Archive for the ‘Healthly lifestyle’ Category

Chocolate: a new medicine? Part One

Tuesday, March 27th, 2012

Dark chocolate, in small amounts, is good for youI was reading The Wall Street Journal this morning and came across an article titled “A Chocolate a Day to Get Slimmer?” I’m not a major chocolate eater, but had heard something on NPR about this study yesterday, so ate eight small pieces of dark chocolate at a board meeting last evening. Then, when I weighed myself before breakfast today, I realized I was down 2.8 pounds.

Should I continue this increased chocolate consumption or was that, as I of course knew, just “water weight” I’d lost? The previous night I’d eaten a prolonged meal with friends at our favorite Thai restaurant and the next morning had gained over three pounds.

Let me digress a bit. Whenever I mention water weight I’m really referring to fluid that the body keeps because of dietary salt excess. I normally don’t use table salt, as I have a family history of high blood pressure and was aware that most of us, eating a typical American diet, were ingesting far too much sodium, the crucial element in table salt. When I eat out I expect my weight to bounce up a few pounds and don’t worry about that short-term increase. The salt in the food causes me to retain fluid and therefore to gain weight temporarily. Many diet plans that advertise losing five or more pounds in the first week are really helping people get rid of water weight.

Okay, back to chocolate. The article I mentioned is important, but the message it’s carrying is nothing new. In 1973 I saw Woody Allen’s movie, “Sleeper” in which he plays a nerdish store owner who is revived out of cryostasis (a form of preservation using ultra-cold temperatures) after 200 years. In that future world science has shown chocolate to be good for you.

Two prominent food gurus, Andrew Weil and Den Ornish, mention health benefits of chocolate. I found Dr. Ornish’s 2007 Newsweek article,”Chocolate to Live For,” in which he mentions a host of medical studies showing dark chocolate, which has higher amounts of beneficial chemicals called flavinoids, may lower blood pressure and and improve blood flow to your brain and heart. White chocolate and milk chocolate have very small amounts of flavinoids and bitter dark chocolate has the most.

Eat a small bite of dark chocolate and meditate

The phrase “moderation in all things” dates back more than two thousand years to a Roman “comic dramatist.” It certainly applies here. None of the articles I read were about eating a lot of extra calories in the form of chocolate. Dr. Ornish’s approach made sense to me; he very slowly eats a bite of dark chocolate, meditates while doing so by focusing on the experience with all of his senses, and regards the very first bite as being the most pleasurable.

What a great way to eat something he regards as a special treat as well as a health food.

I’ve never tried that with chocolate, but having read his magazine piece, I’ll try that approach.

I’ll continue with more medical background on chocolate in my next post, but to whet your appetite will give you a link to today’s article in WSJ.

Happy chocolating.

 

 

 

The very high-priced spread

Saturday, February 4th, 2012

This obese teenager could be headed for trouble

I’ve been concerned about our burgeoning problem of excessive weight, so when the Journal of the American Medical Association for February 1, 2012 arrived, I was intrigued by the variety of articles touching on the subject. Let me start with a disclaimer: I have no clear-cut special competence, no magic bullet for preventing or treating obesity in our children. I do think it’s a major threat to the upcoming generations here and elsewhere in the world. I am also very aware that its opposite numbers, hunger and even starvation, threaten whole populations around the globe.

But my own background, both as a physician and as someone who has successfully fought weight issues (I weighed 218 in 1969 and 148 this morning), has made me concentrate on the American epidemic of eating to excess as a major area of my interest.

The first article dealt with kids and adolescents. A group of CDC researchers reported an update on obesity in American kids, giving data from 199 to 2010. The newest statistics show nearly ten percent of our infants and toddlers are obese and close to 17% of our kids ages two to nineteen. As the kids got older, more boys than girls were obese in this survey with over 4,000 participants.

