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    Archive for June, 2009

    Number Game: Answer

    waist measuresA two-inch increase in waist circumference equates to an 8 percent increase in colorectal cancer risk in both sexes, and an 8 percent increase in heart failure among men, regardless of “initial” waist size.

    Increases in waist size affects more than the clothes you buy; as you can see, there are also very tangible health-related consequences.

    In fact, waist size is a more accurate predictor of heart disease risk than weight alone.

    An increase of just one inch corresponds to a 4 percent increase in the risk of colorectal cancer and heart disease.

    Mind you, this is independent of other lifestyle factors like smoking, lack of physical activity, or high intakes of saturated and trans fats.

    The good news?  The inverse relationship is also true.  For every inch you lose from your waist, your risk for those two conditions decreases by four percent.

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    You Ask, I Answer: Vitamin B12 Shots

    b12 micI try to get a Vitamin B12 injection every few months in addition to supplementing with pills.

    Is that good enough?  Do you suggest I do one or the other?

    I get the injections because I feel rundown and thought maybe I was B12 deficient.  That’s a myth, right?

    — Dennise O’Grady
    New Jersey

    Assuming your body can absorb B12 efficiently, there is no need for injections if you are getting enough of it from your diet or supplements.

    Let’s briefly discuss B12 absorption.

    In order for B12 to be absorbed, it must combine with intrinsic factor, which is produced in the stomach.  This helps explain why gastric bypass patients often require B12 shots (without a functioning stomach, you will not absorb any B12, no matter how much you consume).

    Individuals who have lived with autoimmune gastritis for years also have very limited ability to make intrinsic factor.  Hence, they, too, need B12 injections.

    To make matters slightly more complicated, intrinsic factor is only rendered effective in a sufficiently acidic environment.  SInce stomach acid production decreases with age, it is common for older adults to require B12 injections.  With compromised acidity, B12 can not be absorbed.

    Lastly, if the terminal ileum (a particular portion of the small intestine) is damaged (due to irritable bowel syndrome, for instance) or missing (as a result of surgery), B12 can not be fully absorbed.

    If any of the above conditions apply to you, then a B12 shot is necessary.  Otherwise, you are just fine getting it from food or supplements.

    PS: I have also heard claims of Vitamin B12 shots for weight loss, which are absolute nonsense.

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    In The News: No Toys For Tots

    ST_PosterFood policy news from Brazil this time, where a federal prosecutor in the city of Sao Paulo has “asked a judge to ban [the advertising and “sale” of toys] at [fast food chains] including McDonald’s and Burger King.”

    The man in question — Marcio Schusterschitz (I’ll take “unfortunate last names for $1000, Alex”) — bases his case on the fact that “fast-food toy promotions encourage children to buy high-fat meals through “the abusive creation of emotional associations” that turn them into life-long eaters of high-fat foods.”

    The wording is quite strong, but I agree with the basic idea.

    I have noticed that many media outlets are framing this in an appalling “where in the world is THIS guy getting his ideas from?” framework, but keep in mind that Brazil’s Consumer Defense Code explicitly prohibits advertising aimed at children that “”takes advantage of the deficiency in judgment and experience of the child.”

    As a child, I was never into fast food toys (the food in itself was enticing enough to me), but I remember many of my peers and classmates often begging their parents to take them to a fast food restaurant for the sole purpose of collecting all the toys that were available — for a limited time, of course — as part of the children’s “combo meal.”

    We’ll soon find out if the judge in question wants to consider the case.  I certainly hope he does.

    PS: Yes, I am aware that these toys can be bought separately, but why do fast food chains even HAVE toys to offer?  And, really, for all the fuss children make about these toys, they usually break — or are forgotten about — 24 hours later.

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    Vocab Bite: Cerealitis

    cereal_aislece⋅re⋅a⋅li⋅tis [seer-ee-uhlie-tis]

    – noun

    1. The overwhelming feeling of indecisiveness experienced upon browsing the cereal aisle at a supermarket
    2. The often frustrating and time-consuming quest to find a cereal that is high in nutrition and taste (and reasonably priced); often accompanied by nutrition label comparisons and careful reading of ingredients

    Example: Sorry I took so long at the supermarket.  I had the worst case of cerealitis!

