Archive for February, 2011

Which came first: the diabetic chicken, the obese egg or the depressed farmer?

Saturday, February 26th, 2011

The chicken and the egg

My wife is a Mental Health therapist, attended a conference recently & then got an email from the presenter which referred to a study linking diabetes and depression. I got the synopsis from the Web and then went to our local hospital library where I could get a copy of the article. I'll come back to it later, since it was a new twist on the familiar entity .

the depressed farmer

Firstly, in spite of my post's title, this is no joking matter. I found a World Health Organization (WHO) fact sheet dated January 2011 on diabetes: It's a worldwide epidemic with more than 220 million suffering from the disorder and its consequences including an estimated 3.4 million deaths a year. If you're diabetic your chance of dying at a given age is twice that of your peers. If you are diabetic for fifteen years, you have a 2% chance of being blind and a 10% possibility of having severe visual impairment. Ten to twenty percent of diabetics die of kidney failure and then, of course, there's heart disease and stroke and amputations from diabetic vascular disease.

Next I found a medical article with stark  statistics: in 2007 about 2.6% of the US population aged 20-39 had diabetes, 10.8% of those aged 40 to 59 and 23.1% of those over 60. Diabetes and its complications consume 14% of the US health dollar and we're fairly high up there in the list of countries having a significant prevalence of the disease. Lowest on the WHO list was Iceland at 2% and highest was Saudi Arabia with 13+% of those who are 20 to 79 years old being diabetic.

There is a strong correlation between diabetes type 2 & excess weight, especially among women. That association is 80% or higher in Europe, Latin America and North America according to still another article.

And, as you might expect, eating a healthy diet, getting regular physical activity, maintaining a normal body weight and not smoking are the basic of diabetes prevention. By the way, 90% of diabetics around the world have type 2 disease, resulting from the body's ineffective use of insulin.

So what's the new angle? I already knew that half of all diabetics die from cardiovascular diseases, incluing heart attacks and stroke. I didn't know the odds were considerably worse for women with both diabetes and depression. The article I had printed off followed over 55,000 women for ten years (1996-2006) as part of the Nurses' Health Study. There were strong correlations between diabetes and depression in this study performed by researchers from Harvard, the University of Singapore and two English medical schools. Another professor, this one from Indiana, stated that over the past twenty years they'd learned that people with diabetes are twice as likely to suffer from depression as those who don't have the disease.

The Harvard group, in another article, state that death risk is three times as great if a person has both diabetes and depression. The two diseases appear to be linked; the question of antidepressant drugs being associated with an increased risk of diabetes was raised, but causation is unclear at present.

So once more, eat well, stay slim, exercise and be happy; it's good for your health.

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.

Genetically-engineered Foods

Friday, February 18th, 2011

a large, but normal salmon

I can't say I've had much of an opinion on genetically modified organisms (GMO) or the more recent take on them, genetically engineered (G.E.) foods. After all, goes one argument I've read in a number of places, mankind has been selecting and thus modifying foods/food anmals for certain "desirable" traits for thousands of years, so what's the difference.

Then I read Mark Bittman's Opinionator post in the New York Times online (Feb 15, 2001) and found one crucial difference, honesty. The government has approved three new G.E. foods, one of which becomes hay, another to be used to make fuel (ethanol) and the third a variety of sugar beets. None of them have to be labeled as coming from GMOs.

When I looked at public opinion polls from 1997 to 2010 originating in a number of countries around the globe, people want to know if they're buying G.E. foods. The numbers in favor of labeling are 70-90+%. There's a question of safety in the public's mind, one ABC poll conducted nearly ten years ago had 35% of respondents thinking G.E. foods were safe, 52% voting they were unsafe and 13% without an opinion.

Yet 93%, in the same group polled, thought the federal government should require labeling.

The three G.E. products I'm writing about are alfalfa, corn and sugar beets. The alfalfa could become hay fed to animals, dairy cows for instance, who were supposedly being raised organically, and therefore, strictly speaking, the milk from those cows wouldn't be organic. But we wouldn't know that if the government rules don't require labeling of the alfalfa as G.E.

Now there's a new worry. I printed a copy of a Sep 20, 2010 msnbc.com article titled "Super salmon or 'Frankenfish'? FDA to decide." A Massachusetts company, AquBounty, is producing a G.E. salmon which grows twice as fast as ordinary salmon. The photo of a G.E. AquAdvantage salmon swimming alongside an ordinary salmon of the same age (presumably Photo-shopped together) is striking. I wouldn't have assumed they were the same species.

And the Food and Drug Administration is apparently about to approve the new super fish. Two Alaska Senators and a California Assemblyman have introduced bills to either ban the fish or require its labeling as G.E.

In Europe most foods containing more than 0.9% of GMOs must already be labeled.

The claims in favor of GMO crops are they need less water, less fertilizer and fewer pesticides and similar sprays. Bittman's column notes these claims aren't verified in many instances and most of the world's farmers can't afford to grow the new GMO species.

I'm personally not very afraid of the G.E. crops and even the salmon. Bittman notes that neither allergic reactions nor transfer to people of antibiotic resistance , major concerns of those against GMO crops/foods, have thus far been shown to be factual problems.

But, the labeling issue is quite another matter. If it's a GMO food product, it ought to say so.

