Eating Kale, among other things

June 1st, 2010

Our friend Maggie sent me an email copy of "HEALTHbeat" (I'm putting titles into quotes today as my computer seems to have developed an aversion to italics), a Harvard Medical School publication. It's free on the Web and I signed up to get it regularly. This edition happened start with "Advice to women about supplements-use selectively." and my wife read that with great interest. I ordered two of their print publications, one for women over 50 and one on losing weight and keeping it off. I also sent them an email about what I think was a typo about the recommended vitamin D dosage.

Anyway they talked about nutrient-dense foods as being the best way to get many things we need in a synergistic fashion, which might turn out to be the more effective way as well. I looked through their list which included lots of foods we already eat in our high-fruit-and-vegetable, low-red-meat diet. Among the choices were avocados, bell peppers sweet potatoes, low-fat yogurt, peas, various nuts, salmon and chicken.

So far it sounded like a typical meal at our house. Then Lynnette, to whom I was reading the list, said, "We don't eat kale very often."

That intrigued me, so I went to an older book we frequently consult, "Food" by Waverly Root. The subtitle of this 1980 tome is "An authoritative visual history and dictionary of the foods of the world" and Mr. Root wasn't kidding. Sometimes he'll spend four pages on the histroy of a particular food item. If you ever run across a copy, I'd suggest buying it; we love this book. We also recently found "The New Food Lover's Companion" (the 2007 4th edition) by Sharon Tyler Herbst and Ron Herbst which had a paragraph on kale.

It's a member of the cabbage family, low in calories, high in vitamin C and calcium, and eaten more in Europe than in America, where it's been made into so-called pot greens. My copy of Barbara Kafka's great book, "Microwave Gourmet" gave me a way to cook kale and we'll try some soon.

But back to the Harvard Medical School advice. They appear to think women in America are taking too many multivitamins and that those haven't given all the benefits they've been touted to offer. Their publication for seniors does suggest taking one, but only one such pill a day. They do want you to try some of the foods I mentioned instead (there are more on their list) and to get some extra vitamin D.

We both take one senior vitamin pill a day (which has 125% of the daily recommended vitamin D dose), some calcium, B12, and vitamin C. They'd have us cutting back on some of that, but I'll read more before I do; nothing we're taking seems to offer a risk, as some preliminary studies show may be there for excess vitamin A and E, folic acid and beta carotene. Those studies, Harvard notes, "warrant further studies."

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Paying more for your soft drinks?

May 28th, 2010

I read two articles on the topic of new taxes recently, in this case taxes on soft drinks, teas and sports drinks.  The lawmakers are, of course, not just interested in our health; they need to "plug budget gaps," as one of the newspapers commented, or pay for new programs, including health initiatives. About thirty states are taxing sodas already, including my home state (for the past eleven years as of the 31st) of Colorado.

As expected the makers and sellers of these beverages don't think it's a good idea at all and the sum the American beverage Association spent on lobbying went from $668,000 in 2008 to $18.9 million in 2009 to $5.4 million in the first quarter of 2010. A large part of that went toward fighting off the new taxes.

I drink one diet soda a day and don't mind paying the extra two cents on twelve ounces that has been proposed. I see youngsters in our health club chugging down large amounts of sports drinks every day (I'm there six or seven days a week) and frequently mixing in "muscle-building" powders.

I've looked back over some of the medical literature on my diet soda and there's a controversy as to adverse effects even there. But the question is clearly unresolved, so for now I'll stick to my one-a-day routine.

Otherwise I have a great idea for you: drink water, preferably not from small plastic bottles, maybe filtered if your local water is of concern. I just bought a half-dozen limes (oh my, the price has gone up!) and used my lime squeezer to make a one-quart glass of lime water. It was sitting on a coaster beside my mouse pad as I wrote this. I use the past tense because I just finished the glassful.

I don't think the sports drinks, the muscle-building powders, the sugary sodas make much sense, especially when they come in potentially (and I say that without a great deal of data to support the statement) hazardous little plastic bottles that won't compost or disintegrate for many centuries. I'd prefer to hydrate the old fashioned way, with water.

