Archive for the ‘Vegetables’ Category

Heart attacks Part 2: Prevention: risk factors & our kids

Wednesday, May 23rd, 2012

Here's a risk factor you can eliminate

This post pings off the April 17, 2012 article in The Wall Street Journal, "The Guide to Beating a Heart Attack." I initially wrote about surviving a heart attack (myocardial infarction {MI} is the medical term). Next I wanted to turn toward the prevention side.

I first found the Interheart study's article from 2004, "Nine modifiable risk factors predict 90% of acute MI." The study followed 29,000 people from 262 sites in 52 countries and concluded that the common belief that half of heart attacks can be predicted was clearly an underestimate.

The research group found the same impact of the nine variables everywhere in the world: abnormal blood lipids (fats, like cholesterol) and smoking were at the top of their list. Then came diabetes, high blood pressure, abdominal obesity, stress & depression, exercise, diet and alcohol intake.

I was used to measuring cholesterol and its HDL (so-called good cholesterol)  and LDL (bad cholesterol) components. This study actually used a more sophisticated lipid approach.

They measured the ratios of  the proteins that bind to and carry fats, apolipoproteins A and B. APOA is associated with HDL lipids while APOB is said to unlock the door to cells and in doing so acts as an unwelcome delivery van for cholesterol. When present in high levels, APOB can lead to plaque formation in blood vessels and an increased risk of coronary heart disease (CHD).

They also found some good news: as expected, eating fruits and vegetables daily, exercising and perhaps moderate alcohol intake were associated with lower risks of CHD. Again this was true everywhere in the world.

The WSJ article mentioned that hospital admissions for heart attacks had actually decreased among the elderly; these nine factors were better predictors in younger groups. What can be done to stop the looming specter of CHD among our younger population?

The CDC examined the parameters in a recent online article titled "A Growing Problem." One issue was "screen time." Our kids eight to eighteen average four an a half hours a day watching TV and three more on cell phones, movies, computers and video games. I even read an article about a two-year-old whose parents think learns a lot from their iPad. Maybe so, but how much exercise does that kid (and his older compatriots) get?

The CDC feels there is a dearth of quality physical activity in our schools; as of 2009 only a third of them provided daily PE for our kids. And after they leave school or when they're on vacation, many don't have safe access to biking, hiking, running, playing areas and trails.

Somerville chose healthier food in their schools

One Massachusetts community, Somerville, has gotten attention for their anti-obesity integrated program, "Shape Up Sommerville"  (You can watch the thirteen minute PBS special on their community-wide progress). The Robert Wood Johnson Foundation is attempting to help similar programs get started across the country, especially focusing on childhood obesity.

Recently I heard a NPR comment that caught my attention. If we don't do something to stop the epidemic of childhood obesity, we'll soon be seeing CHD rates soar in people in their 20s and 30s and maybe even younger.

A French researcher said, "Mankind is doing a good job of killing himself."

We need to try new approaches to help our kids. The Somerville plan sound like a good place to start.

 

 

 

Vindication? Part 1

Thursday, January 5th, 2012

One way to get lots of protein

Since the late 1990s when I invented a diet, or perhaps I should say an eating pattern, I've relied on one principal concept: Eat Less; Do More. I came upon this simple idea after listening to a group of medical professionals who were discussing which diet they should go on while they were simultaneously consuming huge portions at our hospital cafeteria.

One of them, I recalled, had tried a high-carb, low-protein diet the past year; losing nearly twenty pounds, then regained it all and more in a few months. Now she was going to attempt  to lose twenty-five pounds with a different approach, this one with an emphasis on protein. I had seen weight-loss plans come and go and didn't believe any of them were the answer, at least not for everyone. I remember coming home and saying to my wife, "Lynn, I've invented a new diet"

I explained it was simply, "Never finish anything; No snacks between (meals); Nothing after eight." I added, "Get lots of exercise."

I lost the seven pounds I had gained on a two-week vacation and didn't need my strategy again until early in 2009. Then I weighed 177 one morning, up three pounds from my normal weight since 1991. I attributed that to eating out four times in the prior week. But when I tried on a pair of good suit slacks, I realized the weight hadn't changed much, but the distribution sure had.

I went back to my eating plan, lost five pounds easily, then coasted a while before resuming the diet. Lynn bought me a digital scale and I weighed myself daily. I also started going to our gym six days a week. Eventually I shed thirty pounds and five inches off my waistline. At 147 pounds I was twenty-five under my usual high school weight. This morning, nearly two years later, I weighed 148.

I allow myself a three-pound zone of weight fluctuation, thinking that would account for fluid shifts and the occasional big splurge. Whenever I exceed 150 pounds I go back on my plan.

Then I read a Wall Street Journal article titled "New Ways Calories Can Add Up to Weight Gain: Study Challenges Idea That Varying Amounts Of Fat, Protein and Carbohydrates Are Key to Weight Loss." It quoted the Journal of the American Medical Association, AKA: JAMA. I went online and found the JAMA article and an accompanying editorial.

I read both pieces in detail, even finding a wild typo, "...their diets were returned to baseline energy levels and diet compositions (15% from protein, 35% from fat and 60% from carbohydrate)." I called the AMA and suggested they correct the numbers since they added to 110%.

Is a high-carb, low-protein diet safer?

