Eating our way across Portugal

October 6th, 2011

 

 

We started just west of Lisbon

 

 

We're on a three and a half week trip, almost all in Portugal. I wasn't planning to add any posts, but brought my iPad2 and realized I could find Wi-Fi connections in many places. So now we're on a two-day farm stay in the Duoro Valley, heart of the Port wine grape industry and we're eating well, perhaps too well.

I'm not normally a chocolate eater but the Mousse de Chocolata" here has been wonderful. I realized today that I've eaten more desserts and more bread (freshly made) than usual, but my slacks still fit and I' using the same belt notch.

So what's keeping me from gaining a significant amount of weight?

To begin with we're often eating one main meal, one smaller one and a fruit or yogurt snack. Breakfasts here have freshly squeezed orange juice, rolls that don't need butter and some cheese. Our lunches have often been eaten in transit and, more often than not, have been light.

Then too we're walking 45 minutes to two hours a day, often up and down hills.

Today for lunch we returned to the same wonderful gourmet restaurant we'd been to last night. As in the previous meal portions were smaller than we get at home. We ate slowly savoring each bite and drank a third of a glass of a late harvest wine the chef had sent us. My wife had a fruit and vegetable salad, while I ate a fish fillet. We really dawdled for an hour and forty minutes, talking, putting our forks down between smaller-than-usual bites and talking...a lot.

I realized we'd spent two and a half hours over dinner the previous evening. This was a European way of dining I noticed as I looked around. Nobody was in a hurry and, tellingly, nobody seemed significantly overweight.

So I've learned a lesson or two on this trip and, in doing so, have enjoyed my food more.

Eating and drinking in Europe: part two

October 5th, 2011

I may switch to red wine

I've been reflecting about our wine drinking in Europe. Here I normally have one glass of sweet white wine (e.g., Riesling Spatlese) three times a week.  It's very rare that I'll have a second glass and when that occurs it's almost always at home. When we're at an evening event we routinely have a "designated drinker" and a designated driver. That's been our pattern for more than twenty years, ever since I saw an Army senior physician, about to move into a choice command position, make the irrevocable error of over-consumption of liquor at a party.

I've noticed a few months ago that other countries have considerably lower blood alcohol limits for drivers than ours in the United States: that altered my own behavior. Rarely in the past, if we were going to spend three or four hours at a party, I might have one drink at the start of the festivities and drive home some hours later. That no longer makes sense.

However, in Portugal, we almost always walked to restaurants and we almost always drank red wine: vino verde (I discovered this meant "young wine", not "green wine), Port or regional products. We were sitting next to a German couple at one delightful meal and started talking about our imbibing habits. They had a white wine bottle on their table while we were trying a local red . They said at home they usually have wine with dinner and drink a bottle every three days. On vacation, they were drinking a bottle a night.

We brought a half bottle back to the hotel and finished it the following evening sitting on the third-story terrace.

Normally, if I do have a second glass of wine I feel a slight buzz. That wasn't happening on this trip. When I thought about it I realized we weren't drinking standing up at a reception, but sitting down at a prolonged meal. Our typical dinner in the States lasts an hour; here we averaged two and a half hours. So both the length of time and our food intake played a part in moderating the effect of the alcohol we were consuming.

We're home now and back to our normal pattern. We ate at our favorite local restaurant yesterday and I had a Thai Ice tea and no wine.

I'm not suggesting any of you should start drinking wine if you don't now, and for those of you who do drink wine now I'm certainly not pushing for increased amounts (having seen far too many cases of cirrhosis). The medical data for a favorable effect of moderate red wine consumption is suggestive, but not definitive as I mentioned in my comments extracted from a Mayo Clinic website. At age seventy, with no history of overconsumption in my family, I'm choosing to err on the side of  the vino. I may even switch from white to red wine.

