What's Eating You?

And the Potato Man of the Year Is...60-Day Potato Eater Christ Voigt - Seattlest

via seattlest.com

Because even the National Potato Council thinks eating a diet of only potatoes is a little unreasonable.

Above and beyond the call of duty, indeed.

John King USA vs the Thurmanator – Eatocracy - CNN.com Blogs

Food in the Field gives a sneak peek into what CNN's team is eating as they travel the globe. Today's contributor, photojournalist Jeremy Harlan is based in Washington D.C., but he travels. A lot.

via eatocracy.cnn.com

I have two words for people who eat foods like this.

Heart Disease. (number one killer of Americans)

I have two words for me for seeing all this bull

Job Security.

That is all.

I have successfully completed 75 units of my credential for recertification to be a dietitian. This is important because it's a goal that's been daunting me since I was an intern.
It's been so daunting that I kept trying to get units because I was so afraid that due to my typical procrastinating nature, I would not finish on time.

Instead I have finished 2 years and 9 months early.

now on to the next project.

National Watermelon Day!

August 3rd is National Watermelon Day in the good ol' U S of A.  This is awesome as "watermelon" happens to be one of my favorite words.  Just say it... wa ter mel on. mmm....

It's a good fruit to enjoy, especially if you're counting calories. One cup of watermelon has less than 5o calories and only 9 grams of sugar. That's still less calories than half of a banana. So enjoy guilt free.

If you search for watermelon recipes, you'll find all kinds of rubbish about covering it with honey and sugar and nonsense. .. best to enjoy it raw. Enjoy the fruit, let the juice dribble down your chin. Yum, tastes like summer. :)

Poll: Number of Americans Drinking Hits 25-Year High - Mental Health | Illness | Disorders - FOXNews.com

via www.foxnews.com

Oh yes, of course Fox News wants us to believe that we're all drinking ourselves to oblivion. Amusingly, the predictor of how much a person drinks is listed in this article as frequency of church attendance.

You know Fox News, some people say (and by "some people" I mean the US Centers for Disease Control) that heavy drinking has been relatively stable for years. And even then, it's taken a dip in the past few years. See their data here.

For those of you who were wondering, binge drinking is drinking more than 5 beverages in a single occasion for men or drinking more than 4 beverages in a single occasion for women.

If you're thinking that you've made a clean getaway because you haven't had that much to drink since your college days, remember that there is a guideline for how much alcohol we can drink and be healthy.

The 2005 Dietary Guidelines for Americans would tell us that alcohol is best consumed "in moderation". It takes quite a bit of searching around to find a definition of this cliched and oh-so-muddy phrase "moderation". Moderation and alcohol means no more than 2 drinks per day for men and no more than 1 drink per day for women.

Even at one drink per day, remember that alcoholic beverages are loaded with calories. Be it wine, beer or a shot of distilled liquor, you're looking at 90-140 calories from the alcohol alone. (Watch the calories add up further in that fancy schmancy Pome-tini or Mango Margarita).

Bottom line, even if you're not a binge drinking depressed reject of the church (like Fox news thinks you are), cut back on the booze. Nobody needs the calories there.

Saving ourselves from the obesity epidemic.

I love this article from the Mercury News about a woman who effectively saved her children from the obesity epidemic. Her son was five and was diagnosed with high cholesterol. This mother was cash strapped and buying inexpensive foods to feed her family, but she knew something had to change. The quote in the article is priceless, though:

"I never got education or nutrition classes for eating healthier, nobody taught me how to feed my children."

So this begs the question, whose responsibility is it to teach us how to eat healthier? The woman in the article was able to get help from the California Department of Public Health, Healthy California program. But not anyone can be a part of that program. What about those of us who don't qualify for low income assistance but still never learned how to cook for ourselves?

