Tuesday, August 4, 2009

Food fight over calorie posting


We need to attack a number of fronts in order to wage a war on obesity. That means we need to agree to exercise, change how we run our kitchens and pantries on the homefront, add PE to school and especially re-think how we eat outside the home. To start that process we have to recognize that a large percentage of the selections are high sodium, high fat, high sugar, and served in portions that are too large. One way to get a handle on outside eating is to have the facts clearly displayed. That means per serving nutritional breakdowns available to our perusal - before we open our mouths..


Currently the legislation that has been passed or is going to be passed in certain states only involves requiring restaurant chains that 20 or more "restaurants of the same name" to follow tis legislation. So smaller chains and individual restaurants basically get a by on this. So do large food companies that have many different small chains, Like the Patina Group, which owns 60 plus restaurants. Statistics show that only 25% of more than a million restuarants fall under this legislation. Sure, it's a start, but we need to do better. And maybe the government needs to help smaller businesses with the science costs of analyzing their food. Because to battle obesity, we need some food transparency.


The reality however is that we will probably, even in the face of this new legislation, continue to battle way-to-high levels of obesity. Why? To quote DeWayne Wickham of USA Today, "We are a country overrun with people who think life is a spectator sport." I would take it one step further and add that we have forgotten that eating food is supposed to be tasty experience that fuels our body and not an American pasttime. And when we gain weight, our response should not be the next trendiest diet but a solid lifestyle makeover that can withstand the test of time. That may mean getting help from health professionals- nutritionists or dieticians, personal trainers, doctors, psychologists, even cooking experts. Otherwise cheap accessible food that is high fat, high calorie, high in sodium and typically processed will continue to be our go to food-in large portions - and we'll eat it while we sit in front of the TV or computer.

Tuesday, July 28, 2009

Obesity costs...alot


The latest headlines that reflect the latest research, polls and statistics confirms what most of us knew already. If you have a dignosis of obesity, it will cost you money. Not just the endless dollars you spend on extra food which when eaten requires extra dollars spent on the latest diet pill, trend, book which works for a short while only to have you spend more food on food, new clothes to fit your growing body (cause you threw the old clothes out when you convinced yourself that you conquered obesity) only to need to spend more dollars on the newer diet books, potions and exercise equipment that you now believe will help you lose the weight you already lost (how many times??).


No, the costs the headlines are referring to reflect the extra care you need because of your obesity. You are likely to develop diabetes type 2, hypertension, heart disease, arthritis, cancer, high cholesterol and then you will need more medical care. You may become so obese that you require specialized medical transport in an emergency or need to have additional trips added to your medical bills to transport you to larger testing equipment that can assess a larger person. Bottom line is that extra weight costs extra money for a variety of reasons and the next generation of young people, who are developing weight issues at an earlier age, will place the burden of these additional healthcare costs on a healthcare system that is already strapped for cash.


So what can we do? We can accept that we all overeat for a variety of reasons and many of us have exemplary excuses for not exercising. That being said- we need to take ownership of our health realities and destinies and work on the causes and strategize so that we reduce temptation, make healthy food more of a regular part of our lives, get the calorie and portion facts that personally work for each of us and add physical activity to our daily lives - whether we like to exercise or not. Personally, I don't like to balance my checkbook, but I do it because bouncing a check or declaring bankruptcy is not an option. I take my daily supplements, regularly, because I recognize there are gaping holes even in my stellar diet. And I seek to create a home and outside the home environment that supports my health. One step at a time, one habit at a time, one day at a time - with planning and strategizing. You can do it too.

Wednesday, July 22, 2009

Swine flu vaccine undergoing tests in Australia


Australia is well into its yearly winter flu season. In addition to the yearly flu vaccine, two small groups of Australians are testing 2 new flu vaccines. adelaide-based Vaxine is vaccinating 300 subjects while Melbourne's CSL has 240 people in their trial. Trials may last 6-7 months which will coincide to the middle portion of our (US) flu season. Should the CSL vaccine work, the Australian government has ordered 21 million doses.

The Australian trials will help to determine the dose of vacine and schedule of administration. Since it's the first time humans will be vaccinated with this new flu vaccine health officials anticipate that it may require two doses of vaccine, a couple of weeks apart, similar to the first time a child gets the traditional flu vaccine.

