Archive for the ‘Unhealthy eating’ Category

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.

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.

Two successes, one failure and a lesson

Friday, December 3rd, 2010

My newest reminder card

Travel is tough on my dieting, but, I've learned recently, so are the events I go to. I had weighed 153 when we left for our trip to Texas where friends hosted dinners, fed us well, too well. I returned at 157 pounds, four over what I now consider my upper limit. I know that I re-started my diet at 177 in May of 2009 and so I'm considerably slimmer, but 157 annoyed me.

So I was concerned; we had Thanksgiving dinner, a series of parties, a Thank the Donors event for the capital campaign I've been running and then would come some holiday events. What could I do to not only lose the four pounds at least, (my real goal weight is 149-150), but to also avoid gaining more. I needed a gimmick.

One of the background books I've been reading is on "mindless eating," the kind of frenzy of ingestion I recognized well. I used to get into this pattern frequently, forty years ago in when I weighed 218.

What I needed was another STOP sign. I already had my red 1/3 cup measure sitting on my kitchen island. Now I needed something for events and occasions. And, when I thought about it, one of those is my weekly writers' critique group. Most of us bring something edible to share and sometimes I get hooked on cookies or something else I wouldn't normally eat.

So I took two three by five inch cards and wrote "Don't Snack!" on one of them and "Don't Eat or Overeat" on the other.

my other card

One card leans up against my popcorn holder which itself is surmounted by the red measuring cup. Eating at home hadn't usually been a problem, but it wouldn't hurt to have an extra reminder.

The other I put into the cup holder of my car. I'd look at it just before going into a house where we were joining an ongoing party or before entering, twice this week alone, the local country club, where we were attending a luncheon for symphony donors and, later in the week, the Thank the Donors event.

Oh, and there was one more event, a baby shower I wouldn't normally have attended. In this case it was for the wife of a young relative. We hadn't seen him since his high school graduation and I felt it was important to go to his spouse's shower.

So here's my score card and the lesson I learned. I looked at the card in my Prius just prior to entering the country club for the luncheon. I ate three fourths of my salad and half my entree and said, "No thanks" to the dessert. I did even better at the donor event. I pre-ate a bowel of cereal and a piece of fruit. At the event itself I ate nothing and drank one third of a glass of Merlot.

But the shower, held at a pizza parlor, was another matter entirely. I didn't remember to look at the card hat evening, shared an appetizer with my nephew and his fiancee and had three large slices of pizza, even eating the dry crusts.

Actually the donor event was last night and today I'm down in my safe zone again. I'm going to lunch with friends at our favorite Thai restaurant, but before I leave my car I'll look at the card.

Lesson learned. I'll bring the "Don't Snack" card to my writers' group next week and look at it just before I leave my car.

I'd never heard of the ketogenic diet

Friday, November 19th, 2010

Reading the New York Times breaking news on my Kindle this afternoon, I came across a diet that was new to me, one that most of us will never go on. But for a small group of kids it can have an incredible impact.

The story was about a nine-year-old boy who has severe epilepsy. In his case his seizures were resistant to all the major drugs that might usually have been effective. He was having them as frequently as 150 times a day.

His parents were desperate until they finally found Dr, Elizabeth Thiele at the Massachusetts General Hospital for Children. She's a specialist in pediatric neurology, an Asoociate Professor at Harvard Medical School and heads up a program for pediatric epilepsy.

One of her interests is keto as the diet is called. When children have drug-resistent seizures, keto can be effective in a significant percentage of cases.

The diet is high-fat, quite the opposite from many of those used by adults for weight loss. The kids on it start in the hospital, starving for a relatively brief period. But our bodies only have enough glucose, our primary source of energy, to last about 24 hours.

After that we burn fat reserves and our livers convert those fats into fatty acids and ketones. The latter pass into the central nervous system and become the brain's source of energy. Somehow, it's not exactly known how, that can reduce how often epileptic seizures occur.

The diet has been around for over eighty years, but when anti-seizure medications were developed and shown to e efective in most kids, keto fell by the wayside.

In the mid 1990s a Holywood producer brought it back. His son had severe epilepsy and drugs weren't helping. Keto did and the producer started a foundation to promote the use of the diet. He got his friend Meryl Streep to star in a film called First Do No Harm and the foundation sponsored a scientific study of the diet.

Since then it's been offered by over 100 hospitals for kids with drug-resistant epilepsy and two randomized, controlled studies showed it can be effective.

The boy in the article eats four times as much fat as protein or carbohydates. He's on a tightly controlled program and even his snack are calcualted. One of those snacks included two slices of bacon, seven macadamia nuts and less than one eighth of an apple. His urine would be checked for ketones as in the slide.

There are diets to lose weight and gain health; there are also diets to help with specific medical problems. I'll never try keto and hopefully, like many kids, the boy in the article will outgrow his need for it.  For now it's been an wonderful asset for his health.

Even more fat for our taste buds

Wednesday, November 17th, 2010

A new and expensive burger

I picked up my copy of The Wall Street Journal this morning, opened it to "Personal Journal," the section I usually read first, and gasped. The lead article was titled  "Bring On the Fat, Bring On the Taste."

That certainly caught my attention... negatively. Then I started reading the rest of the article and got even more upset. The subtitle was "Celebrity Chefs Join Burger Wars, Baste Beef Patties in Butter." The text went on to describe how some of the top chefs in America are now getting into the burger business. Some say they are using only the best kinds of beef and specialty ingredients, but a number of food specialists, among them university professors, say what they're chef really doing is serving high-fat burgers.

Another new burger

They're also charging much more than the fast food restaurants. One of the burgers, made from Japanese Kobe beef and served with foie gras and truffles, costs $39. And that's not the most expensive pattie. Another has truffles, foie gras and Madeira sauce and goes for $60.

Why would anyone eat these cardiovascular time bombs? Well they presumably taste good and perhaps they are status symbols. But they also use beef that has up to 30% fat content, or is basted in butter or, in one iteration, has a double layer of beef with potato chips in between to increase the crunchiness.

As for the chefs, they've realized the high-profits creating the monster burgers can bring. Hubert Keller, a French-trained, high-levl chef, makes 9 to 12% margins from his haute cruisine restaurants. His marginal profit on his first burger unit is 37.5%, so he's opened his second and third and has four more in the planning stage.

So let's go back to why this might be a problem, to our bodies even more than to our wallets. The 2010 Dietary Guidelines for Americans (DGAC) hasn't been released  in its final form yet, but the expert panel's preliminary report, available online, wants us to cut our intake of staurated fats to less than 7% of our total calories.

That makes enormous sense; saturated fats are associated with cardiovascular disease (CVD) risk and people who either have this problem or are at high risk for it need to minimize their intake of these lipids.

We're in the midst of an epidemic of obesity, hypertension, type 2 diabetes (T2D) and 50 million Americans are said to have the metabolic syndrome (a combination of abdominal fat, high blood pressure, insulin resistance (T2D), abnormal blood lipids and several other blood factors making one prone to CVD).

My opinion is the last thing we need is these expensive new high-fat burgers.

But I'd bet they sell well and make the chefs a bundle of money. When it comes to following the DGAC, we don't have a good track record.