I know lots of people would say that it should be a parent's responsibility, and while I don't disagree, the simple fact is that many people already missed that chance to learn and are now having kids of their own. So what about them? Can the government teach us? Well, like the woman in the Mercury News, you might have to qualify for income assistance to get those classes. If you can't take those classes you might look for courses offered through your city, but you would have to pay. 

Can we backtrack a bit to a place in time where we could potentially teach everyone this and a couple of other life skills? You know what I'm talking about right? Home Economics. Marion Nestle proposed this in her blog last week and I totally agree. 

Let me start by saying I never took Home Economics, but then I was taught how to cook by the time I could reach the stove. But as a nutrition student in college, I took cooking classes with people who could not for the life of them look at a table of ingredients and plan a meal. These were 2nd and 3rd year nutrition students! Something has to change. 

Electives like this are barely taught anymore, especially in California, where getting kids to pass standardized tests trumps everything else and the budget doesn't allow anything other that what is absolutely necessary. But there was a time when your local high school taught girls (and boys) essential skills that they would need for life (and potentially for college). 

Food for thought.

The burden of the fine print.

The GAO is so awesome. It's an arm of Congress that completes investigative reports about the things that various companies or even our own government might be doing wrong. Then they publish a report about it. The GAO also has a Twitter account, in case you're a nerd like me and you really want to know what they're saying. 

 And last week they busted a bunch of snake oil salesman, ahem, dietary supplement companies. See here. It seems like they were looking for supplement companies who came close to skirting the regulations in the Dietary Supplement Education Act (DSHEA). Per DSHEA, dietary supplements are exempt from FDA regulation. In fact, if a supplement company comes up with an ingredient that didn't exist prior to 1994, the FDA doesn't test it, but they do have to be notified.

Per DSHEA, the FDA can only intervene if they receive a complaint. These complaints would be limited to things like contamination, the supplement containing an illegal ingredient or an ingredient other than what is stated in the bottle. More often than not, the complaints are due to mislabeling.

It seems like the supplement companies got a really sweet deal by keeping their products away from FDA scrutiny. For this privilege, they have to play by one really simple rule : They cannot claim that any product treats or cures any disease or illness. This is the basis for statements like "calcium builds strong bones" on vitamin bottles. They cannot, by law, claim that calcium will alter the "structure or function" of the human body. They also have to include a disclaimer that the claims were not evaluated by the FDA. This very muddled language you see on your vitamin levels is actually meant to get your attention and make you consider if the product is worth the risk.  But who reads the fine print?

No one, apparently.

Enter the GAO. During the course of their investigation, they not only uncovered products with labels that violated the law and are blatantly erroneous, such as "Garlic prevents obesity and cures cardiovascular disease" but they also called the companies and received potentially deadly medical advice from customer service. One investigator was told that a supplement could replace a medication prescribed by a doctor. Others were told that certain supplements were safe to take with medications for which known interactions exist.

As if this wasn't enough, the GAO also found that 37 of the 40 supplements they tested contained trace amounts of heavy metals. Below the legal limit, but scary nonetheless. Makes me wonder about the whole "more is better" mentality. What if someone decided that taking the whole bottle would be better. Mmm... arsenic poisoning. Sounds fun. Not really.

At the end of the day, the GAO can't cite anyone or close them down. All it can do is testify to the facts it uncovered. Remember that when we push for limited government oversight in the name of personal freedoms, corporations get these freedoms too. And yet, when something goes wrong people always ask why their government didn't protect them. Well, they tried to warn us. The dietary supplement industry is huge, it has a lot of money, power and influence. Supplement companies are in business to do one thing, sell a product. We'd like to think we've come a long way from the man with the waxed mustache selling bottles from the back of a wagon, but have we really?

Thwarted again by a snack.

I talk about snacking a lot. It's an interesting kind of murky, subtle behavior that justifies itself so well. We tell ourselves, "Hungry? Have a snack".  We tell ourselves it's in the name of keeping our metabolism running or that someone told us it was needed to keep our blood sugar up or that we've earned a treat...