Now for a period of five years when I headed a section of our largest Air Force hospital, the section that interfaced with the base itself and, among other things, had a troop clinic for basic trainees and others to get their first-line medical care, I really liked a particular sports drink. When kids from the north came to Texas in the summer for Air Force Basic training, the frequently got dehydated, lost not only water in their swaet, but electrolytes as well. Those young folk did very well with a sports drink as a first step in rehydration. But even they acclimated after a short time (three to four weeks) and water sufficed thereafter.

So my bottom line is here's one tax I'm in favor of.  If you're working hard in hot weather you may need some electrolyte-containing fluid, for a while. Otherwise, drink more water.

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it's a start, but barely that

May 25th, 2010

I recently read an Associated Press article headlined "Food companies say they'll remove 1.5 trillion calories" and was initially impressed until I got into the reality behind this tiny start toward reducing childhood obesity. It turns out that the highly vaunted amount works out to 12.5 calories per person per day. I've blogged and written elsewhere that 50 calories a day works out to be five pounds a year (3,500 calories equates to a pound), so this initial effort from the Healthy Weight Commitment Foundation equates to a pound and a quarter a year.

That may be a start, but it sure isn't much of one.

If we cut our daily intake by fifty calories (and that shouldn't be hard considering how much Americans and some others eat), we'd lose five pounds a year. One hundred calories less a day + 100 calories worth of exercise would result in a loss of twenty pounds over a year. I've done a little better than that over the past year and I'm down about twenty-five pounds.

But let's go back to the food companies, the Healthy Weight Commitment Foundation has over 80 companies, including many of the big names. Sure they're responding to Michelle Obama's speech given in March to an industry meeting, and making some efforts (I'd call it a tiny one) to cut sugar and fat from their products (and hopefully salt also). But the huge number in the headline, 1.5 trillion calories, has to be put into perspective. Twelve and a half calories a day per person sure isn't much.

I think we all need to eat more fruits and vegetables, lose our mid-section excess and then keep it off by increasing our exercise or some combination of diet and exercise. I think the food companies need to cut their products calorie load a lot more than a mere 1.5 trillion calories. Until they do, and maybe even after they do, we should, as much as possible look for ways to eat healthier.

That's easier to say than do for many people. Fresh fruits and vegetables aren't cheap and families living on tight budgets may struggle to put healthier meals on the table. So my push would be for our government (and the food companies) to subsidize food, especially for kids, that's built around eating more fresh fruits and veggies and less processed foods.  We also need to get our kids outside, away from the computers, cell phones and other sedentary lifestyle items and get them interested in walking, running and biking.

It's time and past time for all of us to help bring about the diet and exercise changes we need, both for ourselves and especially for our kids and grandkids.

Then that amazing headline with its dazzling 1.5 trillion calorie figure could actually be put into perspective. Folks, it's just a drop in the bucket. We need to fill that bucket.

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Protect your kids; buy organic

May 21st, 2010

I just read about a study, published in the journal Pediatrics this past Monday, that appears to link childhood exposure to pesticides to Attention-Deficit/Hyperactivity Disorder, known to most of us as ADHD.  The lead researcher is a Harvard faculty member with a PhD and her co-investigators were from Harvard and the University of Montreal. The reported on a government health survey from 2000 to 2004 that looked at kid's urine levels of chemicals that were breakdown products of pesticides, especially of organophosphate pesticides.

The study included 1139 kids who were representative of the U.S. population and 20% of those with with higher than average urine levels of the measured compounds had ADHD. That's twice the percentage of kids with no dectectable amounts of the same chemicals in their urine.

So what's this all mean to us. Well, my wife, a mental health therapist, has repeatedly told me the country is seeing more and more cases of ADHD. And, I had just printed copies of a report by the Environmental Working Group with a "Shopper's Guide to Pesticides." It listed two groups of fruits and vegetables, lableing them the "Dirty Dozen" and the "Clean 15."  The former group was highest in pestcide content and included celery, peaches, strawberries, apples, blueberries, nectarines, bell peppers, spinach, kale, cheries, potatoes and imported grapes: in that order.

The data was based on foods tested after they'd been washed, peeled, rinsed, whatever we normally do to them before eating them. Those procedures help, but don't get rid of pesticides and, in some cases, results in the good stuff, nutrients we'd like to ingest, going down the drain or into the compost pile or garbage disposal.

When you buy those foods, buy the organic variety.