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    You Ask, I Answer: “Carb Blockers”

    phase2-carbohydrate-blocker-source-naturalsToday I saw an advertisement for a product called Phase 2.

    It is supposedly made from bean extracts and slows down the absorption of starchy foods.  You’re supposed to sprinkle it on whatever food you’re eating to lessen the impact of the carbohydrates.

    It was advertised as a way to reduce calories.

    Have you heard of this?  Is it legit?

    –Ron Orbach
    [City withheld], CA

    Phase 2, like other “carb blockers”, attempts to interfere with carbohydrate absorption.

    This is achieved by temporarily rendering alpha amylase — the digestive enzyme that breaks down starches to glucose — useless.

    Like Olestra (the fat replacer responsible for Wow! chips in the late 1990s), Phase 2 — made from white bean extract and boasting the slogan “real food, less calories” — bypasses a nutrient’s (in this case, carbohydrates’) intestinal absorption, theoretically reducing the amount of calories that can be absorbed.

    And, like with Olestra, expect some funky gastrointestinal symptoms if you go slightly overboard with carb blockers.

    My issue with blockers of any sort is that they often accomplish nothing but lull consumers into a false sense of security (“I just ordered a 1,200 calorie pasta dish at a restaurant, but I sprinkled a carb blocker on top, so I can just eat the whole thing”).

    Keep in mind, too, that the number of calories these blockers “eliminate” is unknown.

    Furthermore, these products don’t address some of the real issues behind weight gain:

    • Unhealthy habits
    • Emotional eating
    • Hunger/satiety recognition
    • Overall caloric intake

    Even the creators of Phase 2 are quick to point out that, like anything else, the product is meant to “be used in conjunction with a sensible diet and exercise.”

    The term “carb blocker” is silly enough.  It appeals to low-carb consumers and those looking for magic cures, yet actually targets a very simple issue — calorie reduction.

    These are “keep your wallet safe and sound in your pocket” products.

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    Numbers Game: Measure Your Health

    measureTapeA two-inch increase in waist circumference equates to a _____ percent increase in colorectal cancer risk in both sexes, and a _____ percent increase in heart failure among men, regardless of “initial” waist size.

    a) 3, 6
    b) 8, 8
    c) 7,2
    d) 5,10

    Leave your guess in the “comments” section and come back on Tuesday for the answer.

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    You Ask, I Answer: Hair Analysis

    hair-follicleDo you think a hair sample can provide an accurate analysis of your nutritional status?

    A friend of mine had her hair tested by someone who was able to tell her exactly what vitamins and minerals she needed, and which ones she was getting too much of.

    My friend said it was pretty accurate, but it sounds kind of strange to me.  I’m interested in hearing what you have to say.

    — Deborah Crull
    (location withheld)

    Let me guess.  After revealing the results of the hair analysis, this “someone” offered your friend supplements — rather than dietary advice — at an extra charge?

    Oh, this makes me angry.  Very, very angry.  Simply put, your friend was conned.

    Hair analysis is completely useless to assess nutritional status.

    While certain nutrient deficiencies can affect “hair health”, nutrient concentration in hair does not match that of plasma.  Additionally, most nutrients (like vitamin D) are assessed by examining levels of specific markers exclusively found in blood.

    There are also too many confounding factors to deal with when it comes to hair, such as:

    • Many shampoos contain zinc, which can lead to false “zinc overload” results
    • Hair products can skew results
    • Depending on your water supply, your hair might have higher concentrations of certain minerals (i.e.: calcium) regardless of your intake

    How, exactly, does your friend know this was  a “pretty accurate” assessment?  If what she means is that she already knew what nutrients she wasn’t getting enough of, why did she get this hair analysis done in the first place?

    Additionally, if the goal of this was to determine the nutrients she needs to get more — or less — of, why not simply do a dietary recall or food diary along with a blood test?

    Leave your hair in the hands of stylists, not phony nutritionists.

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    Survey Results: In The Zone

    55855281-fastfoods71 percent of readers who cast their vote in the latest Small Bites survey support zoning laws that regulate fast food chains’ proximity to schools.

    As do I!

    Studies are beginning to highlight the negative health consequences that stem from a lack of zoning laws.  One recent study conducted at the University of California, Berkeley, found that students who attend schools located within a one tenth mile radius of a fast food establishment are 5.2 percent more likely to be obese than students who attend schools located further away from these restaurants.