Eating and drinking European style

September 30th, 2011

Living and eating at a vineyard

We're just back from 3+ weeks in Europe, almost all of that in Portugal. We had keys to an apartment situated in a village west of Lisbon and owned by old friends. Downstairs was a superb Brazilian restaurant and 100 feet from our buildings door was another, more casual eatery in a glass-sided tent-like structure. We dined at those two places a lot, but also rented a car, drove north, and stayed in walled cities, a university town and a farm in the Douro Valley raising grapes for Port wine, olives and some fruit.

We discovered a new style of eating and drinking, far different from American fast food restaurants or home meals eaten on a couch in front of a television set or hurriedly at a table. Many of our dinners lasted well over two hours and almost all were accompanied by red wine.

We had already, over the past few years, changed our style of eating, at least for our evening meal. We move from the kitchen area to the dining room, serve one course at a time, portion out our meat, salad, and vegetables in the kitchen so we don't have platters of food before us as a temptation to refill our plates. We slow down, talk and reflect on our day or on issues of substance. Perhaps three times a week we have a glass of wine, almost always a sweet white varietal. Our dinners often stretch out to an hour in length, sometimes longer.

I've read about the supposed health benefits of red wine (the Mayo Clinic website has an excellent short review on the subject) and, in recent years, realized there are some reds I can drink without having the kind of reaction (mostly nasal stuffiness) I got from Cabernet sauvignon in the early 1970s. I went back to a March 2011 update from Mayo's which, with appropriate cautions, discusses an antioxidant named resveratrol, which comes from grape skins. Because red wine is fermented with grape skins longer than is red wine, it contains more of this polyphenol chemical.

I knew I wanted to try and likely buy some Port. That was easily done during our four-day farm-stay. But elsewhere in Portugal there were various other local red wines. So we walked from our hotel to a restaurant (I don't drink and drive), ordered some red wine and markedly changed our eating style.

Take a bite, put down the utensil, savor, swallow and then talk for a while. Our meals stretched out to two hours and often beyond. In one restaurant we were next to a French couple and beyond them was a Canadian couple. We entered the place before either and left last.

We usually ate bread (freshly made) and ate desserts. I knew I would gain a few pounds, but I also knew I could lose it quickly when we returned home. The food, on average, was wonderful. We ate lots of fresh fish, lots of vegetables and the occasional mousse de chocolata. We hope to carry over some of those habits now that we're home.

 

 

More on the heatwave and its consequences.

September 1st, 2011

Here's one way to cool off

This morning I read in the New York Times Breaking News that comes to my Kindle that NYC has recently seen an unprecedented number of heat-related deaths. The age range of the victims varied considerably; youngsters, a 45-year-old  woman and some elderly folk all were struck down. Today I'd like to concentrate on older adults.

You may or may not believe in global warming (I certainly do) and, if you do, whether humans are making a significant contribution to it. But in the meantime we seem to be experiencing a hot patch and we have to cope with that.

I got up fairly early, took Yoda, my Tibetan terrier, to Whole Foods to buy a sack of his dog food and then took him for a walk. All in 72 to 75 degrees on a day that will later see a 95+ degree peak temperature. And this is in Colorado at 5,200 feet elevation. I checked out temp predictions for Denver and for the mountains; the former will be just under 100 degrees later on today whereas those areas at considerably higher elevation will stay in the 70s.

But agewise, I'm also in my 70s, as of April, and therefore read with interest the National Institute on Aging's paper titled "NIH tips for older adults to combat heat-related illnesses." The basic concepts are threefold: we lose some of our ability to adapt to heat as we get older; we are in a group that frequently has underlying diseases/conditions that fare poorly in hot weather; the meds our physicians use to treat those diseases sometimes limit our ability cope with the  heat.

I'll add a link to the article below, but will paraphrase some of their points and add my own spin.

Firstly some of the physiologic changes we experience as we age limit our ability to respond to elevated temperatures. Those include our cooling via sweating or , in some cases, our limited mobility and, in other cases, our mental responses or lack thereof. Additionally, our ability to vasodilate small blood vessels may be compromised.