But the basic premise of the study's data intrigued me. It's something I've believed for years, calories count, as opposed to what form those calories come in. But there's one extra facet: low-protein diets can be dangerous.

I'll analyze that in detail in my next post.

 

 

Early cholesterol testing now recommended

Saturday, November 12th, 2011

We're seeing more obese kids

With our sweeping epidemic of childhood obesity ( current estimates say over one-sixth of American kids are obese, three times the prevalence rate seen thirty years ago), it's time to take some additional steps. On Friday 11, 2011, sweeping new guidelines for childhood lipid testing were espoused by both the NIH's Nation Heart Lung and Blood Institute and The American Academy of Pediatrics. I found these, of all places, not on the websites of the two august bodies, but on the front page of the Wall Street Journal, an NPR article and in the Los Angeles Times.

The actual article in the journal Pediatrics, won't be out for two more days and should find a fair amount of opposition. Previous position papers by the AAP and the US Preventive Services Task Force have either suggested lipid studies be done in focused groups (eg. family history of heart disease or lipid disorders) or, if universally, no earlier than age 20. The CDC (actually the acronym has changed since it's now the Centers for Disease Control and Prevention), in a 2010 report, commented that a single elevated LDL cholesterol reading in a child may be found to be normal in subsequent testing.

The current recommendation panel, headed by Dr. Stephen R. Daniels, an MD, PhD who is Chairman of Pediatrics at the University of Colorado School of Medicine, is quick to avoid any suggestion of widespread statin use for children found to have high levels of "bad cholesterol," LDLs over 190 milligrams per deciliter. Another panel member, Dr. Elaine M. Urbana, director of preventive cardiology at the Cincinnati Children's Hospital Medical Center, was quoted as saying, "This documents on the fact that this generation may be the first to have a shorter life expectancy than their parents."

So go back to the facts: one-third of US kids are overweight and about 12.5 million of them are actually obese. Even here in Colorado, the thinnest state in the nation, I see some of those kids every day. We're not just talking about high schoolers; some of these fat kids are as young as two.

What's missing is a balanced diet with emphasis on fruits and vegetables and a reasonable amount of daily exercise.

earlier blood tests may let them live longer

Daniels comments, "...the atherosclerosis process really begins early in life." he also said, "Heart disease is the number one killer in our society...people who are able to maintain a low risk through childhood and early adulthood have a lower risk (of dying from coronary artery disease)."

From my perspective, it's our responsibility as parents and grandparents, to help prevent childhood obesity, the accompanying risk of later type 2 diabetes and the huge risk of early heart disease. I filled out a health history form yesterday and noted my mother had a heart attack at age 74 (she lived 'till 90), but ignored my father's need for an artery unclogging procedure shortly before his 90th birthday. That may be something I can put off by eating well and exercising, but that's not the focus here.

I never want to see a child or grandchild die of a heart attack in their 50s or 40s or 30s or 20s.

So blood tests between ages 9 and 11 and again between 17 and 21 make sense.

 

 

Let us eat lettuce...and more

Wednesday, July 27th, 2011

I want more to a salad than just iceberg lettuce

Some years back I told my wife, "I'm tired of the same old salad; could you make a different one?"

We both cook, though she does more of of daily cooking than I do, but salad making is my least favorite part of cooking.

Over the next six weeks she never made a salad I had tasted before; her mix and match approach led to some surprises, but I'm always happy to try new dishes and almost all of them were successes. She added edamame, sunflower seeds, unusual greens; I ate them all. I finally told her, "I didn't mean an entirely new salad every time, just less of the iceberg lettuce, store-bought tomatoes and cucumber with familiar dressing.

We still eat salads at least once a day, sometimes as our main dish with chicken or fish added for protein. Sometimes we'll have a brand new mixture; sometimes I can recognize we've had this blend before and put it on the "keeper list."

Today I read about food companies attempts to get more Americans on the same dietary pathway. The Wall Street Journal had an article titled "The Salad Is in the Bag." I was amazed to read that the typical US adult eats salad with a meal only 36 times a years, roughly once every ten days. Less than half of Americans eat even one "leaf salad" in meals they serve at home in a two-week period.

The two of us are clearly on the far end of that scale when it comes to salad making. Our share of this weeks' vegetables from Grant Family Farms, our CSA, included summer squash, English peas, cabbage, carrots, kohlrabi, cilantro, parsley, green onions, a little broccoli, cylindra beets (new to us) and romaine lettuce. All of those veggies will find their way into salad

I've even gotten more enthusiastic about preparing some of the new salad combinations myself.

So what's going on with the "store-bought" salad concept?

A market research group reported the biggest issue is making salads. Apparently people don't want to take the time to wash produce, inspect it, cut it and come up with mixtures the family will eat (we won't even get into those who abhor greenery).

So some of the major food companies are responding by making salad preparation easier. One concept being explored is adding more kinds of vegetables to bagged lettuce or spinach. That way all you have to do is buy a bag, bring it home, open it before a meal and pour the contents into a salad bowl.

Well that sounds easy, but it turns out to be a bit more complicated than the simple version. One company found wheatberries absorbed moisture; their research director spent six months resolving that issue. Then there's the price issue; bagged salads cost more. Past history and the view of CPSI says there's more risk of pathogen growth and therefore of food-bourne illness.

But pre-washing with newer chemical mixtures, eliminating the need for a second wash at home, may help.

A new and improved version

Salad, anyone?