Archive for the ‘our kids and their weight issues’ Category

New proposed food advertisement rules with hedging language

Friday, April 29th, 2011

And here we go again

In response to the hue and cry about childhood obesity, an Interagency Working Group was set up, under the direction of our Congress, between the FTC, the FDA, the CDC and the Department of Agriculture . Their tasking was to "develop a set of principles to guide (note that word) industry efforts to improve the nutritional profile of foods marketed directly to children ages 2-17" and also to support healthful food choices.

After I read a short Wall Street Journal article on this proposal this morning, I found the original government release from yesterday online and a commentary in The Atlantic online written today by Dr. Marion Nestle, a named chair professor in the Department of Nutrition, Food Studies and Public Health at NYU and a visiting professor at Cornell. I have her 2006 book, What To Eat and consider her a trusted and knowledgeable figure in the field.

Let's start with the Interagency proposal, titled "Food for Thought." It mentions the major sources of calories for youngsters are cookies and cakes, pizza and various sugary drinks. When and if they eat veggies, half of those are chips and fries. Their parents are becoming concerned about childhood obesity as well they should be; one in three kids is overweight and headed toward an increased risk of all the diseases associated with obesity, hypertension, asthma and diabetes among them. They won't, on average, live as long as their folks do.

So, given that issue and the fact that the food industry spends huge amounts to markets these unhealthy food choices to kids, what does this august group come up with?

A voluntary program that should (note the word choice) be followed by the year 2016. Strange I think that's five years from now.

The recommendations, now subject to public comment (read that as efforts to soften them by the food industry) appear reasonable on first glance. They include foods that "provide a meaningful contribution to a healthful diet" and note those food components that should (same word again) be limited (added sugars, sodium, saturated fats and trans fats).

Marion Nestle's comment notes a prior attempt that never saw the final "rules" being implemented, and voices concern that the principles are still voluntary with no agency set up to track compliance and that five years seems far too long to institute these kind of changes. She thought the 2010 proposals weren't strict enough and noted the sodium level mentioned in the 2011 version was actually slightly increased, presumably to allow inclusion of more junk foods. She does congratulate the FTC for its courage.

Well I'll be a little blunter. I'm not holding my breath that these changes will happen short of massive public protest.

Even though 17 major companies are making some changes by reformulating foods and decreasing their markets efforts to kids, I think those will be glacially slower than they should be if we're going to help and even save the upcoming generations.

So it's time for all of us to weigh in on this issue. Start a campaign, talk to friends, write a blog...do something.

 

 

Obese kids, a growing problem

Tuesday, April 26th, 2011

eating too much of the wrong things

There is a very interesting article in the Wall Street Journal today about how Portland, Maine, concerning about the growing number of obese kids in the community, developed a city-wide plan to combat the issue. Their concept has now spread elsewhere in the state.

Well that caught my attention and I started looking for background medical and non-medical data. Many of the websites I visited initially were poorly written, causing me to move on, but I found one for the 6th Biennial Childhood Obesity Conference to be held in San Diego starting 0n June 27th (www.childhood-obesity.net). The underlying dire fact is the percentage of kids in the US who are overweight or frankly obese has nearly tripled in the last thirty years.

The conference offers youth scholarships for travel, hotel accommodations, meals (presumably healthy ones) and registration/materials fees. This way kids ages 14 to 18 can meet with medical experts, teachers, policy makers and other kids to hear the evidence-based best approaches to combating obesity.

some start off the wrong way

Former President Bill Clinton's foundation's web page said we've got ~25 million kids in the overweight and obese danger zones and the medical therapy for obese kids costs us three times that of normal weight kids. Twenty-five percent of our children don't engage in any kind of free-time physical activity.

So is it genetics or food or activity that's causing the problem. I think the answer is "yes," but I'd certainly put more emphasis on the latter two factors. Less than 25% of our high school kids take PE on a daily basis; instead they spend an average of four to five hours a day doing non-exertional "techy" activities including video games, computer use and even plain old television watching.

So back to Portland's plan. They developed a 5-2-1-0 concept: five servings of fruits and veggies, 2 hours or less of "screen time," at least one hour of exercise a day and zero sugar-filled drinks. They've already reversed the upward trend in obesity, but at considerable cost ($3.7 million) and with some difficulty in measuring the results. Now the CDC has recently given over a quarter of a billion dollars to 39 US communities in an effort to both start programs and follow their outcome.