Then we're experiencing, as a nation, an epidemic of obesity and concurrently those who exceed their weight goal by a large amount experience more heat-connected problems. I searched medical websites for the rationale and, if I were a teenager, would have said, "Duh!" The layer of adipose tissue the obese accumulate is the equivalent of wearing an insulted suit, something you wouldn't want to do in the heat of a summer day.

And then there are all those medications we take as we age. One article I found said older people take 2 to 6 prescribed drugs while also taking a number of OTC medications. Those drugs can directly alter our response to heat while potentially causing increased body temperature in a number of other ways, e.g., hypersensitivity reactions or the pharmacological action of the drug itself.

That helps

So if you're an older adult, avoid the heat of the day, get enough fluids and, if necessary, contact the Low Income Home Energy Assistance Program (through HHS) for help with home cooling.

http://www.nia.nih.gov/NewsAndEvents/PressReleases/PR20110718hyperthermia.htm

Can there be long Life without Life?

August 30th, 2011

A "fountain with Youth" that's real

I was reading two articles, in our local paper last weekend when I realized I was channeling Yogi Berra and his famous quote, "It's déjà vu all over again. What's happened is a return to Herodotes, the Greek historian (5th century BCE) who told of a fountain in Ethiopia responsible for extraordinary lifespan and to Ponce de Leon, the Spanish explorer who traveled on Columbus' second voyage (1493) and described the Fountain of Youth, supposedly found in Florida.

Now we have a huge contingent of baby boomers (estimates in the 70 million range) who are about to reach 65 and don't want to grow or look older. The market for anti-aging remedies is currently about $80 billion a year and is expected to top $110 billion in the next four or five years. We live in a society that worships youth and many of our compatriots are being sold magic potions that some claim will prevent aging or at least most of its signs.

One of the articles had an amazing photo of Dr. Jeffrey S.Life, age 72, a body builder and author of a book titled The Life Plan: How Any Man Can Achieve Lasting Health, Great Sex and a Stronger, Leaner Body. You can buy this $26 book for $14.94 on Amazon, but I think I'll skip it.

Dr. Life's program includes diet, exercise and a healthy lifestyle; it also features, for at least some of his patients, injections of human growth hormone (at roughly $15,000 a year) plus testosterone.

The data on these hormone replacement regimens is, to say the least, not as rock solid as Dr. Life's toned torso. The NIH has a division called the National Institute On Aging (see link below), and the Geriatrician who heads this organization is solidly against widespread use of hormone replacement therapies.

http://www.nia.nih.gov/

What makes sense to me is exercising regularly, staying lean (or getting there) and stopping smoking. I noted that Dr Life's mentor died at age 69, a long ways short of my physician Dad's 94-year lifespan. Dad ran most days until his late 70s, stayed trim and quit smoking as a young doc when he realized he had three cigarettes going in three ashtrays in his three-room office.

lots of these out there

I think many baby boomers and others would like to find a magic bullet, a tonic or elixer that would allow them to eat what they want, do what they want and live to 100.

Until you show me a long-term, controlled study that points that way, I think we're as shy of the Fountain of Youth as we were in the days of Ponce de Leon or Herodotes.

Eat less and spend your money on a health club membership or a pair of running shoes instead.

Dengue fever; global warming effects versus a new hope

August 26th, 2011

avoid at all costs

I haven't thought about Dengue Fever in years, probably since I returned from an Air Force tour of duty in the Philippines in 1986. Now global warming and a fascinating NPR tidbit brought it back to the forefront of my consciousness.

Dengue, a major cause of illness and death in the tropics and subtropics, is a viral illness spread by mosquitoes. Worldwide it causes up to 100 million infections and 25,000 deaths per year. The typical result is a high fever, headache, muscle/joint/bone pain and a rash. There is no effective vaccine available and avoidance of mosquito bites is the most effective preventive strategy.