Then there was an article titled “Weight Loss Stratagies for Adolescents,” based on a Boston Children’s Hospital Conference roughly a year ago. The MD, PhD Harvard Professor of pediatrics who discussed the issue began with the case history of a particular obese girl, a fourteen-year-old who was five foot six and weighed nearly 250 pounds (giving her a body mass index,BMI, of 40). Her adoptive parents were overweight themselves, but had to learn to “back off” in their attempts to control her diet. There is some early data that suggests that parents can help by providing health food choices in the home and facilitating enjoyable physical activity throughout the day (versus a fixed “exercise time).

I had seen an example of that with some former neighbors whose boys, in order to have their one hour of “screen time,” had to be outside playing for several hours at a time. Both youngsters were lean.

One critical point to be made is avoiding focusing on obese kids only. A large Danish study, published in the New England Journal of Medicine in December, 2007,  followed over a quarter million children born in the 1930 to 1976 time period. Denmark established a national civil register of “vital statistics” in 1968 and enrolled everyone in the country, giving them a unique number, ironically termed their CPR number. Although that had nothing to do, I gather, with cardiopulmonary resuscitation, which is what I think CPR means, the study did look at risk factors for coronary heart disease.

When your heart's on fire, it may not be from love

The results are impressive and threatening: every one point increase in BMI across the spectrum was associated with an increased risk of coronary artery disease. A child didn’t have to be fat to be at risk later on. One calculation estimated that a 13-year-old boy weighing 25 pounds more than the average had a one-third increase in the likelihood of having a heart attack before the age of sixty.

It’s time to start helping our kids live leaner and longer, healthier lives.

 

Slim down those truckers

Wednesday, November 23rd, 2011

some truckers are relatively slender

I have two series of posts going, but couldn’t resist the article I found in the New York Times while riding a recumbent bike in the gym. The title alone, “A Hard Turn: Better Health on the Highway,” was enough to grab my attention.

The first story was typical, a trucker driving long hours every day, eating all the wrong foods, getting no exercise, gaining huge amounts of weight. I found the online abstract of a 2007 Journal of the American Dietetic Association article cited: long-haul truckers of necessity eat at truck stops and of 92 such truckers stopping at a Mid-eastern US truck stop nearly 86% were overweight and 56.5% were obese.

One of our family members used to be a truck driver and I’ve heard his stories of long days spent behind the wheel, eating greasy foods when he stopped. He’s slimmer now and in better shape as his current employment allows him more exercise time and a choice of where and what to eat.

Now that insurance costs are rising sharply, the trucking firms are getting involved and the truckers themselves, there’s over three million of them in the US, are coming to grips with the issue out of necessity. One group ran a blood-pressure screening clinic for 2,000 truckers at a truck show. Twenty-one were immediately sent to a nearby emergency room; one had a heart attack before reaching the hospital.

drive carefully around trucks like this

Trucks are involved in 400,000 accidents a year and 5,000 fatalities. I just watched a nearly eighteen minute video on how we, as drivers of passenger vehicles, contribute to those accidents; 70% are caused by the drivers of other vehicles (see link below). Yet many of the ones caused by trucker driver error occur because the trucker has a health problem or falls asleep.

http://www.sharetheroadsafely.org/cardrivers/Unsafe-Driving-Acts.asp

Some truckers are taking steps to decrease their weight and its accompanying risks for themselves and those who share the roads with them. A number of companies are helping (and perhaps finding a lucrative new client group). I just looked at a website for “Rolling Strong,” and found a gym in my area that offers fitness programs for truckers. Others are joining Weight Watchers, a solid organization that my slender wife has belonged to for many years (she says she was “chunky” in high school) or creating their own programs for fitness: one carries a fold-up bike in his 18-wheeler and uses it whenever he stops for a break. Many are cooking in their trucks or even hiring a trainer.

Others joined the Healthy Truckers Association of America, paying $7.50 a month to belong to an organization that is rapidly growing (see link below to Chicago tribune article). That group now offers truckers a prescription drug card enabling its members to save ~60% on meds.

http://healthytruck.org/node/101

I applaud all these moves; if I’m on the road with a large truck or a series of them, I’d like their drivers to be in shape and wide awake.

