Health Education: health promotion

Showing posts with label health promotion. Show all posts

When the average is a bad thing.

A friend shared a smart phone app with me yesterday.  It is called Fooducate.  You can visit the webpage by clicking <a href="http://www.fooducate.com/" target="_blank">here</a>.  If you have a smart phone (iphone or android) you can download the free application.  The link was shared with me because I am studying the use of nutrition information in college students and my colleague thought that menu labeling wasn't going to cut it with this age group. (I plan to find out) I went ahead and downloaded the app to test it out. You can hold your phone's camera lens near the barcode of the food item and it will read it.  Then you are taken to a webpage that gives you information about that product - including calories, saturated fat and even if it has GMOs. To set up the application on your phone, you enter 6 pieces of information.  One of them is your weight.  When I got to that screen, there was this message "the average woman weighs 160 pounds and the average man weighs 190 pounds."  I am pretty sure it said the average American....  Let me make something very clear - the average weight is overweight or obese - greater than 60% of the US Population falls into this category.  In fact, the NHIS released data reports today that show the obesity rate is at about 30% currently.  Many women who weigh 160 pounds are not at a healthy weight.  Do NOT be comforted or fooled into thinking that  a 'normal' or 'average' weight is good. (I am not speaking to anyone individually here - a healthy weight is determined by your blood work (glucose, cholesterol etc) and blood pressure, physical stamina, physical and mental comfort, etc) I read the statement re: 160 pounds yesterday and today the NHIS brief was in my mailbox.  I thought that was a neat coincidence. Here is the latest data - in graph form.  This comes from the CDC.  <table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmfPK-o1KkxbtmnvufoaqmvY8AUTf-Aa-W3_R_Qb0PrjBapi9YKUK2QtnxW9yd316VqVq8WNjgysnuDbcDbd4BYMYW0WbvthDJlU-rX_Id0oNnAWsWZIFOFTA9leyl2aopKz5OPOesnH10/s1600/obesity+2012.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="477" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmfPK-o1KkxbtmnvufoaqmvY8AUTf-Aa-W3_R_Qb0PrjBapi9YKUK2QtnxW9yd316VqVq8WNjgysnuDbcDbd4BYMYW0WbvthDJlU-rX_Id0oNnAWsWZIFOFTA9leyl2aopKz5OPOesnH10/s640/obesity+2012.JPG" width="640" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">NOTE: this is one of our Health Indicators... The goal is that white line... we want to be UNDER it.</td><td class="tr-caption" style="text-align: center;"> </td></tr></tbody></table>  Remember that excess weight is associated with metabolic dysfuntion.  This puts a person at risk for diabetes and heart disease.  The state of obesity in this country affects children and adults.  It is not okay for our normal to be unhealthy.  Adults are living longer sicker and our youth are expected to have shorter life expectancies than their parents.  Its a serious problem.

When the average is a bad thing.

A frien d shared a smart phone app with me yester day. It is called Fooducate. You can visit the webpage by cli cking here . If yo u hav...

7:13 PM

Odds and Ends

McDonalds - two things here.  The first is related to the use of branding and marketing by fast food companies, especially McDonalds.  With regard to childhood obesity, there is grave concern about the outcomes when we market cheap, high energy dense nutrient poor foods to children.  If children were not the target of restaurants like McDonald's then movie characters wouldn't be on their glassware and toys wouldn't come in the Happy Meal.  At least one state is proposing legislation that would prohibit this toy association if certain nutrient criteria are not met.  I think that it is a grand idea.  The second item regards this new concept of tailored or focused ads.   As companies learn all about us from our on line activities, promotions are supposed to reflect our true desires, needs and habits.  Probably this strategy needs some tweaking as I received a whole booklet of McDonald's coupons in the mail this week.  None of the offers included salads! P.T and the Back - I was talking with a physical therapist this week about back care.  From reading the blog, you might be aware that the guidelines for treating chronic, even acute, back pain have changed in the last decade.  It is now considered unwise to treat back pain with bed rest and pain pills.  This particular  physical therapist (who has a doctorate) said it another way.  "The best thing you can do for a hurt back is to keep doing everything you did before you hurt your back."  Amen. Weight Watchers - Though I find the WW program to be the best lifestyle approach to maintaining a health promoting weight, I do not endorse the point system or the WW branded foods, per se.  The foods in the grocery store are processed foods, but if one was going to buy calorie controlled meals, WW would be just as good as an another.  It does exclude a good portion of persons who could benefit from the low point foods, as they cannot afford them.  I say all this and then admit that I will buy a WW branded food if the nutrient content appeals to me.  I bought one such product this week.  I like to use low calorie spreadable cheeses on Wasa crackers and usually buy the light Laughing Cow wedges.  This week at Wal-Mart the Laughing Cow was 50 cents more than the WW brand and the WW wedges have a few less calories.  I did not pay attention to the cost per unit though  and realized later that the WW brand had 6 wedges and the Laughing Cow had eight! Trusted Sites - I do not have time to vet the many - hundreds, thousands, of websites that offer nutrition advice and include calorie need calculators.  Because some of you are feeling a need to adjust your intake, let me share two sites that as of today I do trust.  These are  from the US government's <a href="http://www.mypyramid.gov/mypyramid/index.aspx">MyPyramid</a> and  The Cooper Institutes's <a href="http://www.standupandeat.org/index.aspx?id=tools">Stand Up and Eat</a> program.  PCBs - This abbreviation is for the chemicals Polychlorinated biphenyls which were used in manufacturing until being banned in or around 1970.  The are toxic.  Of course, products that contain them are still in use or in landfills.  PCBs are still contaminating our soil and water.  This past week a warning about eating large mouth bass and catfish from some North Carolina rivers/lakes was announced.  In fact, we were told to not eat these fish at all due to very high levels of PCBs.  I bring this up to make a political point.  There is some discussion about whether or not the EPA should have such "strict" standards on emissions and chemical agents and to that I say YES - they should - these contaminations affect health, tourism, jobs, animal and plant life.  It is time to give a damn. Arthritis -  I saw an ad while visiting one of my (web) home pages.  It was from the Arthritis Foundation and the Ad Council.  It said "Moving is the Best Medicine."  Very cool.  In the sub text it advised that exercise and weight loss would be helpful in managing arthritis. Lung Cancer - Here is exactly what the commercial or PSA said - you can make the obvious conclusion.  "Among non-smokers radon gas is the leading cause of lung cancer." Pumpkin Spice - OMG - Have you seen the video or had any of  my pumpkin cream cheese?  I modified a recipe that my sister had - fat free cream cheese, pumpkin, nutmeg, cinnamon and splenda.  I add a little water when I whip it so it is fluffier.  Well, it may be an acquired taste but I really like it especially on a certain Jacobsen's Cinnamon Toast.  Anyways,  I just noticed a Pumpkin Spice Cream Cheese at the grocery store.  I don't know - better start copy right patent proofing my recipes :)

Odds and Ends

McDonalds - two things here. The first is related to the use of branding and marketing by fast food companies, especially McDonalds. With ...