So why am I concerned enough about dengue to bring it to your attention? Simple, we're traveling more, cases have been seen in Florida, Texas and Hawaii; it's an endemic disease in Puerto Rico and, with our climate heating up, I'm concerned that we may see the disease spreading further in the United States and elsewhere. I'll add a link to information on dengue from the NIH's PubMed website.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002349/

There's another concern; more than 5% of Key West residents monitored in a 2009 study had antibodies to the one of the four viruses that cause dengue. That puts them at risk for a much more severe form of the disease if they're bitten by a mosquito carrying a different dengue virus than they were first exposed to.

Dengue hemorrhagic fever is a serious problem, though relatively uncommon. It can lead to a generalized rash, bruising and bleeding and, potentially to a shock-like state, liver and brain damage, and seizures. Early diagnosis and aggressive care measures  can improve survival rates, but half of untreated patients who go into shock die.

Most physicians in the US probably have never seen a case of dengue hemorrhagic fever. I have, in the Philippines, but that was the result of working there for a year and a half. So bringing this disease to the attention of doctors (and potential patients) in locations that previously haven't seen dengue makes sense to me.

the old way to control mosquitoes

But now for the good news. Research scientists in Australia recently released specially-bred mosquitoes, infected with a bacteria that is a parasitic microbe, seen in roughly a sixth of other neotropical insects. Apparently Wolbachia-infected mosquitoes will not spread dengue to humans, but when allowed to intermingle with uninfected mosquitoes, results, in a relative brief period, in those insects also being unable to spread the disease. The article on these experiments came out in Nature, online on the 24th and in print yesterday.

http://www.nature.com/nature/journal/v476/n7361/abs/nature10356.html

Now it's time for large-scale projects in multiple countries, but it looks like dengue may finally have met its match.


 

 

 

 

Beating the heat by using the new data:

August 23rd, 2011

Ready, set, eat well

A recent article in The Wall Street Journal described how the Houston Texans professional football team is using data I read in the Archieves of Internal Medicine online to improve player safety. The Texans are facing some of our worst summer heat and are going to extraordinary lengths to prevent heat-related injury.

I'm not at all sure I agree with their stategem, practicing in triple-digit weather outdoors in the full sun. Their theory is that doing so helps their players remain fresh in the heat of early-season games. Other teams have opted for temperature-controlled practice arenas or night-time workouts or cooler climes.

We'll wait and see the results, but at least they're using the latest medical research and some practical concepts.

Players are weighed pre-practice and afterwards (the team, collectively, lost an incredible average of 450 pounds per two-hour session one week). That's in spite of replacement fluids and ice to the tune of 100 gallons of water, 50 cases of Gatorade and three quarters of a ton of ice for ninety men. One three-hundred-plus tackle lost seven pounds and had to receive IV fluids.

The Archives  article and a subsequent Harvard Heart Letter detailed research and historical perspective. Our intake of sodium, in table salt and foods, is important, but the ratio of how much sodium to potassium in our diets may be even more crucial.

An older edition of the Harvard Heart Letter compared our modern diet to that of our primitive ancestors. Paleolithic man consumed sixteen times as much potassium (in milligrams) as sodium; today our typical diet has nearly five times as much sodium and less than a quarter of the potassium as the hunter-gatherers ate, so the ratio has marked changed.

lots of potassium in this bunch

So how do you return to a healthier diet, in those terms. Well, a banana, for instance has over 400 milligrams of potassium and almost no sodium (1 milligram). An orange has over 230 times as much potassium as sodium, steamed Brussels sprouts 35 times as much (I mean in milligrams in all cases, so scientifically my comparisons are ratios).

The Texan's head dietician and senior trainer are altering the team's diet, using lots (and I mean lots) of electrolyte-containing vegetables and fluids. They even formed a players' food committee to make sure the team members would have choices that they would like. Southerners want okra and potatoes, so that's what they get. The team members were concerned about blood pressure effects from all the salt they're getting; then they heard how the new research showed foods high in potassium and other electrolytes can balance out the effects of sodium.

The proof is in the pudding is the old saying; we'll see how the Houston team does when the season starts.

