Archive for the ‘Healthy eating’ Category

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Eggs, eggs and more eggs

Friday, March 4th, 2011

Eggs from Morning Fresh Dairy

I recently started eating egg whites on a regular basis.  We get our eggs from the Morning Fresh Dairy, the same organic dairy that delivers milk to our front door once a week. Lynnette gets a half gallon of fat-free, locally produced milk every week and I  buy a half gallon of their whole milk every other week. The herd resides about eight miles from us and we enjoy purchasing local products whenever we can. Since I'm moderately lactose intolerant, I also buy vanilla soy milk.

We get eggs from the same dairy, and usually go through a dozen a week. I worried about the cholesterol in the eggs yolks although I love to make omelets. So more recently I've started hard-boiling six eggs at a time, keeping the resultant cooked eggs in the refrigerator and eating just the whites. I felt good about getting egg protein, but hadn't done my due diligence so today I started looking at various comments on eggs.

The eggs come from Platteville, Colorado, a small community about 35 miles southeast of Fort Collins where we live. They're produced under the United Egg Producer Animal Husbandry (UEP) standards and, having Googled those, I'm reasonably content. For instance those chickens get no hormones in their food. The UEP standards started with an independent scientific advisory committee in 1999 and came out as a voluntary program in 2002. The USDA and an independent firm called Validus audit farms seeking UEP certification annually and look at cage space, clean water and nutritious food issues.

a better chicken coop

On the other hand, The Humane Society issued a statement against the UEP in 2009, saying their standards were misleading and the so-called battery cages were abusive. In response the UEP issued their own statement in January 2010 discussing revisions in the guidelines. I haven't been to the Plateville facility, so I can't comment on their "hen-friendly" environment.

The other issue is eating eggs. There has been a recent downplay of the role of dietary cholesterol as a risk factor as compared to saturated and especially trans fats. The Harvard nurses' longitudinal study found that consuming an egg a day wasn't associated with a higher risk of heart disease.

Chicken eggs have been termed the "perfect protein" and supply all essential amino acids needed for humans. The yolk is the question I haven't totally resolved: it contains all the egg's vitamin A, D, and E, but rougly four times the calories of the egg white and a large yolk has greater than two-thirds of the recommended daily intake of 300 mg. of cholesterol. There is debate as to whether the egg yolk presents a significant health risk with a variety of research studies showing differing results. On the other hand, one amino acid, choline, is found only in the yolk. Pregnant and nursing women need choline (from some source), as it's needed for fetal brain development.

So for now I'm going to continue eating my hard-boiled egg whites and I'll try to go to Plateville and do my own inspection of the chicken farm one of these days.

 

 

Posted in food and food-producing animals, Governmental Efforts, Healthy eating, medically-oriented background info | No Comments »

Fish or fish oil or neither?

Tuesday, March 1st, 2011

I read the Harvard Health Letter for March 2011 and then found a series of related medical articles and an interesting editorial. Let's start with the Harvard publication.It mentions four trials of fish oil supplements in people with pre-existing heart disease. None of those showed a positive effect in patients who are also on modern drug therapies.

Above the brief summary box was an longer commentary quoting Dr. Robert Eckel, the former president of the American Heart Association. He said "If you have heart disease, taking fish oil doesn't seem to replace eating fish." He also wrote the editorial I read in the journal Circulation. Dr. Eckel, who is on the staff of the Department of Medicine in the University of Colorado's medical school (down the road about 65 miles from me), carefully analyzed the four studies and concludes that prior evidence showing diets that include fish make sense, but taking fish oil supplements after you've had a heart attack doesn't.

A Mayo Clinic position paper I found online recommends eating one to two servings of fish a week and notes that fatty fishes, like salmon, herring and even tuna, are higher in the omega-3 fatty acids that may help. Talapia (which I've eaten twice this week) and catfish, are less likely to be heart healthy and any fish that's deep-fat fried may be bad for you.

What about those of us who haven't had clinical heart disease (yet)? Even the Harvard letter says fish oil may be okay for preventive therapy. But I'm not able to find good solid data to support this.

It seems true that populations that eat more fish, like the Inuit and some of the long-term participants in the Nurses' Health Study, were less likely to have a variety of severe heart disease issues (heart attacks, sudden death, heart rhythm problems). The unresolved question is whether they also had better health habits or genetics or other reasons for their diminished risk.

So from my point of view I'll continue taking my twice-a-day fish oil capsule. It's one that is third-party tested for heavy metals, PCBs and dioxins and the relative low dose of omega-3s (270 mg of EPA, 180 mg of DHA, 115 mg of other omega-3s) plus the addition of small doses of omega-9s and 6s seems more likely to help than harm

But I'm going to keep on eating fish, try some fatty fishes and watch the literature.