Eating and drinking in Europe: part two

Wednesday, 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

Friday, 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.

 

 

Beating the Heat

Friday, 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.

 

Drinking and driving

Wednesday, August 3rd, 2011

lots of choices, all with alcohol

Twenty-four years ago I was the brand new Deputy Chief of Staff at our largest Air Force medical center. My counterpart at the Army’s hospital across town called and asked if I’d like to attend a party. I said, “Sure, what’s the occasion?”

His commander had just gotten a second star and, as a new major general, would be moving to DC soon. His immediate boss was going to get the one-star job running the medical center. That never happened. I don’t know the exact details, but was told one drink too many led to an off-color comment to the wrong person and then to a lost opportunity.

I got sensitized, through this episode, to drinking at events and, of course, to drinking and driving. I was in a culture where wine and beer flowed freely at parties, but decided I’d be a one-drink person. My wife and I were outliers sometimes; a friend who was a fellow commander when I moved up to lead a small hospital once told me, “I got picked up CWI last night.”

“I know what DWI means; what’s CWI?”

He replied, “Crawling while intoxicated.” Actually he was joking, while telling his story of leaving a party at the commanding general’s home and feeling unsteady while slowly walking to his own quarters, two houses down.

The Wall Street Journal on July 2, 2011, had an article titled “Testing the Limits of Tipsy.” Our US legal limit for driving used to be a blood alcohol concentration (BAC) of 0.15%; now it’s 0.08%. In much of Europe it’s 0.05%; in India it’s 0,03% and in China it’s 0.02%. That exceedingly low BAC limit may turn out to be the most realistic, especially on crowded streets and roads.

But the results can be bad, even to metal bodies

Our alcohol-related traffic fatalities have fallen by 50% since 1980, but still account for one-third of all deaths on the highway. Your BAC after drinking depends on a number of factors: your weight, age, prior drinking history, rate of consumption, if you’re also eating (consuming food may slow absorption of alcohol, but some foods help more than others) and menstrual cycle (women apparently metabolize alcohol a little more rapidly just after ovulating).

Once you’ve absorbed alcohol, your BAC falls roughly 0.015% per hour (for either gender), so it may take a long time to reach a “safe” level, if there is such a thing. As you age your liver tends to metabolize alcohol more slowly; on the other hand, an elevated BAC may affect younger brains more adversely.

Having read this, I’ll plan to continue our long-standing policy: when we go to a function one of us is the “designated drinker,” and usually has only one drink at that. The other is the designated driver. We’ve occasionally each had a glass of wine…at an event where we’ll be eating and not driving for a number of hours. It may be time to re-evaluate that policy.

On holidays like New Years Eve, when we know others will be drinking more than we do, we get off the roads early.

 

Katz Redux

Tuesday, May 10th, 2011

I went back to Dr. David Katz’s classic article published in the Harvard  Health Policy Review in 2006. His example of the Pima Indian tribe had caught my eye the first time through the piece and serves as a cautionary note for the rest of us. I decided to explore the subject further.

mesquite tree

The Pimas, who live not far from us, in the four corners region where Arizona, Colorado, New Mexico and Utah meet, used to be outdoors men and women, taking long-distance walks on a regular basis and eating a diet that fits all the modern parameters for healthy eating. it included two unusual items one of which was mesquite,  which I think of as a tree. I’ve now found that mesquite has bean pods that can be dried and ground into a sweet,nutty flour high in calcium, magnesium, potassium, iron and zinc, and rich in the amino acid lysine.

The other native foodstuff was a drought-resistant bean, tepary, which has recently been introduced into African agriculture . All in all they exercised much more than many of us and ate a high-fiber, low-fat low-sugar diet without an abundance of calories.

Then civilization happened to the Pimas. Now they own casinos and don’t walk anywhere as far as their forebears (their per capita income is still on the low side). They also eat a less healthy “American diet” similar to the rest of us.