But I can certainly see the sense behind their approach.

 

A better school lunch: Greeley in the New York Times Breaking News

August 20th, 2011

It's time for a better school lunch

I was reading the NYT breaking news on my Kindle this morning, when to my surprise I saw an article, "Schools Restore Fresh Cooking to the Cafeteria," on school lunches in Greeley, Colorado. We live 20-25 miles northwest of Greeley and I'd never thought of the city as being a hotbed of innovation.

At a tad under 93,000 inhabitants, Greeley is mid-sized at best, but 60% of its 19,500 students qualify for lower-priced or free meals, so they have decided those meals will be healthy ones.They're not alone in this endeavor. The Physicians Committee for Responsible Medicine has a campaign whose motto is,"Foods served in schools should promote the health of all children." Their 2008 school lunch report card ranked twenty school districts across the nation with letter grades from A to F.

Here's that URL: http://www.healthyschoollunches.org/reports/report2008_intro.cfm

At the top with A's were schools in Montogomery County, MD, Omaha, NE, and Pinellas County, FL, I was pleased that my grandson Jordi's schools in Fairfax County, VA got an A-.  At the bottom were schools in two areas of Louisiana. I bet Greeley will climb up the list in the next few years.

So what's their plan? Like many Colorado schools, they've participated in Cooks for America, a group that runs a chef's boot camp for school cooks  Here's what that organization's website says: "Distinguishing the Cook for America® approach from that of countless other school food reform projects is its emphasis on holistic, systemic change through the creation of a school foodservice work force that is both capable of preparing healthy scratch-cooked meals from whole, fresh foods, and empowered and motivated to do so."

Greeley schools will be cooking from scratch, roughly three-fourths of the time at the start of this school year according to the NYT article, and aim to reach 100% in the 2012-2013 time frame. They'll be using fresh ingredients, avoiding chemicals (e.g., their bean burritos will have 12 ingredients this year versus 35 last year).

Although Colorado has the lowest obesity rate in the nation, Weld County, where Greeley is located, had rates growing faster than much of the state. So the numbers were crunched with amazing results: cooking from scratch will actually save money. A large foundation grant helped with construction and new equipment and the old central kitchen was renovated, so the budget for staff was actually reduced.

Chenically-colored macaroni and cheese

The district hired an experienced executive chef who trained at the Culinary Institute of America (the other CIA) and worked in high-end restaurants. He hopes his concepts for healthy cooking will wend their way back to the districts homes. One of his innovative ideas is to replace the chemically-colored commercial macaroni and cheese with a version whose familiar yellow will come from the Indian spice turmeric. His salad dressing will have no sugar and only a quarter of the sodium that's been present in the factory-made variety.

My hat's off to Greeley.

 

Antibiotics for Food-Producing Animals, Part Two

August 16th, 2011

This turkey could end up as ground meat

The August 13th edition of The Wall Street Journal contained an article extending the discussion of the recent ground-turkey-related disease outbreak and the routine use of antibiotics in animals raised as food. It noted that the FDA has been reviewing the subject for 40+ years without issuing firm restrictions, supposedly because of a lack of data on resultant health risks in people.

There's a long, long pattern of recommendations coming from scientific panels without any conclusive followup by the FDA or the USDA. The history of these committees and advisory groups is well documented in a Health and Human Services paper I found online and will briefly summarize. I'll provide a link for your own perusal if you get interested in reading more on the subject.

In 1968 the UK started a Joint Committee on the Use of Antibiotics in Animal Husbandry and Veterinary Medicine . The "Swann report" presented to Parliament the following year concluded "that the administration of antimicrobials to food-producing animals, particularly at sub-therapeutic levels, poses a hazard to human and animal health."