6:17 PM

The GAO Gets Genetic

I didn't want my title to be so clever as to prevent you from reading, but my post is about the genetic tests that are marketed to YOU in magazines, Internet ads and on the TV. I have already told you that they are not ready for prime time and that the biggest concern from some experts and certainly from me, is that people will rely on the test results over common sense and family history. This view is vindicated in a very recent General Accounting Office report. I really think that you should read the whole thing. It is a 33 page pdf document that can be accessed <a href="http://http//www.gao.gov/new.items/d10847t.pdf">here.</a> The GAO investigated several genetic tests and the companies that make them in 2006. They found them to be unreliable. They also found that the companies made disease predictions that were not medically valid. Since then, new tests have been developed and placed on the market. Some companies suggest that they have the support of experts. Very recently big chain drug stores agreed NOT to sell these new tests. The field of human genetics is a remarkable and valid science. Please do not take my strong distaste for the direct to consumer marketing of retail tests to be a judgment against the science. It is not. Genetic testing and counseling has been in place for many years and for a number of diseases it is VERY accurate. The tests that are currently available for YOU to buy and use at home with a saliva DNA test are NOT scientifically valid, useful., accurate, legitimate or endorsed by the leading genetic experts. In fact, the GAO report has some charming quotes from some of them. Let us see, one person described them as "complete garbage." Another expert used the word "horrifying" and still others noted my most pressing concern which is that people might get a test result that demotivates them to make healthy lifestyle decisions. Some of the companies try to sell supplements as well. They say the pills will prevent certain diseases. This is an illegal statement. The claims are fraudulent. The advertising tactics explained in the report are despicable. I would NEVER purchase these 300 to 1000 dollar kits. It just gets crazier. Some of the people in the "sting" operation actually had the diseases that they were tested for and told that their risk for getting that particular disease was low. The GAO sent the same DNA sample to different companies and got completely different results on the same diseases for the same person. Companies offered consultation but rarely did more than regurgitate the results. People were told to talk to their doctors, but I gotta tell ya, the average doctor doesn't know what to do with these results either. That is NOT a reflection on the doctor but on the tests. I write this blog in order to help people make decisions on things to do and not to do in order to increase their chances of a long, quality, active, limited diseased life. The best that any of us can do is know what has happened to people both with similar genes as ours (our family) and with similar lifestyles (people who smoke for example, or don't exercise or do exercise, etc). If you want a valid prediction of what will happen to YOU - that is where to look for answers and place your bets. This sentiment is stated quite directly in the report. One expert suggested that people send in the DNA sample, the 500 dollars, complete the family history profile and then through out the DNA results and go from there! Please read the<a href="http://www.gao.gov/new.items/d10847t.pdf"> report </a>- a government agency doing something to protect the consumer from fraud. It is a good thing. (btw, the GAO report is not a clinical study or rigorous research, but it is informative)

The GAO Gets Genetic

I didn't want my title to be so clever as to prevent you from reading, but my post is about the genetic tests that are marketed to YOU i...

4:00 PM

Respect Your Feet

Not only do I now have more respect for my feet, I also have it for a certain organization. Actually, I have always taken care of my feet as I am a runner and though I can get through many aches, pains and strains, I cannot run on a hurt foot. When I heard about cosmetic foot surgery however, I was a bit aghast. I sought the opinion of the American Orthopedic Ankle and Foot Society also known as AOFAS. They issued a press release on this topic in June and you can read it <a href="http://www.aofas.org/Scripts/4Disapi.dll/4DCGI/cms/review.html?Action=CMS_Document&DocID=313">here</a>. It definitely cautions against having these surgeries, which include toe shortening and fat injections. Yes, because wearing high heels is often uncomfortable at the balls of the feet, some podiatrists will take fat from another part of the body and put it into that tender area. Comfort is only one of the reasons women, mostly, have this elective surgery. Another reason is to beautify the feet for the super exposure they get in what we women call strappy shoes. I am the last person that will have this surgery because for five or more years, I have eschewed heels in general. I do buy gel pads to put inside my shoes though and so I get that, and SURE it is nice to have something to do with the fat we don’t need, but the AOFAS is very clear to point out that the risks are significant with these procedures. I want to add that I am now impressed with the folks at AOFAS for more than their stance against the surgeries. I clicked around on their website and found a link regarding healthy eating. SEE – there is nothing that being overweight doesn’t effect. Along with encouraging us to maintain a health promoting weight, the clinicians suggest that we engage in regular physical activity to avoid arthritis. Additionally, they address osteoporosis and encourage adequate consumption of vitamin D and calcium. I also learned that one of the first indications that a person has osteoporosis is a stress fracture in the foot!

Respect Your Feet

Not only do I now have more respect for my feet, I also have it for a certain organization. Actually, I have always taken care of my feet as...