The consequences were those you’d expect. obesity and diabetes. Fifty percent of the adult Pimas are obese and of those 95% have diabetes. The tribe is now part of a major NIH research project (the website is at http://diabetes.niddk.nih.gov/dm/pubs/pima and then add /pathfind/pthfind.htm or /obesity/obesity.htm), which over the past 30 years has shown that before gaining weight, overweight people have a slower metabolic rate.

This so-called “thrifty gene” theory originally suggested in 1962, looked at populations, like the Pimas, who over thousands of years would have alternating period of famine and feast. When there was little to eat, they stored fat. Now that they don’t need to do this in the same fashion, the gene has led them toward the diseases associated with obesity, especially diabetes.

less healthy than mesquite flour

An update from the Harvard School of Public Health mentioned the mayor of Boston having banned sale and advertising of “sugar-loaded drinks” from city-owned buildings and city-sponsored events. The chair of HSPH’s Department of Nutrition was quoted as saying, “There is abundant evidence that the huge increase in soda consumption in the past 40 years is the most important single factor behind America’s obesity epidemic.”

So not all of us have thrifty genes to blame for weight gain. But we can start by abandoning those sodas and other sugar-laden drinks.  And perhaps, to whatever extent we can, returning to a diet similar to our own ancestors, with more locally grown fruits and veggies leading the way to better health.

 

 

exercise and eating as you get older

Friday, April 22nd, 2011

you may not want to try this much weight

I was reading a food and exercise article this morning in a Nutrition Action Healthletter, a publication from the Center for Science in the Public Interest, a group whose watchdog goals I often support. CSPI has been around for forty years and when I looked at its board member list I saw the familiar name of David A. Kessler, MD, JD, the former FDA head and ex-dean of two medical school.

The April 2011 article my wife showed me was titled “Staying Strong: How exercise and diet can help preserve your muscles.” Well I’m two days shy of my 70th birthday and a gym rat, there six days a week. And I eat well or so I thought. What’s there for me to learn from this article?

I agreed with the opening quote from Dr. Miriam Nelson, the director of Tuft’s Center on Physical Activity, Nutrition and Obesity Prevention, “Muscle is the absolute centerpiece for being healthy, vital and independent as we grow older.” Of course, having a functioning brain helps. But I wasn’t about to quibble with a distinguished figure like Dr. Nelson, who is a Fellow of the American College of Sports Medicine, an Assocatiate Professor at Tufts and founder of the Strong Women program.

The Healthletter said most of us lose muscle mass starting in our late 30s and early 40s. I had certainly noticed that a few years back, in spite of being physically active. To reverse the process, or at least keep a decent amount of muscle, resistance training is advocated, I’ve been doing lower body exercise mostly (an hour+ on a recumbent bike), but recently added back some weight training for both upper and lower body.  Ben Hurley, a PhD Exercise Physiologist at the University of Alabama, feels muscle power is the key to fall prevention, a critical factor in the elderly.

Even if you fall and break a bone, like the oldest member of my wife’s Strong Women, Strong Bones class, did, your chances of having a rapid recovery are considerably increased. Her docs were amazed at how she bounced back. Strength training, in several studies, has been shown to increase bone density.

What else did I need to do? The new information in this Healthletter was of the amount of protein we need as we age. I read the article and added a hunk (~4 ounces) of leftover beef to my cereal, milk and fruit breakfast. That advice came from researchers at UT Galveston (and numerous other universities), especially a PhD Associate professor, Dr. Douglas Paddon-Jones, who’s worked with NASA on usingartificial gravity and amino acids to preserve muscle mass in astronauts.

Is leucine the key?

The bottom line was to eat more protein and to add some to your breakfasts and lunches as you age. One particular amino acid, leucine, appears to be most crucial. it’s found in whey (in milk and cheese) and in fish, poultry, eggs and meat. I’ll write more about timing of amino acid intake another time.

 

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.