That seemed clear-cut to me. The report said that the increase in antibiotic-resistant enteric (intestinal) bacteria of animal origin resulted from the use of those drugs for growth promotion of farm animals.

enteric bacteria in their home turf

Since then, there have been a number of "expert panels" and task forces, both in the United States and elsewhere that have reached essentially the same conclusions. What's lacking is any large study (preferably more than one)  showing a direct connection between antibiotics being given to entire herds and resultant human illness. There has been a lot of "indirect evidence" implicating the widespread use of these drugs in animals as a potential human health hazard.

The animals in question, typically turkeys, chickens, cattle or pigs, are  not being treated for specific diseases. They are, en masse, given antibiotics in their feed or water, primarily to increase their weight gain (and thus their profitability for the companies raising them).

A spokeswoman for the National Turkey Federation was quoted as saying, "Antibiotics have been safely used on farms...for half a century to treat and control disease in animals and to improve the animal's (sic) overall health, allowing for greater productivity."

The article in The Wall Street Journal said, "Industry groups are cautious about regulation." They feel human health may actually be improved by the longstanding practice of antibiotics being added to feed and that meat prices are lower becuase the animals use less energy fighting disease and therefore grow faster.

Now six members of Congress asked the FDA to actually implement the proposed rules. After all, it's only been 40+ years and a number of outbreaks since the concept has first been proposed. There was another recall in April 2011, this one of ~55,000 pounds of ground turkey.

It's about time to tighten up the rules.

 

http://www.fda.gov/downloads/AnimalVeterinary/GuidanceComplianceEnforcement/GuidanceforIndustry/UCM216936.pdf

Beating the Heat

August 12th, 2011

Cooling down

We've been away for a short vacation with our eleven-year-old grandson at Harry Potter Wizarding World in Orlando. It was hot and humid much of the time, although the frequent rain storms helped cool things off.  One of the reasons we moved from the San Antonio area to Colorado after retiring from the Air Force was the heat. My comment in the late 1990s was, "Texas has Summer and the other three days."

I grew up in Wisconsin, my wife in Montana, and although we lived in a number of locales during each of our 20+ years as USAF officers, most of them were in warmer climates. We wanted four seasons in our retirement location and we certainly have them now.

Florida brought back memories of my years in Texas; sixteen of my twenty-three active duty years were spent there. So the article in the August 2, 2011 edition of The Wall Street Journal titled "Spotting and Taming Signs of Heatstroke" caught my attention.

I've had very little experience with heatstroke, but considerable dealings with heat exhaustion, a milder manifestation of heat-related illness. A lot of that was with basic military recruits, many of whom moved to their initial Air Force training from cooler places. Most of my own exercise these days during the summer months is in an indoor setting, so I'm at somewhat lesser risk in spite of being seventy.

Heatstroke killed over 3,000 Americans from 1997 to 2007 and the National Weather Service statistics said 138 in 2010 and at least 64 in thus far in 2011 died from heat-related illnesses. In some years heat causes more deaths than hurricanes or floods, the other major weather-linked agents of fatalities.

Games offer less risk than practice

Hydration, hydration, hydration is a major, but not infallible preventive step with water being ranked as good as sports drinks according to a co-author of the American College of Sports Medicine' guidelines. High-school and college football players, who suffer the majority of heat-related sports deaths, need rest breaks, shade, and water, especially during practice, according to that expert who had his own brush with heatstroke in 1985 during a 10K race. During the games themselves, he says, rest breaks are built in.

Along with athletes (and infants left in a hot car), older adults are at high risk, especially those with underlying diseases treated with medications that can worsen the severity of the reaction to heat.

Treatment of heatstroke is a medical emergency, so early diagnosis is critical. Look for confusion, irrational speech, skin that is red, hot and dry, rapid pulse, throbbing headache, dizziness  and nausea; some of those casualties become unconscious. Call 911 and get the victim into the shade.

Beyond that lies controversy with some professional groups recommending cooling the afflicted person as rapidly as possible in a cold or ice-water bath, others such as the American Heart Association suggesting fanning and sponge-bathing the person or misting them with cool water, rather than ice water.

Looking at online news articles, I think we may break records this year for heat-associated illness and deaths.