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

You and your not-so-little dog too

Tuesday, February 22nd, 2011

the way for both man & dog to lose weight

The Wall Street Journal has an interesting article about obesity in pets this morning. That made me recall Blue, the fifty pound beagle I once had and, more recently Suzie, a cocker-springer mix who, as she got old clearly needed to diet, and her pack mate Dewawho was jealous of the special foods Suzie got to eat.

I'll come back to them in a bit, but let me return to the article first and the lessons it presents for us both as pet owners and, in some cases, as participants in the epidemic of obesity. Many pets eat "people food" which in itself is a bad idea. The example I read about was a dog that got steak and chicken and ice cream; not surprisingly that dog also became obese.

For pets, as well as for humans, obesity leads to multiple medical problems. One pet insurance company (yes some people do get health insurance on their dogs and cats) paid $25,000,000 in 2010 in claims for pet health problems related to obesity. Another said five of its most expensive insurance claims relate to weight issues.

Okay, lots of us don't own pets (we no longer do), so why does this relate to us?

The problem here is too much of the wrong food and too little exercise. Does that sound familiar?

So now companies are rolling out new low-calorie pet foods and even exercise equipment. The article showed a pet treadmill and a "tread wheel" with prices ranging from $375 to $999.

How about a nice walk instead? And while you're walking your dog, guess what? You too will be burning calories.

One pet resort is offering a contest for owners and their pets to simultaneously lose weight. Another had a "Fit and Spaw" retreat last month. None of these places, I'd bet, are inexpensive.

Somehow the wheels have come off, to use a phrase that comes from a totally different arena.

As a civilization we're eating too much, too frequently, too many of the wrong foods and getting far too little exercise. And guess what, now it's showing in our furry companions.

I seldom walked Blue, didn't do enough physical exercise myself in the days when he was part of the family, and both let him eat, and not infrequently ate myself, too much of the wrong things. With later pets I talked to our veterinarian and started a low-calorie diet that made sense for Suzie, an elderly dog with heart failure. That included carrots instead of dog treats. Her pack mate Dewa, younger and slimmer, wanted some of the carrots too and continued walking with me on a regular basis, including several mountain trails.

While this was happening I got back on the more veggies and fruits trend and pushed my exercise. Now dog-less, but slender, I'm continuing to eat more sensibly and exercise regularly.

So maybe this is a lesson for all of us; some have traditional pets, some have critters that don't fit the paradigm (chubby goldfish?), some of us currently have no pets.

All of us can look at our life patterns; eat less, eat the right things, do more.

Posted in Complications of Obesity, Dieting, Exercise possibilities, Healthly lifestyle, Healthy eating, Obesity | No Comments »

Dietary fiber: The latest from the NIH-AARP study

Tuesday, February 15th, 2011

brown rice and couscous

Okay, I confess; I didn't know there was such a thing as the NIH-AARP study either. Today I was reading the Wall Street Journal and saw an article titled "Fiber-Rich Diet Linked to Longevity." It mentioned the large ongoing study that I subsequently found online. Back in 1995-96 three and a half million questionnaires were mailed out to AARP members aged 50 to 71 who lived in one of six states (CA, FL, PA, NJ, NC, or LA) or two metropolitan areas (Detroit and Atlanta). Why these particular states and cities were chosen wasn't immediately clear to me.

Roughly one out of seven returned the questionaires, still that's over half a million people and an large number of medical articles have been generated from following this group over the past fifteen years. The stats on the subjects of the study interested me; 60% were male, 90%+ were white, non-Hispanic, only 11 of the men and 15% of the women were current smokers. Body mass index and education levels varied widely.

I read the newspaper article about dietary fiber, tried to get the online article from the Archives of Internal Medicine (they wanted $30 for 24 hour usage of the paper) and then found the (free) NIH release on their MedlinePlus web page.

The report says eating a fiber-rich diet could cut your risk of dying from heart disease, respiratory disease or "other causes" by 22%. The lead author works at the National Cancer Institute and mentions that the 2010 Dietary Guidelines push whole grains, vegetables and fruits. But the study, with over a third of a million participants, said that the fiber from fruits wasn't a factor in the reduced death rates. That doesn't mean we shouldn't eat fresh fruit though.

Fiber has already been linked to lower risks of diabetes, reduced rates of some cancers (liver, bladder, esophagus, kidney, head & neck) and less tendency toward obesity; here it's also associated with a lower mortality rate from heart disease or respiratory disease.