5:43 PM

Odds and Ends

Tamiflu - an email came out this week from the nonprofit organization Public Citizen noting some research that the benefits of using Tamiflu in reducing duration, symptoms and severity of the flu is highly exaggerated by the makers of the medicine, Roche. In fact, the headline was Scamiflu - pretty funny that. Juicers - I have heard commercials for juicers recently. I imagine that this is due to it being the holiday season. The ads are misleading in that you get the impression that juicers are really healthy. Sure making your own juice has got to be better than buying juice, but that isn't the point. Eating fruit is the healthiest option. Fruit contains fiber along with fructose and drinking juice without fiber " in its natural state" is not so wise a thing to do. You consume more calories and more simple sugar. Fosomax - At a conference this week, some positive words were offered in regards to oral bisphosphonates like Fosomax. Two separate studies, retrospective, have shown that women who have taken these drugs for at least one year have less incidence of breast cancer than women who have not taken them. This is not a clinical study however, so no conclusion can be drawn. It is probable that people will be enrolled in a study in the future in which some are given an oral bisphosphonate and others placebo and those people followed over time. The results of the studies have not yet been published or evaluated by the medical community. The drugs do have a history of being effective in preventing bone loss, but concerns about side effects have also been raised. Peanut Butter - I just have to say, because it is a passion - even mission - of mine, to have all the world eat Smucker's All Natural Peanut Butter, or at least that type of peanut butter - why would anyone NOT. Just remember that the peanut butter of your childhood is not good enough for your kids and not good enough for you. If the ingredient list is long and unpronounceable, it is NOT wholesome. Peanuts contain good, heart healthy fats (so reduced fat is not needed). Buy a brand that contains peanuts - or peanuts and salt - PERIOD. Trust me, the added oils are not needed and your daily dose of Omega 3s should be in grams not milligrams... Just trust me.... (Go NYG - game on!)

Odds and Ends

Tamiflu - an email came out this week from the nonprofit organization Public Citizen noting some research that the benefits of using Tamiflu...

4:59 PM

Odds and Ends

Okay it IS odds and ends day and I have my note card here to remind me of the week's thoughts, but I have to say, I am reading a fascinating article from the online mag, Financial Times, regarding the creation of statin medications and especially the "wonder drug" Lipitor. I hope to write about that tomorrow. The Impact of Pictures: My family is busy these days so maybe this blog post will escape their attention. I always think about that because they know me in ways that the general reader does not. It is good that my readers do not know everything but today I will tell you a little something. It is not so earth shattering. I have said before that I was once, for a significant period of time (5 plus years), quite overweight, even my family has forgotten how much overweight I was. Over the holiday I got my hands on some old photos and well.. ouch. And it isn't that I have forgotten, because I never will, but seeing the pictures breathes life into the fears I have of being that girl again. It was not a happy time and in that I can tell you, "food does not make you happy." Unfortunately (?), the fear of the past makes me extremely disciplined and that upsets people, like my Mum, much more than it upsets me. I would rather skip all the extras (food wise) and be comfortable in my own skin. It keeps me content. That being said, my rigidity is mine, I own it and I do NOT encourage it. At the same time, it is worth emphasizing that my extremism does not excuse you from doing your own due diligence. We have to do what works for us, and being overweight is not going to "work" for anyone. Excesses: In America, we have just finished the Thanksgiving Holiday. People make a whole lot of food to celebrate a time we do not remember. What we are really doing is giving thanks for blessings and abundance, which, in my personal sphere, is possible. I hope that everyone enjoyed the day and then moved on - back to the routine of moderation. There are some who have difficulty moderating. A friend told me today that she quickly clears the home of all the extras - pies, stuffings, heavily sweetened or buttered casseroles and such. I think that is a good idea, of course, she does her best not to make too much to begin with, but in the end, it is better to toss it then to wear it. Toys v Candy: This story is true. This story only got more interesting as it went along. This is something I observed today and as it was happening, my blogster mind was at work. I was in line at the grocery store, where I must say, I am most often aghast. Today I was behind what appeared to be a three generation trio of women. The youngest of these was approx. two years old. The grandma, not old at all, possibly 50, gave the child a plastic "magic" cell phone that was on a rack near the register. I noticed her reaching for the phone, I saw the price on the shelf, about three dollars, and I thought WHOA that is too much money, BUT it is so much better than giving the kid candy which is what so many others do. That little girl, she was so happy! She chatted and laughed and her eyes were all lit up. I had to smile myself. And when they were all paid up and about to leave, I thought I heard the woman I assume to be the grandma, say "I'll get you another one." But she didn't, she TOOK IT AWAY and put it back where she had gotten it from - they left the store with the previously happy and content toddler squalling at the top of her lungs. Oh MY, I was just stunned - cruel I thought it was, but that is a harsh word. A few hours later though, I thought OMG - they put that phone BACK on the shelf!!!! What if your kid puts it next to his or her MOUTH next.... ? SIGH... I really need to stop shopping, it causes me stress. WLS: I wouldn't even know that acronym if it weren't for my dear dear friend who had Weight Loss Surgery. She knows, and regular readers know, I OPPOSE it, it seems crazy and reckless and extreme and scary and well, I have run out of words, but I don't like it. At the same time, I want my friend and others who suffer with severe obesity to lose weight and regain their health, so I support her and those like her, 100%. Today, however, I heard a commercial on the radio that got my dander up. First a woman spoke, she spoke about being very much overweight and thinking every day when she woke up that she wouldn't eat (mistake) or she would eat less, but at the end of every day, she had failed. Then the man says that he is so big his son has asked him to stop taking him to school. Now I have to say, the man sounded like an actor and the woman sounded a little more legit. Then the commercial went on to promote weight loss surgery and it irked me. If a person truly needs this type of extreme, invasive, risky intervention, then let the person's primary care physician make that call... it isn't like the person is choosing a household product, it is a life changing, extreme medical intervention... and that is the end of the odds and ends..... remember - you cannot indulge every day without paying the consequences - so Thanksgiving is OVER people... :)

Odds and Ends

Okay it IS odds and ends day and I have my note card here to remind me of the week's thoughts, but I have to say, I am reading a fascin...