    A 2004 study published in the Annual Review of Nutrition concluded that adolescents who consume fast food on a daily basis eat an average of 187 more calories a day than those who eat fast food less frequently.  These additional 187 calories can amount to weight gain nearing 19 pounds in just one year.

    Additionally, the Coronary Artery Risk Development in Young Adults (CARDIA) study concluded that consumers who eat fast food two or more times a week had a one-hundred percent increase in their insulin resistance compared to consumers who ate at fast food establishments less than once a week.

    In large US cities, the proximity of fast food establishments to schools is undeniable.  Eighty percent of Chicago’s elementary and high schools have at least one fast food restaurant within a half mile, and 18 schools in New York’s East Harlem are located within 500 feet of a fast food restaurant.

    I do not consider these zoning laws a “solution to a problem” as much as a necessary step to solve the REAL issue — improving the moribund National School Lunch Program.

    How can we expect healthier school lunch policies — and, no, that does not mean steamed peas and paltry salad bars with wilted lettuce — to be effective if students, particularly those allowed off-campus during lunch hours, have fast food available to them a few blocks away?

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    In The News: Nacho Ideal Lunch

    school lunchMore news on the deplorable state of national school lunch, this time courtesy of The Chicago Tribune.

    At one North Side school cafeteria, “one line leads to fish nuggets, iceberg lettuce and canned peaches, Another [to] burgers and breaded chicken patty sandwiches, [and] the longest line to lunch workers [serving nachos].”

    This is no anomaly.

    Nachos are an almost daily entree at most Chicago public high schools and middle schools.  This means that “about 100,000 Chicago public high school students, 80 percent of whom qualify for free and reduced-price lunches, can choose nachos as an entree every day.”

    The school district is quick to point out they “recently switched to whole-grain fried chips for its nachos and added chicken to the ground meat.”

    Big whoop.  A deep fried chip is a deep fried chip, whether it’s made with whole grains or not.  The addition of chicken to ground meat is also rather meaningless, considering the atrocious amount of sodium added to it.

    Wait, they have an even better defense — at least the school lunch isn’t “as bad” as what they can get at a fast food chain.

    What’s next?  “Yeah, we know your child’s math teacher is pretty horrible, but at least he doesn’t beat them with a ruler if they get the answer wrong”?

    The article also touches upon the laundry list of problems with the National School Lunch Program:

    • It is heavily dependent on United States Department of Agriculture commodity foods (the main ones being meat, soy, corn and wheat)
    • Vendor reimbursements are tightly linked to food sales
    • School districts are given minimal funds to cover not only food costs, but also equipment and labor

    The most frustrating aspect of this “debate” is the argument that “kids just don’t live vegetables.”

    By this, officials mean that children don’t like steamed, unsalted carrots and peas.

    Who does?

    In the “glass is kinda sorta almost half full if you look at it from this angle” department, Congress will soon reevaluate the Child Nutrition Act, setting up the possibility of changes to the National School Lunch Program.

    Oh, who am I kidding?  That glass is almost as empty as Heidi Montag’s skull.

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    Numbers Game: Answer

    olive_oilReplacing two tablespoons of extra virgin olive oil with two tablespoons of light olive oil in your cooking saves you zero calories.

    Although “light” has become associated with reduced — or no — calories, it does not apply to olive oil.

    From a caloric standpoint, light olive oil and extra virgin olive oil are identical.

    In this situation, “light” refers to taste; specifically, a much less pronounced flavor than that of extra virgin olive oil.

    Light olive oil is also processed slightly different than extra virgin varieties, making it more suitable to high-heat cooking methods.

    It’s obvious, though, that some light olive oil manufacturers are hoping to confuse consumers.

    Many of these bottles have the word “light” in large capital letters, with the word “tasting” right underneath in significantly smaller size.  Tisk tisk…

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    Personalized Nonsense

    DNA_human_ancestry_AfricaOn an almost weekly basis I receive e-mails from companies offering “personalized multivitamin kits.”

    The pitch goes something like this: fork over a three-digit figure (I’ve seen ranges from $150 – $400) to receive a special cotton swab in the mail.  You are to scrape the inside of your cheek with this swab and return it via postal mail (in a special container, of course)

    A few weeks (and more dollars) later, your custom-made multivitamin mix tailored to your genetic profile arrives.