Now a real question, and one asked directly by a dietician/exercise physiologist who commented on the study, is whether those who choose high fiber diets also lead healthier lifestyles (e.g., more exercise, no smoking). That may well be the case, but why not add more whole grains to your own diet? That seemed to be a nugget of nutritional advice that could benefit everyone.

The recommended fiber intake for adults over 50 is 30 grams for men and 21 for women. That's a lot of whole grains and where can we get them? I found a Harvard Medical School list online and copied and pasted it into this post.

  • Amaranth
  • Barley
  • Brown rice
  • Bulgur (cracked wheat)
  • Whole-wheat pasta or couscous
  • Flaxseed
  • Millet
  • Oats
  • Quinoa
  • Rye
  • Spelt
  • Wheat berries
  • Wild rice

We cook with some of these (e.g., barley was in the bison, potato, carrot and turnip stew we had this week). We eat brown rice, millet seeds, wild rice, oats and flax seeds on a regular basis (we had a dish of steel-cut oats at breakfast today; most of the rest we've tried at one time or another.

More fiber, especially from whole grains, makes sense. Give it a try.

Posted in Governmental Efforts, Healthy eating, Life Expectancy | No Comments »

Hooray for Mark Bittman

Friday, February 4th, 2011

The New York Times

A while back we purchased a huge cookbook by Mark Bittman who writes columns in The New York Times. That was a gift for our Indian children (formerly  graduate students at CSU where we were their "local parents) and had the title How to Cook Everything Vegetarian. We liked the cookbook so much that we purchased a copy for ourselves (we're not vegetarian, but eat that way perhaps 25% of the time and certainly eat more fruits and veggies than meat the rest of the time).

The bookstore had a used copy of his 1998 book How to Cook Everything and I bought that also and then received as a gift from friends on the Times staff his 2008 update of that book. They became two of our favorites, especially since Bittman gives 10-20 options for preparing most items, a real chance to variegate your menu. We later purchased a copy of Bittman's 2009 slender volume Kitchen Express: 404 Inspired Seasonal Dishes You Can Make in 20 Minutes or Less. That's written in a looser style and should appeal to my wife Lynnette, but thus far we haven't used it as often.

So we've become Bittman fans and when I noticed in my online NYT offering for Feb 1st a column by Mark  I hurried to read it. The title of that Opinionator piece was "A Food Manifesto for the Future." The coulmn was trenchant, to say the least, and Mark ended by saying he'd expand on its topics in later coulumns.

I think you should try to retrieve it for thorough reading, but I'll summarize his points. They are: end our current huge goverment subsidies that end up supporting the "processed food"industry and shift that money (or at last some portion of it to farmers and even markets that grow and sell "real" food." Get rid of the USDA's conflicting double duty assignment to simultaneously increase sales of corn and soy (among other farm products, but especially those two) and serve as the source for advice on good nutrition (the latter job could potentially go to the FDA).

The issues also include: outlawing CAFOs (concentrated animal feeding opereations), while aiming toward more sustainable metohos that don't pollute our envionoment; help us all to do more of our cooking at home; use govenments taxing powers to decrease the sales of the all-mighty cheeseburger and similar foods; increase recycling while reducing waste (he cites an enormous fertilizer-caused dead zone in the Gulf of Mexico); strenghten truth in labeling laws and put lots of oomph (dollars) behind sustaiable agricuture>

There it is, paraphrased mildly as it's all the things I agree with.

Our American diet isn't what it should be, not by a long ways. One of the most obvious manifestations of that is how many of us are overweight or obese. That's fairly obvious just walking around. What I don't see every day are CAFOs and, since I don't eat fast food, the lines at the chain food outlets. Or, for that matter, the hidden costs of our US subsidies to Big Agriculture.

Thanks for the first in what promises to be a series of columns well worth reading, Mr. Bittman.

Posted in Governmental Efforts, Healthy eating | No Comments »

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.

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Posted in Food-related disease, Governmental Efforts, Healthly lifestyle, Healthy eating, medically-oriented background info, Obesity, our kids and their weight issues | No Comments »

Caveat Emptor

Friday, January 7th, 2011

An article that got me thinking and Googling

Remember when phlogiston was the answer? Well maybe not; that was a long time ago, but ideas in science and medicine come and go.

Two things reminded me of that in the last few days. I usually try to keep up with developments in those areas of medicine that I have a direct or even peripheral interest in. I read the abstracts in the Annals of Internal Medicine and decide which articles make sense to read in full. I look through the bi-monthly Journal Club appended to Annals and do the same.