4:57 PM

There is a Guideline for That

Medical and voluntary health organizations as well as governmental organizations and departments of health often propose guidelines for treating specific diseases. The guidelines are meant to offer a treatment outline that is based on the best data available on efficacy and safety. Not all recommendations refer to the use of drugs. There can be guidelines for treating sports conditions for example that physical therapists follow in regards to exercises to prescribe. I am most versed in the Clinical Practice Guidelines for Treating Tobacco Use and Dependence because it is my job to promote them. They ARE backed by our Department of Health and Human Services and the CDC as well as some medical organizations. Two other guidelines that come to mind are for the treatment of hypertension and the treatment of high cholesterol. Today I read the Guidelines for Treatment of Erectile Dysfunction. Yup, I am all about promoting penile health. These guidelines are not the official position of any other agency at this time, but they are formed out of research from several random controlled clinical trials and they are offered by the American College of Physicians to whom I give some clout. In the analysis of existing studies, the scientists have determined that hormonal therapy for erectile dysfunction is not recommended as a first line therapy, but may be applied to individual patients based on their presenting symptoms. Erectile Dysfunction is defined as not being able to maintain or sustain an erection sufficient for satisfactory sexual performance, consistently over time. Treatment is indicated if the problem exists for three months or more. In other words, if a man cannot get an erection after being out all night drinking, that is not ED. Of course, I like the phrase "satisfactory sexual performance" - is that subjective or does the partner get to offer an opinion?? These guidelines recommend the use of erectile dysfunction medications such as Viagra, Levitra and Cialis as well as two more. Can you believe that there are 5 different medicines for this condition?! The drug names are sildenafil, vardenafil, tadalafil, mirodenafil, and udenafil. They are Viagra, Levitra, Cialis, no brand name yet - drug under study, and Zydena which is not for sale in the USA (respectively). The class of drugs is referred to as phosphodiesterase type 5 or PDE-5. I am beginning to doubt my professors who assured us that you have to have a drug that treats an illness more completely or safely then an existing drug or a drug to treat a condition that is not yet treated in order to get an approved new drug application from the FDA. Why are there FIVE or at least THREE in the US. The research shows that all five are equally as effective and have minimal side effects. The clinical guidelines do NOT recommend one drug over the other and say that the decision should be based on patient and doctor preference, side effect profile and / or cost. [I am going to guess the patient will request the one that had the best commercial] Here is a link to more info on ED [it does discuss hormonal therapy but the guidelines state that the evidence for benefit is inconclusive] <a href="http://www.medicinenet.com/impotence_ed/article.htm">http://www.medicinenet.com/impotence_ed/article.htm</a> ED can be associated with age, weight, diabetes, heart disease, depression, prostate cancer, low testosterone levels and smoking.

There is a Guideline for That

Medical and voluntary health organizations as well as governmental organizations and departments of health often propose guidelines for trea...

4:35 PM

Cholesterol is Better On then In

What? Exactly. In a popular magazine article about skin care, I read that though water was a great hydrator for the body, it was not what one should turn to for acute dry skin issues. The benefits of sufficient water intake are numerous, but include proper care for our vital organs and assistance with digestion. And without water, we will die. I know from my work in health care that the skin can be used as a test for dehydration. Doctors or nurses may pinch the skin on a person's forearm and watch to see if the skin goes immediately back in place or puckers for a moment. Go ahead, try a little pinch on your arm.... Being dehydrated and having dry skin however, are a little different. In the article I read, it was suggested that the best care for skin was a moisturizing lotion BUT the better lotions have fatty acids, even cholesterol, in them. Apparently, (and a bit of Internet research confirmed this) we have surface lipid on our skin (lipid is a fat - including triglycerides and cholesterol) and if it is depleted, the lotions can help replenish. It was also said that this lotion based cholesterol would not enter our blood stream - so that is cool. Look at your labels, of course cocoa butter contains lipids as do lotions with stearic acid, or probably any "acid" words. There are oils in plants, plant sterols are lipids, but also know that some come from animals (esp. most stearic acid), so if you are a vegan, you might watch out for your lotions. I am guessing that "not tested on animals" doesn't mean they weren't made from animals.. eek. I found something positive to say about triglycerides and cholesterol.... but no where did I read that trans fatty acids were essential to good skin, so they are still EVIL. By the way, other environmental factors can effect ones skin. These include sun, wind, cigarette smoke and even hot water. (in the winter it is possible to bathe every other day and still keep your friends - unless you are getting your daily moderate to vigorous exercise and sweating alot)

Cholesterol is Better On then In

What? Exactly. In a popular magazine article about skin care, I read that though water was a great hydrator for the body, it was not what ...

4:50 PM

CORN

In response to an article regarding biofuels, a person wrote a letter to the editor opposing the use of corn as ethanol. It wasn't just any person. It was the CEO of Smithfield Foods. I read his letter and was being swayed against corn as an alternative fuel product, especially as he argued that the price of corn has risen significantly because of federal policy that drives its use. Mr. Pope argues against using a food crop in this manner. Well, that does make sense. It made more sense though when he noted the adverse effect this has on livestock who have corn as a staple in their feed. I do not want to deprive cows, horses, pigs and even chicken, of their food. Also, I do not myself eat those animals. Actually, I eat very little corn (only those baby corns) and no meat or poultry. In the end however, Mr. Pope's rationale made me like the idea of using corn for fuel. He indicated that our current policy and those that increase ethanol mandates would adversely effect price, sales and I know he also meant consumption of cereals, meats and sodas! Ah so Mr. Pope. Using corn for fuel could reduce the obesity rate (less red meat and foods sweetened with high fructose CORN syrup) in this country - and I thank you for pointing that out!

CORN

In response to an article regarding biofuels, a person wrote a letter to the editor opposing the use of corn as ethanol. It wasn't just...

