

More on "What to Eat"

Friday, July 23rd, 2010

I finished Dr. Marion Nestle's book, "What to Eat" some time ago, but got distracted by several other books and articles in various publications I read. Now I'd like to return to her superb volume and make a blanket statement to begin with. I've been concentrating on books, articles and online sources, in the wide field of food, nutrition and dieting for well over a year now and have found and read a number of excellent publications . If you were limited to reading only one book in the area, I'd strongly suggest this one.

That being said, I'd like to devote a few posts to the book and my reactions to it.

Nestle expanded my concept of who benefits from our having an overabundance of food available, and eating much more of it then we should (remember two thirds of Americans are overweight. and half of that group, one third of our total population is obese). So of course the food industry, in all its manifestations, food production, sit-down restaurants and the plethora of fast-food outlets, benefits directly from our overeating.

What I hadn't thought of as collateral beneficiaries were the whole diet industry, our expanding number of health clubs, our pharmaceutical firms and even my colleagues in medicine.

Then there's the stock market angle. A number of those entities I've listed (a list I've obtained from reading Nestle's book) are actually publicly owned and have shares traded on the stock market. As such, my take is they need to demonstrate constant growth, or at least a pattern of growth, to maintain share value.

Nestle also emphasizes changes, over the last thirty years or so, in our eating patterns. We are encouraged to snack from an early age and most of those snacks, unlike my occasional piece of fruit, are empty calories. More calories ingested equals more weight, unless you're also burning more calories.

I'm now six and a half weeks out from back surgery and won't be able to return to our own health club for another ten days. So for now I'm walking, and going a little further each day. Today I walked for seventy-five minutes. I wasn't moving very rapidly and I didn't calculate how many calories I burned. I didn't care really; it was a beautiful morning (I started at 7:45 AM) and I enjoyed the walk. I chose a different route than I've taken in past days and saw some different scenery.

A major part of losing weight is to think about what you're doing when you shop, when you eat and when you chose how to spend your time. I may watch a TV show from time to time, but I'd rather spend the same amount of time exercising.

How about you? What choices do you make in these areas?