On the other hand the clean 15: onions, avocados, sweet corn, pineapple, mangoes, sweet peas, asparagus, kiwi, cabbage, eggplant, cantaloupe, watermelon, grapefriut, sweet potatoes and honeydew melons (in that order), are the least contaminated.

We just signed up for a twenty-six-week couples share of vegetables + a twenty-three-week fruit share from a local CSA. I decided if I were going to write this post, it made sense to "put my money where my mouth was."

Think about the issue, especially if you have children or, for that matter, grandchildren.

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Getting help in remembering to exercise

May 18th, 2010

I read an interesting article this morning. A study conducted by researchers at Stanford using subjects averaging in their mid 50s and previously inactive showed the importance of social support in helping people develop and maintain an exercise regime. The project followed adults, with an average age in their mid 50s, for a year and showed that people who got phone calls, even monthly ones,  from a health educator markedly increased their time spent exercising. That's compared to a group who only got initial health education classes. Even automated phone calls work, but a human touch was best. Those new and improved health habits held at the 18-month followup.

There were other bits of information I gl.eaned: the majority of people, like me, prefer to exercise alone. My wife participates in four exercise classes a week; I don't join her in any of those. I often think my way through issues as I exercise (especially during the 65 minutes I spend almost every dayon a recumbent bike), zoning out and working through issues or just allowing thoughts to come up as they will.

The Stanford lead investigator, Dr. Abby King is a PhD professor of Epidemiology and Medicine at Stanford's Prevention School of Medicine Research whose major research study relates to the role of physical activity as it links to other healthy behaviors and promotes improvements in life-coping mechanisms. She herself usually is a loner when it comes to exercise, but sometimes drips out for a period of weeks and then tends to join a small class to get back into her usual pattern.

What I take from this is if you don't find it easy to get into a pattern of regular exercise, find a buddy who will call you from time to time. Most of us will never end up in a formal research project like Dr. King's; almost all of us could help a friend and be helped in return.

Lynnette was just on the phone calling her another woman who is in the twice-weekly "Strong Women, Strong Bones" class she takes. She's developed a brand new, close friendship through this class, frequently has a cup of coffee afterward with her exercise buddy and the two of us, from time to time, go to dinner with her friend and that woman's husband.

As we age, I think social support is crucial and, if friends can help us stay in shape, maybe lose a few pounds or keep those off we've lost already, they have even more value in our lives.

So find an exercise buddy or even someone who'll help you keep working out, whether you walk together, go to a gym together or just make phone calls to support each other's good habits.


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Another good book

May 14th, 2010

I recently ordered a book by Susan Yager with the intriguing title The Hundred year Diet: America's Voracious Appetite For Losing Weight. I'm waiting for the book to come in, but the quote in The Wall Street Journal's book review section was enough to hook me. It mentioned a prior WSJ article with a great line from a physician saying, "If there were a drug with the same benefits as exercise, it would instantly be the standard of care."

Yager's book traces our preoccupation with dieting from the early 19th century to the present. Now we're tracking our calories, watching out for high-fructose corn syrup, but prior fads had us on high protein diets, chewing our food and chewing it and chewing it before we finally swallowed the mouthful, avoiding this food or that.

I'm waiting for Yager's relatively slim volume (it's only 260 pages in length), but in a few minutes I'm going to go to the gym and ride a recumbent bike for 65 minutes (or more) until I'm past the 20 miles/650 calorie mark. I'll do some stretches and work on a few machines, but for sure I'm going to ride the bike.

Lynnette in the meantime will be out walking. A recent book by Miriam Nelson and Jennifer Ackerman with the title of "The Strong Woman's Guide to Total Health" suggests brisk walking for an  hour a day. Nelson was the co-chair of the group that authored the 2008 Physical Activity Guidelines for Americans and directs a center at Tufts which concentrates on obesity prevention.

So there's two approaches to losing weight. I don't believe in "fad diets." I do believe in eating less and doing more. Our diet increasingly focuses on more fruits and vegetables and we're looking in to the options with a local CSA (community-sponsored agriculture) organization. We can purchase an "egg share," a vegetable share," a winter vegetable share," and/or a "fruit share."