    Wow — so futuristic!  And, come on, who doesn’t love a personalized service?

    Too bad it’s not quite as scientifically edgy as it sounds.

    Although the field of nutrigenomics (nutrition as it pertains to our individual genetic code) is in the beginning stages (think building the first floor of a 300-story building) and holds plenty of promise, the science is not yet at the point where it can make specific nutrient recommendations based on a genome.

    Many of these companies claim that nutrition guidelines are useless since they are meant to apply to 98 percent of the population.

    Remember, though, that recommended intake figures for vitamins and minerals are meant precisely as that — guidelines.

    It is expected that certain populations, or people with certain conditions, will alter their intake somewhat from them.  For example:

    • Menstruating women require more iron than non-menstruating women
    • Smokers have higher vitamin C requirements than non-smokers
    • Teenagers require higher calcium intakes than adults over the age of 65
    • Women who breastfeed need more vitamin B6 than a man in his thirties

    Remember, too, that in the case of most vitamins and minerals, most adults are already getting plenty — partially because most adults are getting many more calories than they need.

    There are a handful of vitamins and minerals that are under-consumed in the United States (mainly iron, calcium, and potassium), but most people’s intake of the B vitamins and zinc, for instance, are well-above the recommendations.

    Even if we could tell someone that they need, say, 20 extra milligrams of vitamin C a day, the goal would be to get that nutrient from food (ie: eat an extra half orange), rather than costly supplements.

    A few years back, the Goverment Accountability Office released a wonderful report on the accuracy and efficacy of these “at home” genetic tests.  I highly recommend leafing through it.

    Click here for a brief summary of the paper, and here to read highlights from it.

    In the meantime, don’t let fancy shmancy futuristic advertising pry open your wallet.

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    You Ask, I Answer: DNA & RNA in Food

    rnadnaI saw a package of brewer’s yeast the other day that had DNA and RNA levels listed with the rest of the nutritional info.

    That seems a little bizarre to me. We’re ingesting DNA all the time from most foods and our own body fluids. Why would the manufacturer choose to list this?

    Are any other foods labeled with this info as well?

    A quick Google of the supposed health benefits of nucleic acid supplementation yields results that all want me to buy something.

    Is there any legitimate reason to care about one’s level of nucleic acid intake?

    — Lizzy Foulker
    Vancouver, BC

    None whatsoever.

    Foods high in protein (meats, legumes, nuts, and seeds) are “good sources” of nucleic acid.

    I put that in quotation marks because there is no Daily Value or recommended intake figures.

    If anyone ever tries to sell you a product by mentioning RNA and DNA amounts, shrug and say “so what?”

    I suspect this manufacturer’s decision to promote DNA and RNA values of his yeast are an attempt to cash in on those who follow the anti-aging market and believe DNA and RNA rich diets are the key to youthful looks.

    If anything, too much nucleic acid can be problematic.

    Our bodies convert nucleic acid to uric acid.  A buildup of uric acid (as a result of ingesting too much nucleic acid) can result in rheumatic condition known as gout.

    Last I heard, rheumatic diseases were not exactly a sign of youth…

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    You Ask, I Answer: Children & Soy Milk

    pearl-original-soymilkDo you think it’s okay for toddlers to forgo cow’s milk altogether and just drink soy milk instead?

    — Jane (last name withheld)
    Waltham, MA

    Absolutely.

    As long as the brand of soy milk they are drinking is fortified with calcium and Vitamin D (as most are) and it contains some fat (as most do), I don’t see a problem.

    Since soy milk provides roughly a half or two thirds of the fat in whole milk, be sure to make up for that by providing some extra fat in their meals.

    I certainly don’t recommend buying “light” versions.

    Remember, too, that all soy milks (except unsweetened ones) contain added sugar.  Yes, even plain flavors.

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    Vocab Bite: Foodarazzo

    paparazzifood⋅a⋅raz⋅zo [food-uhraht-soh]

    noun

    1. Annoying individual (usually a friend, family member, or workmate) who always comments on what you eat, usually accompanying his or her nosiness with judgment.