I Googled the name of Dr. Victoria Rogers, a pediatrician mentioned in the article. She works as Director of the Kids Co-op at the Barbara Bush Children's Hospital at Maine Medical Center and is involved in the 5-2-1-0 Goes to School program, another  Portland-based program called "Let's Go!," and the state-wide Maine Youth Overweight Collaborative.

In Maine alone, Let's GO is now active in nearly 350 schools and the local business men and women who funded the original project are able to see some preliminary results already. One phone survey found increasing (but still relatively low) percentages of kids adopting healthier eating and exercise habits. Dr. Rogers and her cohorts want to follow 1,500 kids who are in the Let's Go! study long term to see if they change their eating and exercise habits for a lifetime.

So what's happening in your town or city and your state. It's our kids; we have to make a difference in their lives and this is a great way to do so.

 

 

Eating Disorders, Part one

Wednesday, April 6th, 2011

Drugs as food

I was reading the Wall Street Journal yesterday and saw an article titled "Food may be addicting for some." Thus far I've been able to find the Archives of General Psychiatry online and ran across a synopsis of the article that was perhaps more erudite, but less helpful than the newspaper article. I then read a "psychcentral.com" review of the study.

Let's start with the newspaper. It describes a study on a small number of subjects, 39 women, who had MRI brain scans after completing a short food addiction test that was originally designed to detect people with eating disorders. Fifteen of the women had high scores indicative of potential addictive eating problems; those same women had markedly different brain scan results than the lean subjects.

Okay, let's go back a ways. Last year in the journal Nature Neuroscience, Scripps researchers found that obese rats had brain alterations as compared with lean rats. The changes in the rats' brains were similar to those reported in people who are drug addicts. In short we normally get neural (brain-mediated) rewards for "pleasurable" activities. Similar rewards occur in response to addicting drugs.

The current study started with 48 healthy young women, some of whom were thin and some fat (or as, in our world of political correctness, we now term "obese."). They were enrolled in a "healthy weight maintenance' study.  Thirty-nine MRI results are reported, after the women were show pictures of chocolate milkshakes or a less enticing solution and some actually got either the milk shake or a tasteless control surrogate.

Then they had brain scans and the pattern of neural activation was much like those seen in drug addicts. Either food intake (or even viewing a photo of food) or drug use can stimulate the brains release of chemicals we find pleasurable.

"It ain't easy" for some to lose the extra weight

So what does this mean for society? Number one: not everyone can lose weight by following a deciding to diet. Number two: the omnipresent visual food ads can be detrimental to a segment of our population. Number three: I think organizations similar to Alcoholics Anonymous may be one aid to that group of the obese.

The lead author, Ashley N. Gearhardt, a doctoral student at Yale, who help devise the 26-question Food Addiction Scale, was quoted as sayying, "Some of them actually stop socializing because it gets in the way of their eating."

We've got a major problem here folks. I gained a few pounds on a 11-day trip to see old friends all of whom wanted to feed me wonderful meals. When I got home I went back to my usual eating pattern and the extra weight dropped off rapidly.

That's not going to be as easy for some and darn near impossible for others.

 

They're finally here!

Tuesday, February 1st, 2011

I woke up at 6:30 AM this morning and weighed myself: 149.6 pounds, right in the middle of my goal weight.  I've been working on my life style changes, more exercise and less food, since May 2009 and, although I bounce up and down 2-3 pounds, I'm basically lean.

Breakfast was a quart of "lime water" (I squeeze fresh limes three times a day), a cup of regular coffee for Lynnette and of Cafix for me (a blend of barley, rye, chicory and sugar beets; I avoid caffeine), a banana and a home-made oatmeal dish with millet, brown sugar, sunflower seeds, walnuts, and ground flaxseed to complement the commercial oatmeal. There's no salt in any of the above and we added fat-free milk (Lynnette) or soy milk (Peter) to our oatmeal. We'll eat our big meal of the day at noon and at home.

The Wall Street Journal's Personal Journal section had an article titled "New Dietary Guidelines: Less Food, Less TV." The June 2010 DGAC version from the advisory committee of sceintists and nutrition experts had gone through the expected round of commentary, largely from food indusrty sources and the final products, as always is considerably watered down. You can find it online at www.dietaryguidelines.gov if you want to read the entire document, or skim through portions.