4:49 PM

Direct from Wisconsin

Some highlights from the Smokeless and Spit Tobacco Conference that I attended today: I had been aware that the nicotine absorbed from smokeless or spit tobacco was not uniform. Just as there are different amounts of cancer causing agents in products, the nicotine level can vary. The nicotine absorption is also affected by the user. In other words, nicotine absorption can be affected by how long the product is kept in the mouth and if the dip or quid moves around in the mouth. But much more than that, nicotine content can vary by as much as 14mg per 2 gm pinch. Knowing this, I now understand why trials of nicotine replacement therapy have failed to increase cessation rates in smokeless tobacco users. You have to substitute the same amount of nicotine that you were receiving in your tobacco product when you quit and use NRT. If some people were getting 30 to 40 mg a day of nicotine but using a 21 mg patch, well there you go, failure. It would be and is hard then for tobacco cessation specialists and physicians to know what dose of NRT to recommend unless we have the data on nicotine level at our disposal. When discussing whether or not smokeless tobacco (SLT) use would be better than smoking we have to look at context. If someone uses NO tobacco and then starts using SLT because it was marketed as “safe” it certainly is NOT harm reducing. No tobacco use is far safer than any SLT use. If a person is smoking and also using SLT it is not harm reduction. However, if a person switches completely from smoking to SLT only, it does reduce harm for that smoker. I was surprised by a statistic today. We were looking at several variables and in those variables the number of smokeless users, concurrent users , smokers and non tobacco users and in all categories but one there were more non tobacco users YEAH! The only category that had more smokers than non smokers was in the unemployed. Now we can play with that statistic. For example, is it that smokers are not hired, or that smokers are fired? Or is it that people lose their jobs and become smokers? Whatever it is, the persons that can least afford the financial and probably health effect cost (no insurance or Medicaid) are the ones using the most!

Direct from Wisconsin

Some highlights from the Smokeless and Spit Tobacco Conference that I attended today: I had been aware that the nicotine absorbed from smoke...

7:42 PM

Odds and Ends

I observed a beach cleanup this weekend which involved a group of children who appeared to be middle school aged. They did a great job and obviously learned about our environment and the effects of littering and pollution. The cleanup occurred at one of Florida’s tobacco free beaches. I was dismayed however when I saw that their reward included French fries, Fritos and soda. I bet they would have loved some water melon and a cool water bottle. Speaking of food! I made it through airport security in Tampa with all my food this time. I did not try any freezer pack but was happy to eat my Wasa crackers and Laughing Cow 35 calorie cheese wedge on the plane. Other items in my lunch bag included, grapes, an orange, veggie lunch meat, string cheese, two or three cookies (low cal of course), a granola bar and self made peanut butter crackers. Well… I was going from Tampa to Madison WI. Oh and there is a grocery store one half mile from my hotel. Speaking of traveling J I was rather stunned at the amount of disabled persons at the airport. I guess because it was the second time I have traveled recently and have seen a lot of older persons in wheel chairs. I do not remember it this way. I guess itI could be for a number of reasons. There are more older persons and there are more diseases related to poor lifestyles that can lead to disability. I read today that there were 12 million persons aged 65 and older who were considered disabled. To follow up on my breastfeeding blog yesterday I want to give the definition of exclusive breastfeeding that is used to conduct the studies. Exclusive breastfeeding, based on the WHO definition , refers to the practice of feeding only breast milk (including expressed breast milk) and allows the baby to receive vitamins, minerals or medicine. Water, breast milk substitutes, other liquids and solid foods are excluded. Also, I failed to mention yesterday that the issue with the infant formula in Vietnam also included advertisements that allude to outcomes of intelligence and height in children who are given the formula………. In regards to disability, much can be prevented by adopting an exercise routine. The Physical Activity Guidelines for Americans includes recommendations for every single age group and the disabled. Even older persons are encouraged to do 30 minutes of moderate intensity activity 5 days a week. There is no UPPER limit, the guidelines states that more is better. The minimal 30 x 5, the better 60 x5 and the exchange is vigorous activity instead of moderate at 25 x 3 or 25 x 6. (that is minutes per day but 150 minutes or 300 minutes total of moderate, 75 to 150 vigorous, it is better to spread it out though) Health Care Reform bills are promoting measures to include wellness programs and disease prevention. It is hoped that after passage of a bill, insurance companies will cover these types of programs and providers will be compensated for encouraging weight maintenance and physical activity. Now, to overcome the providers’ reluctance to “hurt your feelings” we may have to pay a lot… plus an additional reward for providers taking their own advice!

Odds and Ends

I observed a beach cleanup this weekend which involved a group of children who appeared to be middle school aged. They did a great job and ...

3:19 PM

Breastfeeding: USA vs Vietnam

As a lay person, I know that breastfeeding is important. As a health educator, I understand that it is something to be encouraged. Before seeing a story about the state of breastfeeding in Vietnam this morning, I knew that breast milk was so health promoting that even smoking mothers were encouraged to do it. The benefits of breast milk outweigh the effect of nicotine or the other chemicals in cigarette smoke. I did not know that our Healthy People 2010 had established goals for exclusively breastfeeding infants up to three months (60%) and six months (25%). These numbers are similar to global targets put forth by the World Health Organization. To learn more about Healthy People goals, objectives and progress see link below <a href="http://www.healthypeople.gov/">http://www.healthypeople.gov/</a> We have made a lot of progress in the percent of mothers who EVER breast feed, but not so much with the exclusive or continuous breastfeeding. Breast feeding is encouraged for at least the first year and on through the second year if possible. The article about Vietnam was eye opening on several levels. The first is that the country’s rate of continuous, exclusive breastfeeding up to six months is only 17%. A real problem in the country is the aggressive marketing of infant formula. Interestingly, the formula makers, even ones from the USA are treating doctors, hospitals, health care workers and clinics in much the same as our drug reps treat them here. They encourage them to promote the formula, through lunches, office furniture and even commissions. It is illegal to do so, but the fines for breach are very low. The economy there is worse than ours and the doctors are paid very little. The benefits of breastfeeding are not limited to the child. Breastfeeding improves the mother’s health and also is economically beneficial. According to the CDC and other sources, like WHO and UNICEF, the benefits include: Less risk for ear infections and skin conditions, like eczema, less gastric upset and diabetes, decreased risk of sudden infant death, obesity and chest or lung infections – there is much less risk of chronic disease and diarrhea also - all lowers infant mortality rates For the mom who breast feeds, there is less risk of diabetes, ovarian and breast cancer I guess what strikes me the most from exploring this more today is the numbers. Ever breastfeeding numbers have increased throughout the world and this is a fantastic thing. They are high in the US and high in Vietnam - over 75%. The goal for all countries however, is to increase the rate of exclusive breastfeeding for the first six months. The goal of the US is again, 25% and of Vietnam, 50%. And my most interesting find is that the US rate is at 11% for the continues exclusive up to six months and Vietnam’s rate, the rate that was so alarming as to warrant the investigation on the infant formula companies, is 17%. I guess we need to do a little better oursevles USA.