Then I find suggestions in the two papers and several magazines I read and hunt down the original articles on which they are based.

Some of that is personal; we each take several prescription meds plus a senior vitamin, a large-dose B12 pill, vitamin C, fish oil capsules and vitamin D each day and our supplements have varied over the years as new articles come out.

But even as a medically-trained (now retired for 12+ years) individual, there are times when I find a sudden switch  in the conventional thinking to be jarring.

Two of those happened in the past week.

I was about to write a blog post on Omega-6 to Omega-3 ratios in our diet and give my take on what our optimum ratio should be. American diets have had a ratio well over that in many countries; some advise altering that from the current/recent 15:1 or even 40+:1 to 2:1 or 1:1.

Then my wife, aware of my interest in the area, showed me an article that led me to contacting a senior Harvard professor. Dr. Frank Sacks works in the Department of Nutrition in the Harvard School of Public Health and has chaired, co-chaired or been the principal investigator on a number of well-known, multi-center studies.

He was kind enough to respond to me email and sent me two of his publications, one from the journal "Circulation 2009; 119; 902-907 and the other from The Journal of Clinical Endocrinology and Metabolism 91(2): 309-400.  Bottom line: he feels both Omega-6s and Omega-3s are good polyunsaturated fatty acids (PUFAs) and that ratios make no sense. I'm still digesting his articles and may comment on them later.

Then a friend gave me an article from The Atlantic. It had the intriguing title I pasted in above. I read the lay publication and then Googled the man written about.

Dr. John Ioannidis is a Professor of Medicine at a Greek university, Adjunct Professor at Tufts (where he did his fellowship after graduating from Harvard) and Director of the Preventive Medicine Research Center at Stanford.

Nearly ten years ago he began a project in Greek hospitals that eventually led him to state as much as 90% of the research articles published in medical journals have one or more critical flaws. This isn't limited to medicine, of course. Similar work, termed meat-resaerch, has been done in a variety of scientific fields, with the same conclusions.

Yet a late 2007 blog post by a surgeon/scientist comments 1). to paraphrase Churchill's famous bon mote on democracy, medicine's use of randomized clinical trials and peer-review is the worst way to find the best new treatments, except for all other ways. Whether "evidence-based" reviews have improved the system remains to be seen.

Statistical analysis, as done in a commentary on Ioannnidis's work, can explain why even a quarter of the very best studies can yield incorrect results.

Yet medicine moves on, discarding treatments found to be ineffective or harmful.

In the meantime, I'll not try the latest and "best"..at least not most of the time.

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

Maybe not all trans fats are bad for you

Monday, December 27th, 2010

We're back at the trans fat farm

I got my copy of the Annals of Internal Medicine today and, for once, read at least the summary of almost all the articles. One in particular caught my eye. It's a report of a prospective study that was multi-institutional (Harvard, the NIH, University of New Mexico and University of Washington with associated branches for two of the schools), fairly large (3,736 adults), multi-racial and lengthy (1992-2006). The study group was limited to adults over 65 who were living in the community, not in institutions. It was termed a "cohort study" and one definition of that is "A study in which a particular outcome, such as death from a heart attack, is compared in groups of people who are alike in most ways but differ by a certain characteristic, such as smoking."

In other words it's not a prospective controlled study, which I view as a higher level of medical research; in those you decide in advance what the object of the study is and select groups again in advance who will differ in some important aspect (e.g., they will or will not receive a particular medicine that's being studied or they'll be put on differing diets with one group getting whole milk and the other low-fat or non-fat milk). That may seem a subtle distinction, but it's an important one to me.

In any case the outcome was fascinating, though I'd term it preliminary.

Remember I mentioned trans fats (or more precisely trans fatty acids) as being bad guys. Well here's a case where one particular trans fat may be a good guy.

Most trans fats in the diet of Americans are/were artificially produced (I say were because a number of places (NYC and California) have almost totally banned them (less then 0.5% is allowed in the CA law). The FDA required strict labeling of these in 2006.

But small amounts are found in milk and  red meat. This study appears to demonstrate that a  particular trans fat called trans-palmitoleate, found in whole milk is associated with a lower risk for developing diabetes in adults. The effect wasn't found with red meat consumption or low-fat milk consumption.

Now that's very interesting, but it doesn't prove this particular fatty acid itself is healthful, only that, in this admittedly large and well-conducted study, that it's "associated with" several good metabolic effects, i.e., less diabetes and less obesity. The fatty acid could be a marker for consumption of something else that causes the effect.