So here's a section of what it says:

• Reduce daily sodium intake to less than 2,300 milligrams (mg) and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children, and the majority of adults.

• Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids. • Limit the consumption of foods that contain refined grains, especiallyrefined grain foods that contain solid fats, added sugars, and sodium.

How do we translate that into simple English? More than 1/2 your plateful should be vegetables and fruits, buy lower salt products and don't add any when you cook or at the table; eat less red meat. Eat real food, not food products; read labels carefully when you shop. I'd add: eat out less and exercise more.

I read Dr, David Katz's column, "New Dietary Guidelines: A Physician's Perspective" on the Huffingtonpst.com website (Katz is the Director of Yale's Prevention Research Center). He agrees that the feedback gave a politicized spin to the final document, but liked the new emphasis on obesity and chronic disease prevention (roughly 1/6 of our kids and 1/3 of our adults are obese). He didn't care as much for the continued emphasis on dairy and meat consumption with less attention paid to plant-based diets.

So this version of the Dietary Guidelines isn't all that much different from prior versions, unless you read carefully and, in some cases, between the lines. I found a section (Chapter one, page 3) on "The Heavy Toll of Diet-related Chronic Diseases that I'll comment on at another time.

What's Good for General Bullmoose...

Thursday, January 20th, 2011

A Bull Moose has some clout

Several major concerns in Americans' diets have apparently taken another step to resolution. I've written how the dietary salt (sodium really) recommendation has recently been lowered so that about 70% of us (all but the young, white and quite healthy) should be ingesting only 1,300 to 1,500 mg. of sodium per day. That's tough enough to do. I saw a recipe yesterday in a "Light Cooking" magazine my wife gets that was interesting: a steak hash. But per portion it had 1,000 mg. of sodium.  That's over two thirds of what I should eat in a whole day. I didn't bookmark that recipe.

Then there's the relatively high cost of fresh fruits and vegetables compared to some other choices, so called "prepared foods" one can buy in the supermarket. Those mixtures are often filled with sodium, fats and sugars, but they're comparatively cheaper in many instances.

We're fortunate enough, as a pair of USAF retirees,  to be able to buy our fruits at the Air Force Base Commissary closest to us as we did when we drove to Cheyenne to see our Dermatologist today. And in the summer, of course, we've again purchased a veggie share and a fruit share from the local CSA, Grant Family Farms. Next summer two sets of friends will join us in that, so the variety will go up and the price per item down as we purchase larger shares. Then we got a quarter of a "hand-raised" cow this year at a wonderful per pound price. That came through friends whose neighbor has a very small herd and sells a few each year.

So what if you're on a tighter budget and don't live where friends and their neighbors have livestock?

Today in The New York Times appeared an article titled "Promote Healthy Foods."  It details how Wal-Mart (since 2008 I think it's actually Walmart), now the biggest retail concern in the country has a new plan, one that over the next five years will cut down on packaged foots content of the sodium, fat and sugars. That gradual approach doesn't ring well with some; I saw some negative quotes, but other countries have followed the same pattern with success. it's hard to go from high-salt to low-salt diets in one urgent push. I know since I tried that when my own blood pressure first went up in the early 1980s.

I tried some "no-salt" foods and hated them. Yet now, some 25+ years later, I'm quite comfortable adding pepper and other spices and using no table salt and no cooking salt.  We cook with a little salt when we have company, using less than the recipe calls for, and I frequently see our guests adding salt at the table. When we eat alone there's no salt shaker there.

Wal-Mart is also planning to offer fruits and vegetables at lower prices. And the article said they plan to build some more stores in rural and "underserved" areas. The company has been discussing healthy eating and our epidemic of childhood obesity with the First Lady and she apparently endorsed their efforts. Why is this significant? Well it's because they can pressure their suppliers to follow along with the concept. They are the Bull Moose herd leader and others tend to tag after them.

We don't do much shopping with them, but in this case I say, "Hooray for Wal-Mart."

The American Year of the Vegetable

Monday, January 3rd, 2011

Ever since we met our Chinese graduate student, back in 1999, I've enjoyed figuring out what the current Chinese year is. For instance, 2010 has been the year of the Tiger, while 2011, starting February 3rd will be the Year of the Rabbit.

vegetable medley

But an Opinion piece in the Wall Street Journal today was titled "2011: The Year of the Vegetable." I read that and my copy of the Harvard Heart Letter, which arrived in this afternoon's mail, and found they were both urging us once again to eat  more veggies (and, in the latter case, more fruits).The newspaper article's theme was slanted toward preventing childhood obesity and its many significant consequences, diabetes and joint problems among them.