Here are the concepts that appeal to me strongly: buy local, eat more of the good stuff and find some form of exercise that you're capable of and will do on a regular basis. Carve some time for it out of your busy life. Eat slower. Enjoy your dining companions conversation. Drink some water before that first bite. Serve really small portions of anything you crave that is obviously fattening.

Stay away from fad diets.

Posted in Dieting, Healthly lifestyle, Healthy eating, medically-oriented background info | 4 Comments »

Nuts to you (and to me too)

May 11th, 2010

I just read an abstract in the My 10, 2010 edition of the Archives of Internal Medicine, having had my curiosity tweaked by a short piece in today's Wall Street Journal. There's a reason I always want to check the source material in the medical literature. When I was a Nephrology research fellow and attended on the clinical service a few months a year, a former patient came to me and asked if I'd read a chapter from a book his father, who had an unusual kidney disease, wanted to follow advice from. The book was written by a famous lifestyle guru and the writing and references cited were quite impressive. My patient knew that my boss was a field editor for two peer-reviewed research journals and that I, therefore, as part of my duties, critically read a half dozen articles a week prior to their being accepted (or rejected) for publication.

I picked twenty articles from the pertinent chapter and then went to the medical library. The book's author had claimed they all supported her concepts of what kidney patients should do. But, after reading them carefully, I concluded that not a single article had said what she claimed it did. Lesson learned and retained.

So the WSJ article talked about the health benefits of eating nuts, specifically tree nuts like walnuts, almonds, hazelnuts, macademia nuts, pistachios and also peanuts (which turn out to be a legume). They mentioned a series of studies on the subject.

In this case, when I found data on the lead researcher, an Internal Medicine physician who heads a deptament at a California university, I saw that he had a longterm interest in nuts and had pooled data from 25 nut consumption trials done on subjects of both genders, who were not taking any medication for elevated lipids or had normal lipids to start with.

The short form of the study's results would be eating nuts is good for you, can reduce your blood fats, if, and this is a big if, you're not obese to start with.  More nuts, roughly 2.4 ounces a day, led to better results than lesser amounts.

So I went to our big chest freezer, found a sack of walnuts and one of almonds, and we will start regularly adding nuts to our daily diet.

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Salt Intake and Stomach Cancer in Young U.S. Adults

May 8th, 2010

An interesting article appeared in last Wednesday's Journal of the American Medical Association. It reported a National Cancer Institute surveillance program which covered a large segment of the American population (about 25% of us) and reviewed over 39,000 cases of stomach cancer. The rates of new cases of this frequently fatal disease declined in almost all age groups except for while adults age 25 to 39 where it climbed almost 70%.

Now this could be just a statistical issue and the overall rates were still quite low (1 in 200,000). But, on the other hand, the one major association found was to diets, especially those high in salt and foods preserved with salt and low in fresh fruits and vegetables.

The study was looking at cancer in the "lower stomach," sometimes felt to be caused by chronic infections with H. Pylori, the same bacteria that's associated with ulcers. This is as opposed to disease in the cancer in the "upper stomach" associated with reflux disease.

Most other adults in the age range studied (25 to 80) had a clearcut decrease in rates of developing stomach cancer and black adults shared in this decrease. The authors noted that historically the incidence of this form of cancer has been higher in parts of the world where foods are often preserved with salt. Those rates have declined in many countries along with decreased rates of H. Pylori infection and the overall decrease in U.S. rates was certainly not unexpected.

We're left with an actual increase in one group. It will be further investigated, but the authors noted that salt intake has been going up in Americans in general and wondered if altered eating patterns were the culprit in the young adults in the study.

Hmm.. I've written before about our excess salt intake (for some of us it's more than twice what is recommended)  and suggested we could lower high blood pressure incidence with all of its potential for devastating consequences if we were to cut down on the salt, both by adding less and by eating less of those prepared foods that are high in sodium content.

Now we have one more reason to spurn the salt shaker and shop wisely for more fresh fruits and vegetables.

Posted in Healthy eating, Life Expectancy, medically-oriented background info | 4 Comments »

A book on food and human history

May 4th, 2010

I read The Economist regularly, but was unaware, until I purchased the book, An Edible History of Humanity, that Tom Standage, listed as the magazine's business affairs editor, was also an author. I've just started leafing through his 2009 book, having finished reading one of the two book club selections I needed to get through by next week. But even perusing the book over a few minutes, I've already seen it connects to a number of topics I'm interested in.