 

...and then we mentally write off the calories from the snack as if they didn't exist because it was, after all, just a snack. When did this become the cultural norm? When did it become the expectation that we could "just have a snack," as though it didn't matter? What ever happened to being told, "don't have a snack, you'll spoil your supper"? Why do I feel like my values on this matter are so archaic?

In my experience, most people have snacks when they're not even hungry. Snacking is driven by smells, memories, the anxiety that is caused by watching someone eat your favorite food while in your immediate vicinity. Snacking is driven by the desire to have a taste for something in the mouth. It's almost as though it's become another way that we crave constant stimulation. As if the constant flashing lights from the video game screen weren't enough to send our brains into overdrive, we need a little sugar-fat-salt rush to keep the sensation rolling. This has become acceptable, expected behavior in our world. 

Research published by the USDA shows that snacking behavior has increased along with (you guessed it) the obesity epidemic. Snacking behavior in kids increased 40% between 1977 and 2001, while the incidence of kids actually eating 3 meals decreased. It's not to say that the snack replaced the meal, because the nutrient content and quality of the snack was probably not so great. But then consider the kids that have 3 meals and one snack per day or 3 meals and 2 snacks. Consider the adults that have 3 meals and 3 snacks on a daily basis. Consider the day-in, day-out calories and energy of all those snacks combined. The snacks really do add up. 

How then, have the snacks found their way back into our mouths when our minds are focused on weight loss? Easy, we're all trying to practice "portion control". And the economy, cause snacks are cheap. Consider now the restaurants, from sit down to drive-thru that are offering "snacks". These snacks can un-villify McDonald's and KFC, they can make a trip to the Cheesecake Factory fit into our diets. The snacks are inexpensive. They're quick to eat. They are a "portion". Or so we think. 

I submit for your approval:

McDonald's Chipotle BBQ Snack Wrap: 330 calories

McDonald's Mac Snack Wrap: 330 calories (it's a burger patty in a tortilla. Am I the only one who thinks that is totally gross?)

KFC Snacker with Crispy Strips: 290 calories

KFC Snacker with Fish: 320 calories (provided to trick all you people who thought fish was healthier)

Cheesecake Factory Ahi Carpaccio: 260 calories (says it serves 2, but who are we kidding?)

Cheesecake Factory Roadside Sliders: 731 calories

If 290 calories sounds like nothing to you, consider that you probably wouldn't eat the "snack wrap" all by it's lonesome. Add potatoes or a small drink and you've broken the 400 calorie mark, easily. Three "snacks" like these are more than enough calories for an average person in a day. Call it what you want, these "snacks" are meals.

They are trying to trick us. 

Research. Or: vilifying the kind souls of scientists for my own amusement.

I love reading research articles. I've been shuffling through them since they were required reading in college. I like to devour the articles looking for trickery in language and leaps of faith in logic phrased in fancy-schmancy scientific double-speak used to make it sound like the researchers discovered something that may not be true. 

 In my mind I see a room full of scientists typing away, going through multiple edits and revisions. They are desperate to get their work published and fulfill years of planning and research and experimentation. They are living a lifetime of all my grad-school all-nighters. These writers of my imagination are trying to secure a legacy, get published in a major medical journal, or *score* have their title mentioned during Good Morning America. 

If you are a scientific researcher and I've just offended you by vilifying your job, I do apologize. Sadly for both of us, my critical thinking skills are at their sharpest when trying to find "the catch". This is especially fun with stories that make it onto Good Morning America or any other morning news brief.

Lucky for you I still don't own a TV, so I haven't seen GMA in months. But our time will come again. 

This morning I was handed an article torn from the newest issue of JAMA (Journal of the American Medical Association). It hasn't made GMA yet (that I can tell) but it is getting some press time. 

The purpose of the article was to determine a correlation between minutes of exercise and weight gain over time. The observational research was initiated on the premise that the federal guidelines for 150 minutes per week of "moderate intensity" aerobic activity are necessary to receive substantial health benefits are completely arbitrary; not to actually determine any sort of concrete detail on how much exercise we actually need.