As the writer of the piece stressed, it's not the kids fault. We as adults and especially as parents and grandparents need to provide healthy choices and strong roles models. Which is to say, we ourselves are responsible for the epidemic of obesity in our youngsters.

How do I mean that? Well to start with our kids should be given healthy food and see that we also eat those foods. Recently, in two iterations, Lynnette and I hosted young adult children of old friends. Their parents are a doc and a nurse who worked for me in the Air Force. One twenty-two year-old  man came with his college roommate for a six-day stay. His older sister, a senior in medical school, visited here for two days while applying for the local Family Practice residency.

Even more veggies

All three young adults ate everything we suggested, including Brussels sprouts (we microwave or steam them and they're a completely different vegetable than the over-cooked ones I had as a child).

I asked the two whose parents I knew, "How come you are so willing to try different foods?

Both responded, "Our mother, when we were kids, said we had two choices. We could eat what the family was having...or we could starve."

I know their folks and I'm sure they would never have allowed the kids to starve, but  they both got the message. "learn to eat everything."

The author of the Opinion article mentioned that only 26% of adults (this came from a recent Center for Disease Control & Prevention survey) eat three or more veggie servings a day. He added that some of those who claim to match that minimum intake would count a hamburger  topped with a tomato or lettuce as a veggie serving.

That means three quarters of us don't meet that standard. Why? Probably because as kids, we didn't acquire a taste for eating them in the presence of adults who did.

So it's up to us to help our youngsters learn what a healthy diet is. And we better start now, or we're, in a sense, dooming our offspring.

I know those are strong words, but think about what's happening with our children; many of them are eating the wrong things and exercising less than we did as kids. Will their lifespan be shorter?

It's time and past time to set examples.

Guidelines for diagnosing food allergies in flux

Wednesday, December 15th, 2010

I've been tracking down some changes in the diagnosis of food allergies, especially in kids. I started with a Wall Street Journal article, dated Tuesday, December 7, 2010 and titled "New Rules for Food Allergies." That mentioned the National Institute of Allergy and Infectious Diseases, a segment of the NIH under the US Department of Health and Human Services, had recently convened an expert panel on the subject.

The resultant guidelines were published in the "Journal of Allergy and Clinical Immunology." I found a review in WebMD (webmd.com) and then the lengthy report itself online at the NIAID website. I realized it was so voluminous there was a separate 29-page summary for clinicians and a much shorter set of guidelines for patients with a more thorough patient guideline to be published in 2011.

An Epi-Pen for severe allergic reactions

So what's the short version? Well to start with about 5% of kids and 4% of adults have food allergies. If they eat specific foods they may have reactions varying from mild to life-threatening.

The most freguent food allergies are to eggs, milk, peanuts and tree nuts, soy (that surprised me), wheat and some shellfish. Kids often outgrown an allergy to milk, eggs, soy and wheat, but not those to peanuts and tree nuts.

There are no cures to these allergies and having a mild reaction to a food once doesn't mean you won't have a severe reaction on another exposure.

Allergies often are seen in people who have some other diseases, asthma for one example and eczema (a skin disease) for another. Those plus a family history of food allergy may alert you and should alert your physician to your having a greater risk of food allergies.

Neither of the usual office tests used to diagnose food allergies, is definitive. Those include a blood test looking for antibodies to specific food and skin-prick test where a tiny amount of a suspected allergen is paced on a forearm then pricked to see if a wheal result.

The only test that proves you have a food allergy is a food challenge. That must be done, for safety reasons, under the careful direction of an experienced healthcare professional.

Yet all is not as dire as the above sounds. One study published in the Journal of Pediatrics this fall looked carefully at the medical records and testing of 125 children who had been sent to the National Jewish Hospital in Denver for evaluation of eczema and food allergies.

After careful food challenge tests were evaluated, over 90% could go back to eating foods they had been avoiding.

A few other tidbits caught my eye: peanut allergies are especially severe and, fortunately, I'm seeing more and more labels that specify this product is (or is not) produced in a peanut-free environment. Wheat protein allergies are not synonymous with celiac disease, so those having such allergies may not react to gluten in oats, rye and barley. And fish allergies, which tend to start after childhood, can be another very severe problem.