Breastfeeding: USA vs Vietnam

As a lay person, I know that breastfeeding is important. As a health educator, I understand that it is something to be encouraged. Before se...

5:45 PM

Exercise Equipment Claims

In the ACSM Health and Fitness Journal an article similar to the ones I have been writing about claims on meds, diets and supplements discusses claims for exercise equipment. The first point made is one we hear often. If it sounds too good to be true then it probably is not true. You may have seen advertisements for machines that claim to burn more calories than a treadmill. According to the ACSM these claims are rarely justified. The ad may say for instance that there was a clinical study, but that tells you no more than a clinical study about a medicine tells you. That it was done does not mean it found anything to be true. Often times the promotion states that the two machines were used at the same speed and the one burned more calories than the other, but it doesn't add that the intensities of the two machines were different. It is also said in this article that machines that boast being low impact are not really the machines that we would want to use unless we had a medical condition such as osteoporosis. In fact, the ACSM states, "most clients should be encouraged to judiciously include impact-generating exercise." The ACSM also clarifies that "fat burning" exercise is not the answer to weight loss, but that the number of calories burned from any source are what matters. The formula for weight loss that the ACSM advises is this: intensity X duration X frequency. If you can do a low impact activity longer and more often then it may be best for you, other wise, moderate intensity activity is best. Also validated or invalidated as the case may be, are the calorie burned amounts offered by machine readouts. Even when you can enter your weight and age and your heart rate is monitored the machines can be off by as many as 1000 calories! Remember what has recently been said, calories are hard to burn. Do not expect 30 minutes on the treadmill to burn 200 hundred calories. Any machine that claims to reduce the size of a specific body part, like your abdominal area, should signal warning bells. No one can spot reduce. Often when an ad claims inches off your waist the fine print includes that results are not typical and that results are dependent on exercise AND diet. Look for peer reviewed research if you are on the fence about one of these claims. And remember, you want something that is clinically proven with statistical significance. The research should involve a large group of people and have a comparison group that did not use the same equipment.

Exercise Equipment Claims

In the ACSM Health and Fitness Journal an article similar to the ones I have been writing about claims on meds, diets and supplements discus...

4:15 PM

Support from the NFL

Today I want to give a shout out to an NFLer who really doesn't get a lot of good press. The reason he gets kudos from me and on my health promotion site is because he is a big man who eats a whole lot of calories and does a lot of physical activity, including a very serious weight training routine, but still chooses to eat healthy to get his calories. In fact, he orders his food in much the same manner as I, and that, from a 6 foot 3 inch 223 pound man, is something to share with the world! Terrel Owens, a wide receiver for the Buffalo Bills was featured in a WSJ article on "What's Your Workout" this week. In discussing his diet, or what he eats on a regular basis, he spoke of lean proteins such as chicken, grilled fish, low fat yogurt and egg whites. He is quoted as saying that he eats five to six small meals a day, hello, just like ME! He also eats whole wheat pasta and steamed or raw vegetables. When he gets a salad at a restaurant he tells them to hold the bacon and cheese, JUST LIKE ME! If he is going to be on the road a lot, though, he brings a chef along who can prepare him healthy meals. I am my own chef, but he could hire me. He also avoids sweets. Oh and one of the best things he said is that he no longer drinks protein shakes or really any kind of liquid calories, preferring to eat real food to get the protein that he needs. Man oh Man.. he just validated years of what I have been saying.. Cool Beans. If I ever get to do a community based obesity intervention and he stops pissing every body off, he can be my celebrity spokesperson!

Support from the NFL

Today I want to give a shout out to an NFLer who really doesn't get a lot of good press. The reason he gets kudos from me and on my hea...

4:51 PM

Pfizer Pays

In my paid work, I address (educate) health care professionals, students and groups of persons interested in the field of tobacco treatment. Because of this, I learned about FDA approval processes and guides for using medications. In my presentations, on some level or another, I explain that a medicine becomes available for use through a process that involves applications to the FDA, lab tests on animals and experiments on humans, phase I, II and III clinical trials, panel recommendations and final FDA approval. The FDA approval will be for a certain indication and whatever that indication is, is what the drug company can market and promote the medicine to treat. You have heard me say this here, but again, this is FDA approved use or first line use. (As an aside, drug companies do have to create a drug to treat a condition that no other drug treats, or treat a condition more effectively than an existing drug, or do the same as an existing drug, but with less side effects, etc) Once a drug is approved for a condition, the drug company can do its promotion, its commercials and such, for that FDA approved purpose. IF it turns out that the drug also treats another condition or one of its side effects is something beneficial to people without the disease condition, a physician can CHOOSE to prescribe that drug for an off label use. Legally. A company cannot blatantly market the drug nor offhandedly promote it for any other use. This includes spending money on doctors and nurses with gifts and meals, handing out samples and mentioning that Geodon(antipsychotic) might also work on children, or Bextra ( NSAID like Vioxx)is good for a sprained ankle, or Lyrica (for epilepsy) helps with pain. Pfizer has just pleaded guilty to illegally marketing Bextra for acute pain and for promoting at least Geodon and Lyrica for off label uses. They have to pay 2.3 billion in settlement costs. I was witness to these events. Drug reps from Pfizer came to the hospital with gifts and suggestions, they hosted dinners for interns and certain Attendings appeared to be educating others on these off label uses. I know that we prescribed Lyrica to treat pain, which was legit, but I don’t know how we figured out to try it. I myself was given samples of Bextra to take for an acute running injury, which was an off label use. Pfizer is being watched more closely as this is the third time it has had to settle in court for such behavior. It is on a 5 year special scrutiny list and a reporting system is being set up so that clinicians can report when they feel a Pfizer rep was inappropriate. There were 13 drugs involved in this particular case.

Pfizer Pays

In my paid work, I address (educate) health care professionals, students and groups of persons interested in the field of tobacco treatment....