First thing to consider when evaluating a study: Who are the researchers talking about? In this study, the subjects were 34,000 middle aged women who were healthy at the end of a previous study (the Women's Health Study). These women did not have heart disease, cancer or diabetes at the start of the study. Their mean age was 54. Think about this. In a country where 1 in 3 people is obese, these researchers have hit a gold mine of extraordinarily healthy middle aged women. Where did they find these people?!

The researchers were able to distribute the women into 3 activity levels and keep a couple of things pretty even. Across all 3 groups the ages are roughly the same, so is the percentage of subjects who are white, as well as the total calorie intake per day (as verified by a food frequency questionnaire). There's an important point here: the women who exercised more ate less fat in those calories and more fruits and veggies than the women in the other groups. Additionally, the women who exercised more had a higher level of formal education and were more likely to use HRT if they were postmenopausal. I'm not sure what HRT has to do with any of this, but it does make me wonder if that means they have health insurance, or at least the means to pay for the drugs.

Another thing to remember in any kind of observational research: attrition. The researchers followed these women for 156 months. At various points in time they are missing data from several hundred women. They can show statistical significance between less weight gain and lower BMI,  no history of smoking and increased amount of exercise, but DUH. What were all those people doing who weren't turning in their exercise surveys to the researchers? Were they exercising? Following the curve? Losing or gaining in such a way as to become an anomaly? We'll never know. Would these numbers be the same if they ONLY counted the women who replied?

One important thing they did note was the older subjects who exercised less, gained more weight over time than their younger counterparts. The people who exercised the most and gained the least were younger and started out with a BMI of 25 or less. Does this have to do with metabolism? Menopause? Nah, it's most likely because old habits die hard. The older you are, the harder it is to change your ways. So start young.

So far the news articles I've seen have pulled from this the gleaning example of the study's most successful participants. The people who started out with the lowest weight and gained the least were exercising about one hour per day. (But they were also doing lots of other stuff, see above). News articles will translate this to the recommendation of "exercise one hour per day to prevent weight gain". But remember, this relationship might only apply to you if you're white, college educated, a non smoker who eats a low fat diet that is high in fruits and vegetables and you're continuing these habits into your 50's and you're already leaner than the average American.

Otherwise, all we're looking at is a statistically defined coincidence of events.

And more recreational reading for me. 

Article: Lee, I-Min, et al. Physical Activity and Weight Gain Prevention. Journal of the American Medical Association. 2010: 303 (12): 1173-1179

As a Registered Dietitian in my first certification period, I've been a little bit scared of the whole "Portfolio" process for logging my educational units.

I read journal articles from time to time and if I took the ADA quiz, then I know my units are safe. But what about other things? I attended a medical education event recently at UCSF I figured that since the units would be applicable to doctors and psychologists that I'd be able to claim them too.

I carefully referred to my PDP Guide on the Commission for Dietetic Registration's site and did my best to claim the hours I felt applied to nutrition. But still, my fingers were crossed that they would accept it.

Even though I'm certain I've completed legitimate educational hours, I have this fear that I'll be down to the wire in 2013 when I'm up for recertification and that I'll submit my hours only to have something rejected. Then I'll have to appeal or pay some fee to fix it or I don't know what.

This fear is borne from the fact that I can be kind of lazy and a total procrastinator.

Imagine my glee yesterday when I noticed a button on the CDR site, "submit for mid point review". Finally, a quick little double check that I can use to ensure my units completed thus far would be acceptible. Hooray!
Less than 12 hours later, I got an email from CDR saying that I could check in to read the review.

Just as I'd hoped, all my units completed will be approved when I submit them officially.

All is right with the world.

40 more to go.

Commission for Dietetic Registration www.cdrnet.org
American Dietetic Association www.eatright.org