I give my wife her allergy shots at home, so I keep Benadryl and an Epi-Pen handy. Food allergies are nothing to sneeze at (no pun intended), so if there is a family history of them or you or your child have eczema or asthma, make sure you get a thorough evaluation by a qualified physician.

Healthy School Snacks

Friday, October 22nd, 2010

I read an interesting article in the Wall Street Journal yesterday and then perused lots of background information on the Web. The article itself described the challenges of designing a vending machine that could dispense healthier snacks, especially for schools. I had heard that many school districts and even some states were concerned about the obesity epidemic and wanted to quit offering candy bars and sugared sodas. It's not that easy.

One company now offers a vending machine with two major compartments, one for bananas and the other for fresh-cut fruits and veggies. The banana compartment is kept at 57 degrees and the other area at 34 degrees.  They're working on the issue of keeping the fruit, especially the bananas, from getting bruised when it's selected and falls to the delivery area.

The Center for Science in the Public Interest has a website which I found by Googling "Healthy School Snacks." They noted that over a nineteen-year period (1977 to 1996), our kids' calorie consumption from snacks had increased by 120 calories per day. That's roughly equivalent to a ten pound a year weight gain.

They estimated that cost of serving fresh, frozen or canned fruits and veggies would be about 25 cents a day. That's a lot less than their estimates for single-serving bags of potato chips at 69 cents or candy bars at 80 cents.

They gave some suggestions for kid-friendly snacks, including a clever recipe for "Ants on a Log." made by spreading peanut butter on celery sticks and adding raisins.

Then I found the December 2009 Massachusetts Food and Beverage Standards to Promote a Healthier School Environment. They mention the national Action for Healthy Kids (AFHK) initiative (http://www.ActionForHealthyKids.org). That website is well worth looking at, but I concentrated on the Massachusetts plan itself.

A survey done in Massachusetts in 2005 showed over a quarter of students at risk for overweight or already overweight. So state officials and a bevy of advisors were concerned about so-called "competitive foods," which often are high in fats and sugars.  These are sold in vending machines, in school stores or in fundraisers and compete with the well-regulated school lunch and breakfast programs.

Now the state has published a set of well-reasoned guideline for various foods and beverages that might be offered in the schools. The John Stalker Institute website has links for the information.

Take a look, whether you have kids or grandkids in school or not. We need to get behind efforts like this. Adults may be set in their eating habits and reject sound advice; school kids are a captive audience in a sense and their lifetime eating habits can be influenced for their good.

I'd be bugged too, or would I?

Tuesday, September 21st, 2010

I picked up the Wall Street Journal this morning and saw an article, "Virus linked to Obesity." The virus in question is called adenovirus 36, or Ad-36 for short and, when I started combing medical articles, was first found in 1978 in the feces of a girl with a bowel disease. Its kin cause respiratory, eye and bowel infections, but Ad-36 is the only known virus that can attack fat cells directly.

There are a host of articles on Ad-36 and similar viruses; many of them associating it with obesity in other species, chickens and mice among them. Several studies have found antibodies to Ad-36 in humans, more freqently in those who are obese.

An article that was just published online in the journal Pediatrics is causing quite a stir. That came from a pediatric subspecialist in San Diego and studied Ad-36 antibodies in obese and non-obese children aged 8 to 18. Of the 124 kids in the study group, over half were obese and of that group 22% had antibodies to Ad-36. This is in contrast to 7% of the non-obese group, so 78% of the kids who were Ad-36 positive were obese

Now there are articles out there that don't support the same linkage. Another San Diego group, this one a US Navy research unit studied 300 military subjects, half of whom were lean and half obese, and found antibodies to Ad-36 in 34% of the obese group vs. 39% of the lean group. That article was published last November in the Journal of Obesity.

The animal research seems to imply that Ad-36 infection can lead to obesity and maybe that's true in people also. The question in humans remains as to which came first, the obesity or the infection.

And we shouldn't forget that only 30% or thereabouts of obese people in these research papers had the antibodies. If Ad-36 does lead to weight gain in humans, what about the other 70%?

This is a fascinating new subject and isn't confined to the us.  Antibodies to Ad-36 have been found in Australia and England as well. I'm sure we'll be hearing hear more about viral infections and their link to our obesity epidemic.

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.