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.

Dietary supplements and scams

Friday, February 11th, 2011

and it isn't cheap

When I was at Langley AFB in th early 1970s, we had an opportunity to take a field trip to the Cayce Institute. Edgar Cayce was a supposed psychic who lived from 1877 to 1945. I came away from that trip with a healthy dose of scepticism, not so much about Mr. Cayce himself, whose work I never saw, but of those who inherited his mantle,

That scepticism has served me well over the years and today led to a prolonged web search on the supposed benefits of acia berries as a dietary modality and supplement. It started with a news article I found that claimed a Channel 10 employee had lost 25 pounds in 4 weeks on the "Optimal Acai" program.

I began tracing the story and found a number of websites that were pertinent: WebMD said acai berries are claimed by marketeers to be an "elite superfood with anti-aging and weight loss properties." They did note that the berry, which comes from a palm tree found in Central and South America, has lots of antioxidant capacity, even more than other berries (cranberry, raspberry, blueberry). It contains chemicals that are in the flavinoid and anthocyanin family, the latter being found in red wine for example.

But as to the claimed health benefits of this particular berry, who knows. Thus far there are no studies that show it's better than other similar fruits.

MedlinePlus, the National Library of Medicine's consumer information source, notes the acai berry has antioxidants, but says there is insufficient evidence thus far to show its effectiveness.

So how did the acai berry craze start? In November of 2004 a dermatologist, Dr. Nichoas Perricone, appeared on the Oprah show. Subsequently a post on oprah.com touted his so-called superfoods, especially acai. The comment that struck me was "harvested in the rain forests of Brazil, acai tastes like a vibrant blend of berries and chocolate."

Well that sounds yummy, but who is Dr. Perricone and what's the data? And why do I connect this back to Edgar Cayce?

Dr. Perricone is a dermatologist who writes on weight loss and anti-aging. He's also an Adjunct Professor of Medicine at Michigan State's medical school. One of his books, The Perricone Promise, tells of neuropeptides and their role in aging and focuses on a particular diet. A three-month supply of a neuropeptide-based serum that his own company sells costs $570.

Subsequently there have been scams with emails sent off linking to supposed news reports on the acai berry diet; one was to a website New7health.com which had an identical claim as the supposed website I saw today (reporter lost 25 pounds in 4 weeks). This was exposed as bogus in March 2010 and led me to reread the supposed Channel 10 health news article.

Part of the promise beside rapid weight loss is to eliminate bad toxins built up over many years and remove sludge from the walls of the colon. Now I was back at the Cayce Institute with a basic part of their program being so-called "High Colonics," enemas to lose weight.

I won't believe any of this kind of spiel until The NLM and other reputable medical organizations report controlled, double-blind, peer-reviewed, evidence-based studies.

The "tippling" point

Tuesday, February 8th, 2011

one too many

My wife clipped an article from The Wall Street Journal last week and stuck in my "read this, Peter" stack she keeps. I got around to it yesterday and was impressed enough to do the background research. The writer had looked at the 2010 Dietary Guidelines for Americans and focused on the beneficial effects of moderate alcohol consumption.

Well that caught my attention; I drink a glass of wine two or three nights a week, rarely drink two and never more than that

The author of the short article, Stanton Peele, is a psychologist, attorney and writer on addiction recovery. He is a PhD, JD who has written nine books on addiction and has a different view than the "Disease Model" that many of us were taught in our medical training. His take is  the "Life Process Model"in which addicts use their drug of choice to cope wih life. I did note that eleven years back some of his research was sponsored by the Distilled Spirits Council and the Wine Institute  (their support of his work ended in 2000).

Okay that made me a sceptic, but I decided to read the section on alcohol in the recently released 2010 DGAC. It begins by emphasizing the hazards of heavy EtOH intake, quoting a 2009 study attributing 90,000 deaths a years to alcohol "misuse" in the United States. It also estimates that 26,000 deaths were averted (I like that term better than prevented since eventually we all die) by moderate EtOH consumption.

The traditional definition of moderate is one or two drinks per day for males and one per day for females. A lot of people exceed those levels with 2009 and 2010 studies showing estimates of 9% of men and 4% of women drinking heavily.

So what's the good stuff assuming you're an adult, not pregnant, don't have a drinking problem and don't have disease that are exacerbated by alcohol? it appears from extensive reviews of the medical literature that moderate drinking isn't associated with weight gain (remembering that EtOH is "empty calories and you still have to eat a balanced diet). Also moderate evidence supports less cognitive decline with age in moderate drinkers and strong evidence "consistently demonstrates" a lower risk of coronary heart disease in moderate drinkers. Bone health as shown by the incidence of hip fractures appears to be improved by moderate drinking.

MVAs and drowning as well as falls are more likley with heavy drinking, but the risk for these is less well estbalished with moderate drinking.

There's even a section on lactation and breastfeeding; Alcohol reduces milk production and decreases infant milk consumption for three to four hours after alcohol is consumed, but the DGAC concluded that after age two to three months, an infant's exposure would be negligable if the mother waited three to hour hours after consuming a single drink before breastfeeding.

And of course nobody is urging you to start drinking if you don't already.

So I'm going out to dinner with my wife and a friend tonight and will order a glass of wine.

But she's going to drive home.

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.

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.