5:03 PM

Lessons from Bears

Bears are getting ready for winter. Some bears are showing up in people's houses, breaking into their cars and rummaging through their trash. Bears are getting aggressive in their pre hibernation efforts, especially in Colorado. People have been told for years, not to feed the bears, but have not listened. Now people in some Colorado towns are being beseeched to scare the bears away.. yell, throw rocks, call the police, but do NOT encourage the foraging beasts. Here are some things to be learned from the experience of Coloradans : 1) Processed foods that people eat are high in fat and calories 2) Berries, nuts and plants are low in both 3) To gain weight for the winter's rest, bears consume about 20,000 calories a day 4) It is easier and more efficient to eat the foods found in cars, trash and kitchens, then to eat hours and hours and hours of plant based foods 5) If you do not want to gain layers upon layers of fat like bears do, then eat the plant based diet!

Lessons from Bears

Bears are getting ready for winter. Some bears are showing up in people's houses, breaking into their cars and rummaging through their ...

5:52 PM

Odds and Ends

Another week has ended..for me time flies, for others it drags... I understand this. I have a few scraps of paper here with jotted down notes. The first few regard calories, specifically our discretionary ones. One of my dear friends sent me part of the package from some disposable plastic containers she recently purchased. Why? Because the label says that they are perfect for 100 calorie snacks. My friend wondered if people might think that the container could be filled with anything and have 100 calories.. Good call. And wow, that would be very cool! My mom mentioned that her yogurt had 11g of sugar and asked me if that was a lot because it sure seemed like a lot but it only had 80 calories. First, YEAH Mom for reading your labels! Second, well, I told her that I try to have no more than 8g of sugar per serving in any product when I can, but that it didn't seem awfully bad. I looked at my yogurt just now and I have two. One is a Dannon brand and the other, Walmart, both are the low calorie kind. And well, I know at least one of my friends will think I make this stuff up, but seriously, the Walmart value brand only has 8g of sugar per serving and the national Dannon one has 11g. The one my Mom was talking about was the Publix Supermarket brand. Oh and I would add that we are allowed about 24gs a day for the 6 teaspoon of sugar recomendation, so Mom has three left after her yogurt! Another friend, they all send me bits of info so I have something to do in the evenings, told me about this new cream she bought for her face. It has shiitake mushrooms in it. I thought you were supposed to eat them, but of course, there is soap with yogurt in it so what do I know. My friend bought the facial cream because it was recommended by two older women who looked phenomenal and swore by it. Just a quick search and I can see that there are properties in the mushrooms that may be beneficial but I did not uncover any good research studies to prove the hypothesis. Now, here is a real humdinger. Be fit or be a frog.. a real issue to ponder. Let me tell you what happened...It involved two completely different events. Earlier in the week, during one of my tobacco education classes, a student challenged the notion that quitting tobacco and possibly warding off deadly diseases was a smart thing to do. At best, he implied it was unneccesary and at worst, futile... because you cannot change your destiny. The student noted God in the conversation so I refrained from much of a challenge. I thought about it though, for days. I meant to say back to him, but did not, sure, but what if we are destined for some great physical challenge.. shouldn't we live our life so that we could meet it, just in case. I firmly believe that we should take care of ourselves in case we don't get hit by that car or shot by the jealous lover at age 40 or 50 but instead live until we are 90, because living that long without physical and mental faculties intact is just NOT pretty. Then the second thing happened. Last night I caught my cat apparently in the act of getting a frog into the house. The time before I just found the dead frog. So in through the cat "window" came the cat and frog. The frog hopped across my bed and my cat chased after with intent to kill. I scolded the cat and wondered how in the world to catch a frog. Ah plastic ware.. I got a container and returned to the bedroom. Cat and frog were in the closet at this point, I trapped the frog, yelled at the cat again and then went back to the kitchen. How to pick it up??? I returned with a plate. Cat still guarding trapped frog. It was actually easy. I scooted the plate under and lifted all taking the frog out my front door. And away he hopped, headed towards the stairs and a nice tropical courtyard. This morning I walked to my car, and there on the pavement was a sprawled flat dead frog. Surely it was NOT the same frog. But if it was, well, you can't change destiny and that just stinks.

Odds and Ends

Another week has ended..for me time flies, for others it drags... I understand this. I have a few scraps of paper here with jotted down not...

5:05 PM

Sweetness

First, thanks for the comments on yesterday's post! I love to know you're out there... Today 's story first showed up on my yahoo home page last night from several news sources then again this morning in my print news copy ( wall st journal). So do let us talk about SUGAR, added sugar that is, white granulated or sticky syrup SUGAR. The American Heart Association has made a formal recommendation on the amount of added sugar or non nutritive sugar we should consume, if any, on a daily basis. The goal is to reduce overweight and obesity and the diseases so associated. Whether or not added sugar directly causes obesity is not yet proven. What can be said is this: You have a certain amount of calories that you need per day. This amount will keep your weight steady. Which type of foods you use to fulfil that requirement determines what your body will then do for you. So weight aside, nutrients can heal you, fuel activity, accentuate brain power, help you perform physically and keep you free of chronic disease. You can spend all your calories on junk or pleasure-only foods, but you will get a compromised system in return. Your vehicle will be a lemon. The more calories you spend on sugar, the less you spend on lean proteins, good mono and poly unsaturated fats, and the complex carbs that are our fruits, vegetables and whole grains. The American Heart Association recommends that women consume a limited 100 added sugar calories a day, or 6 tsp which should be about 25 grams and men, (of course it is unfair) men get 150 added sugar calories, or 9 tsp at ~ 37 grams. Most of the time the food packages list sugar in grams not teaspoons. This is an approximate conversion as sugar has 4 cals per gram and Rachel Johnson from the University of Vermont who authored the recommendation gave the calorie requirements. I just did the math. Recall that I have suggested that you do not buy any processed food that lists the sugar as more than 8g per serving. Also, determine what exactly that serving size is and act accordingly. Added sugar refers to table sugar and syrup, sugar in processed foods and some dairy foods like ice cream and sweetened yogurt. The biggest source for us is soda and juice. Most women would use all their discretionary sugar and then some in one regular soda. And as you have heard me say, "Lose the Juice." Sugar in juice is discretionary sugar in fruit it is not! Now the American Beverage Association and the Sugar Association are not happy about this AHA statement and want to remind you that there is not a direct link from sugar to obesity, but as you can see, that is not the only reason to avoid sugar. Oh and a last note on a comparison made in the WSJ article that got my dander up.. I KNOW that rarely happens, any ways.. A moderately active middle aged woman might consume 1800 cals while a Sedentary middle aged man would consume 2200 Okay, first HE does nothing and gets to eat more, second, why don't we change just the one variable, ie sex......... and compare the same activity level...