    Example:  My office deskmate, Ralph, is such a foodarazzo.  If he walks past my desk when I’m eating breakfast, he asks a bunch of questions about it and makes some obnoxious comment about how unhealthy it is.

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    You Ask, I Answer: Fiber Supplements

    citrucel_capletsWhat is, in your opinion, the healthiest fiber supplement?

    I have used psyllium husks for a long time in smoothies but have recently switched to Citrucel because of the delightful taste (it’s just like tang) and convenience.

    This is somewhat of a contridiction for me because I have made it a habit to avoid beverages high in sugar like soda and ice tea, and I’m concerned about the sugar content in Citrucel.

    Is it relatively high for a fiber supplement? Is it the equivalent of drinking a unhealthy ice tea mix or soda?

    Also, what are your thoughts on those Viactiv chocolate calcium chews?

    Jessica (last name withheld)
    San Antonio, TX

    Citrucel — “the fiber with no excess gas” — contains 100% soluble fiber.

    Remember, that is the type of fiber helpful for lowering cholesterol and achieving a feeling of fullness more quickly; insoluble fiber helps speed things up through the digestive system.  We need both types.

    Whole wheat breads are 100% insoluble fiber; oatmeal is 100% soluble fiber, and all other foods (fruits, vegetables, nuts, legumes, etc.) are a combination of the two.

    Citrucel contains two grams of soluble fiber per scoop — roughly the same amount offered by one apple.

    Citrucel also tacks on roughly 4 and a half teaspoons of sugar per scoop.  So, two scoops equal the amount of sugar in one 12-ounce soda can.

    My main “issue” with fiber supplements is that while they provide actual fiber, their health benefits are much lower in comparison to fiber-rich foods.

    With something like Citrucel, you are getting fiber and nothing else.  With an apple, or oatmeal, or almonds, or a baked potato, you are getting fiber along with hundreds of health-promoting phytonutrients.

    So, in terms of which is the healthiest fiber supplement, my answer is: “food”.

    A half cup of raspberries, for example, packs in 4 grams of fiber and just 32 calories.  That’s twice the amount of one Citrucel scoop and HALF the calories.  As a sweet bonus, you get vitamins and loads of phytonutrients and antioxidants.

    A medium-sized banana contains, on average, 3 grams.  And, by simply making a sandwich with 100% whole grain bread, you add six grams to your day.

    There is a notion that fiber is hard to get in one’s diet, but it is widely available — in lots of different foods.  Here’s another example:  a cup of black beans adds 15 grams to  whatever recipe you are making (stew, chili, salad, etc.)

    If you like to make your own shakes/smoothies at home, one way to quickly and conveniently add fiber is to add a tablespoon of flaxseed and a tablespoon of wheat germ.  You won’t notice any difference in taste and those two tablespoons add 4 grams of fiber.

    By the way — this notion that Citrucel is superior because it provides fiber without gas is slightly misleading.

    Gastrointestinal operations vary from person to person; in that way, they are very much like snowflakes.  No two are alike.  However, there are two main factors that cause gassiness with increased fiber intake:

    1. Increasing fiber too soon (i.e.: someone who normally consumes 12 grams of fiber a day waking up one morning and starting off their day with 14 grams of fiber via a high-fiber cereal).
    2. Increasing fiber without increasing fluid intake

    As long as you increase fiber intake slowly (think tacking on two grams a day until you reach your desired goal) and accompany it with increased fluid intake, you should be able to minimize bloating and gassiness.

    As for the Viactiv tablets — the ingredient list is semi-sketchy (high fructose corn syrup AND partially hydrogenated oils!), but it is a low-calorie, low-sugar product.

    Is it the ideal way to get calcium?  Absolutely not.  I mean, really, if supplementing is the ultimate goal, is a regular calcium tablet that horrible to swallow?

    However, when push comes to shove, Viactiv is at least a way to get significant amounts of calcium.

    The problem is that so many people tend to focus on ONE nutrient and forget that by eating whole foods high in one nutrient, they would get more “bang for their buck.”

    Case in point — a calcium pill is just calcium.  Kale (a leafy green vegetable high in calcium) is also a source of vitamins, minerals, and phytonutrients.  Similarly, a cup of yogurt provides calcium along with protein, B vitamins, phosphorus, and potassium.

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