One of those is the ongoing controversy about genetically modified food. Early in Standage's book, he discusses the progression of teosinte, an ancestral form of maize, to modern corn. It seems clear to me that human selection of which crops had their seeds spread was responsible for this. The author notes that a cave in Mexico has a series of ancient cobs that vary from half an inch to eight inches in length and talks of the high likelihood that farmers of the past would have deliberately chosen those mutated maize varieties that produced larger ears.

So we've been fiddling with our food crops for a long time. Well and good in many or even most instances; basically I have no problem with the concept . But Standage also discusses the 1845 Irish potato famine where an over-dependence on a single food and a devestating crop failure caused by a fungus infection, led to a million deaths.

So on the one hand I often approve of our modifying our food sources, but, as I've mentioned in previous posts, I personally think some of the heirloom varieties of vegetables which are available in our local farmers markets just plain taste better than their super-market cousins. They also may protect us in a fashion by their being different.

I don't want us to become reliant on a single variety, a solitary kind of almost any food crop. The need to produce more corn, more tomatoes, more potatoes, may have been one factor leading to the highly productive mega-farm concept of agriculture, but I worry that it also exposes us as a country, or even as a species, to the risk of famines if a new vegetable disease and/or climate change wipes out a particular strain of a crop or multiple crops.

Is this at all a realistic issue? We now have highly developed, well-connected sources of production and shipping of food items, but we also have a burgeoning human population and the threat of global warming, derided by some, but strongly concurred with by many.

I'm in favor of keeping multiple food sources and expanding our choices whenever possible.

That's enough for today; I realize I've tried to connect some dots that may seem isolated from each other, but I think they're well worth cogitating over.

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How much do I need to exercise?

April 30th, 2010

I keep running across short articles on exercise and its resultant health improvements; they vary a lot! One, taken from USA Today and published in the Journal of the American medical Society, reported on a long-term study done by researchers at Boston's Brigham and Women's Hospital and Harvard Medical School. This was a huge project, following 34,000 women for thirteen years. The group's average age was 54 when the project began and the women were eating a regular diet and not trying to lose weight. Over the extended period of the study the average weight gain was six pounds. Not very surprisingly, those who exercised more gained less than those who were relatively inactive. But notice they weren't dieting, just exercising.

A second article included multiple takes on excercise. A cardiologist from the Mayo Clinic in Rochester mentioned an overweight patient who started to consume a better diet and got moderate exercise. He lost weight and clearly improved his lipid panel results (the surprise ending to that story was he was his own patient in this instance).

Comments made at the yearly meeting of the American College of Cardiology supported the moderate exercise concept, with a number of studies showing more aggressive approach to preventing heart disease were no more effective than moderate ones. Other studies showed that adding multiple drugs to lower lipids didn't seem to offer additional benefit and a large NIH study concluded that aggressively lowering systolic blood pressure (that's the upper number your doc looks at when you have, for example a blood pressure of 145 over 95) wasn't more effective in preventing strokes or heart attacks in a group of over 4,700 diabetic patients.

What does this all translate into for you. At least my approach is to eat well, keep my weight down and get some exercise as often as possible, sometimes by going to the gym and sometimes by walking up and down the stairs to my second-floor office. I've stayed away from using lots of meds for minimal changes in my lipids and don't have a blood panel done very often (The last time I had one, all my results were okay). Of course I've worked hard at losing the roll around my middle (I've gone from a 37-38 inch waist to 33-34 inches in the past year) and cut my weight 25+ pounds. The dose of my blood pressure medicine was cut in half when I did so.

Listen to what your own doc tells you, but I strongly suggest you take some steps yourself to improve your health. They don't always have to be huge ones, but, in the final essence, you're the person who can do the most to extend your lifespan. Start by doing some walking; think about small things you can do arround the house that burn calories (like my extra stair climbing), ask your doc if you're okay to do more strenuous exercise and if you do so, very gradually increases in your workout pattern make sense to me).

But whatever you do, don't just sit there and let the pounds accumulate, especially pounds around your waist.

Posted in Exercise possibilities, Healthly lifestyle, Life Expectancy, medically-oriented background info | 9 Comments »

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