Sweetness

First, thanks for the comments on yesterday's post! I love to know you're out there... Today 's story first showed up on my yah...

4:59 PM

Water

I want to write about water today. Water in the sense of environmental health more so than physical health, but do let me start there. We all need fluids to maintain well, our life. We get the fluids we need both in the things that we drink and the foods that we eat. There was a time when many health care professionals from docs to exercise physiologists were telling us that we need 8x8 glasses of water a day, or 64 ounces. That was never a scientific finding or official recommendation, and most people know that now. We still need water however and where we get it has also been a matter of controversy. I.E “everyone and their water bottles”… plastic and waste, chemicals and landfills, cost and fraud, tap water vs spring..(in bottled water) etc. I live in an apartment and have for the last two years. The water from my tap has an awful taste. I have struggled with this dilemma, as I do drink 60 or so ounces of water a day. Buying packages of bottled water every week is too costly for my wallet and our environment. I tried filling bottles with water and leaving them uncapped in the fridge for say 24 hours, as my niece suggested, but it only took the edge off. I filled my bottles at work from the portable water cooler as often as possible, but it wasn’t enough. I went away for about a week and when I came home, I was unaccustomed to the taste of my tap water again. It was gross. I kept thinking it could not be good for me. Now I have gone back and forth with what to do for almost the whole two years. I looked at filters you add to your faucet and filtered pitchers. I evaluated a home water delivery system, or buying a cooler and refilling it at the supermarket weekly. For a while I bought two gallons of water on the weekend to drink during the week, but even recycling those two jugs was an issue for me. Plastic recycling is not necessarily a safe, economic or even actual thing. I worry about that. So I finally bought a water pitcher which came with one filter and an additional box of three filters, on sale at Walmart I think. Fifteen dollars each. The filters last 2-3 months. It was the best thing I ever did. The water tastes fine. I do not have to carry any cases of water or gallon jugs and I do not have to discard any waste. Also, if it is true that plastic bottles can leak chemicals into our water, I am mostly avoiding that as well. So if you also struggle with this, I recommend the pitchers! My schedule is getting the best of me and I am not sure that I will be able to blog tomorrow. If not, please accept my advance apologies… Deirdre

Water

I want to write about water today. Water in the sense of environmental health more so than physical health, but do let me start there. We a...

6:14 PM

Odds and Ends

My final thoughts for the week: Fiber: Interestingly, I learned one thing new about the positive effects of fiber in the diet. I have long suggested my cereal bars as a great source of tasty fiber with the message that fiber can remove bad cholesterol, keep blood sugar level, help you to feel full and keep your elimination system working well. It can also help to keep the good bacteria working in your gut. The last one is what I learned today. I read an article about food companies adding fiber to everything, which you know I abhor and in that article it was said that the companies are adding fiber because consumers do not like it when things such as sugar and salt are taken OUT of their foods. It was also said that the price will be steep and the outcome will be poor. Many of the new products will have more sugar and fat than is healthy, to go with the fiber. For goodness sakes. Natural sources are best and lowest in calories, remember that. And here again is the cereal bar recipe. http://www.youtube.com/watch?v=qEZkK_Z3deQ&feature=channel_page Diet: Just a note. My friend and I were talking about my passion on wellness and diet earlier this week. In that conversation we talked about the misconception that some people have on the word diet. You see “diet” is a noun not a verb. It is NOT something that you do and if it is, you are bound to be disappointed, but the overall picture of what you consume. For example, my diet consists of lean non meat proteins, many vegetables, fiber and fruit with some monounsaturated fats. That is what I eat on a regular basis. Your diet is the food that you eat not that you don’t eat! Exercise: On my mind this week because I seem to be in a bad place in that regard. My preferred form of exercise is mostly inaccessible and my second and third choices are themselves causing me some difficulty or pain. Even so I have to remember what I have said in one of my side bars, which is, “I will not wallow, I will not whine and I will not succumb.” So each day I find a way to exercise and I keep my chin up and I know that I will find a good place again. Tobacco: Early this week I mentioned that I was seeking the source of the nicotine found in medications that people use to quit smoking, or nicotine replacement therapy. I received an answer from GSK, but now I realize that I didn’t ask the necessary follow up question. Does the nicotine comes from tobacco that cured or uncured? Curing is what creates tobacco specific nitrosamines which are linked to cancer. It is an important question. The same question about nicotine sourcing needs to be asked of the electronic cigarette makers. Sunscreen: This time at the beach I heard a parent say the right thing so that is worth noting as well. A dad came to the beach with his two children, an umbrella, a chair or two, some sand tools and buckets and began to unload. He said to his children, approximately aged 5 and 2, “Ok, the very first thing we have to do is put on your sunscreen.” And he proceeded to slather them up! Me and Julia: And lastly, I saw the movie Julie & Julia this weekend and really enjoyed it. I will say this about me and Julia Child. We both love food, love to eat and love to cook. We both love a place. She loved Paris and I love Sarasota. So she thinks butter is divine and I eschew it in all recipes. She was tall and big boned while I am short and a bit dainty. Otherwise, really, we could be twins!

Odds and Ends

My final thoughts for the week: Fiber: Interestingly, I learned one thing new about the positive effects of fiber in the diet. I have long ...

5:51 PM

Health Education

When the average is a bad thing.

Odds and Ends

The GAO Gets Genetic

Respect Your Feet

Odds and Ends

Odds and Ends

There is a Guideline for That

Cholesterol is Better On then In

CORN

Direct from Wisconsin

Odds and Ends

Breastfeeding: USA vs Vietnam

Exercise Equipment Claims

Support from the NFL

Pfizer Pays

Lessons from Bears

Odds and Ends

Sweetness

Water

Odds and Ends

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