More studies need to follow this one, of course, but the authors suggest that if those were to show the same effect, a case might be made for enriching/supplementing milk with this fatty acid. They also mention that, until this issue is resolved, the current push toward drinking only low-fat or even no-fat dairy products may be viewed differently.

No pun intended, but I need to digest this information a little before making a choice for myself.

Posted in Food Additives, Healthy eating, medically-oriented background info | 2 Comments »

I'm over 100

Friday, December 17th, 2010

Well I don't mean I'm that old (actually I'm 69), but I looked at my old posts in the process of extracting tidbits to go into the book I'm working on, Eat like the Doc Does, and realized this would be my 103rd post. On the over hand, if my brain and body hold out, especially the former, living past 100 might be okay.

This man is over 100

There's a Chicken Soup book coming out on December 28th with one of my stories included. The book has the subtitle "Shaping the New You," and is centered on diet and exercise and lifestyle topics. My story is titled "Life Changes." I got ten pre-print copies, kept two for myself and sent eight out to friends, writing mentors, relatives and former graduate students.

When I reflect on the changes I've made in my lifestyle and diet over the past year and a half, I come up with a few simple concepts. I eat less overall and lots more veggies and fruit. I exercise more, usually iding a recumbent bike for an hour and five minutes a day and sometimes hiking or snowshoeing. I fall off the diet wagon from time to time, but always get back on (I weigh twenty-five pounds less today than I did in May of 2009). And finally, I usually think before I eat...not always, but usually.

I came up with an acronym for my weak spots; I've mentioned it before, but will reiterate. it's TABLE, meaning my triggers for overeating and mindless eating come when I'm "ticked off," on "autopilot," "bored," at a "low energy/late night state" or at an "event," loosely defined.

I'm by no means perfect, but my progress keeps evolving. This week my wife identified an area where  I could short-circuit one problem area. I got a new Clancy book and instead of reading until eleven, which is my usual pattern, I stayed up until 12:30 devouring not only the book but also five different snacks.

The next day, after our discussing the issue, I read while I was on the bike and again from ten until eleven PM, then quit. My weight, which had ballooned up two plus pounds, was down three pounds today, back in my acceptable range.

I don't expct this to ever be easy, but I don't intend to be one of the 90% who regain their weight after losing it.

Find your own path and join me. It's time and past time.

Posted in Dieting, Exercise possibilities, Healthly lifestyle, Healthy eating, Life extension, tricks and gimmicks, Unhealthy eating | 1 Comment »

Two thirds of us can benefit

Saturday, December 11th, 2010

I just read an article in the Annals of Internal Medicine, the journal published by the American College of Physicians. Although I've been retired since 1998, I still am a Fellow of the ACP and their publication is the only medical journal I subscribe to and read (at least scan) regularly.

Counseling session in progress

This months Annals had a meta-analysis, a review of multiple papers, on the subject of behavioral counselling and its effects on cardiovascular disease. I scanned it and wasn't overwhelmed; then I read it in detail and was highly impressed.

The authors, two physicians, one PhD and a person with a Masters degree in science, reviewed 13,562 abstracts and 481 articles, looking at the effects of low-level, intermediate-intensity and high-intensity counseling that was intended to promote either an increase in physical activity or a healthy diet or both.

They were looking at the effects counseling produced in patients who did not have cardiovascular disease, hypertension, diabetes or abnormal blood lipids. Some did have borderline high blood pressure or other risk factors, most did not.

At first I thought the relatively small results meant that the time wasn't well spent. Blood pressure was reduced in most studies, but not by much; the same was true for lipids.

But there were almost no ill effects (they estimated one heart attack would occur per 1.42 million person-hours of exercise, usually in people who started as couch potatoes.

But the unimpressive decrements in blood pressure, especially in those with borderline BPs to start and the relatively small changes in cholesterol and LDLs, when translated to large population groups, were stunning.

A decreased incidence of coronary heart disease (CHD) of 6 to 16%, 30% in those more at risk, from what seemed a tiny change in BP, was impressive. A 25% decrease in CHD from a 10% decrease in total serum cholesterol was also striking.

Most of these counseling session, of course, especially the more intensive and repetitive ones, would be done by someone other than the physician involved.

But I finished reading the article and said, "Counsel on, nurses and therapists." it certainly seems worth it in both normal-weight and overweight, but not obese people. I'm less sure of the results in that group and they didn't appear to be involved in these research projects.

I had thought that most of us blow off the words directed to us in these kinds of medical encounters. Maybe that's changing and it's about time.

Posted in Exercise possibilities, Healthly lifestyle, Healthy eating, medically-oriented background info | No Comments »

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