Though the swine flu has become a worldwide pandemic, experts do not want to fast track a vaccine through trials at the risk of safety. It is expected that first signs of efficacy will be clear six to seven weeks after the vaccine is administered. Both companies are hopeful but feel that there is no guarantee that the vaccines will work. Swine flu is a bit daunting in terms of its behavior and pathogenesis, so only time and these first trials will tell if vaccine protection will be successfully disseminated during this year's resurgence of the H1N1 flu here in the US.

Tuesday, July 21, 2009

Child obesity versus child abuse


USA Today, July 21, Life Section features an article on a mother being accused of child neglect/abuse because her teenage son has ballooned to the morbid obesity category. This case follows a similar case in New York, back in 2007, which involved a female teen who weight over 280 pounds. The mother did not receive jail time in the NY case, though the daughter was temporarily placed in foster care (the young man in this new case had a similar fate). Recommendations in the New York case included nutritional counseling, cooking classes and regular gym workouts. In both cases the mothers have pleaded "not guilty" and offered the explanation that they are not "force feeding" their kids and as older teens, they have access to food away from home.


The New Yorker magazine features an article in their July 20 issue-Why are we so fat? To bottom line the contention - we, as humans, evolved to seek food, which was not plentiful, to eat a lot to sustain us through famine times, and unfortunately, we are still eating that way, though food is plentiful and we are not nearly as active as our ancestors. And sure, fake foods and high fat/high sugar options make us just want more.


Today on Fox news/Cavuto, there was a discussion about our new Surgeon General who, according to one fitness expert, is clearly carrying excess weight - he estimated an additional 50 or 60 pounds. "What kind of role model is this?" the expert asked. Cavuto countered that maybe she has a slow metabolic rate or she is "fat and fit." Frankly that fit and fat belief is a bit of a health conflict.

In response I counter the following- I recently measured my RMR-resting metabolic rate- and it is under 1200 calories per day. That means if I do no activity, I can only eat less than 1200 calories in order to avoid weight gain. That's not a lot of food. If I do moderate to strenuous exercise, I get to add about 300, maybe 350 calories - not a whole lot of calories, considering the exercise effort. And clearly, if you look at my physique, I do carry muscle mass that is obvious - and yet, it does not seem to be inspiring my metabolic rate. So I learned a long time agao (not even scientifically knowing my RMR) that I needed to be a calorie counter, cautious eater. My genetic destiny is 3rd generation obese - so when I lost 50 pounds in my teens with Weight Watchers, I knew that to help my kids someday avoid that "genetic tendency" I needed to be really smart about how food and calories and portion sizes and activity were presented to them, from a very young age.

I did not want to create eating disorders in my kids or a preoccupation with food, but rather "healthy food attitudes." And I certainly wanted them to feel that daily execise is equal to brushing your teeth - it has to be a daily habit. Period. So in answer to all these theories in all these articles and discussions, I feel very much justified in pointing my finger at parents and saying that just like my mom had a genetic destiny and she then compounded that issue with her "fat habits" teaching me to overeat pretty much everyday (the wrong foods) - I was able to thwart those genes in myself and my kids by establishing healthy eating and exercise protocols, that exist inside and outside the home. Sure we as a family eat treats, but not everyday and with great relish and slow pace. And in response to clients and friends who seem to feel the need to "fatten up their thin kids" I respond - look at yourself and your husband in middle age. The "fattening up" will happen inevitably (to many of you who were slim earlier in life) without you hastening it in their youth- why not combat that inevitability by showcasing a smart and healthy approach to eating?

I don't dispute the food abundance, the poor quality food temptations, the video and computer contributions to sedentary lifestyle and the emotional pull that draws us to "treat every emotion with food." I also acknowledge that if you are financially challenged, you have to put some effort into healthy food access. I do however believe that parents are the significant contributors to how children interact with food and physical activity. Most of us deserve an F on that report card.







http://www.fatfamiliesthinfamilies.com/

Wednesday, July 15, 2009

Hormone therapy and ovarian cancer...vitamin D

A new study of a large body of women suggest that use of HT (hormone therapy) - whether short (6 months) or longer -correlates with an increased risk of ovarian cancer. When clinicians decide to use any medication, they engage in a risk/benefit assessment, usually sharing that with the patient. Up until this study, it was believed that short term use of HT for moderate to severe persistant hot flashes was a reasonable approach, with the caveat that two years of use should be the cut off and with the understanding that after every several months of treatment the womwn should wean off the HT and see if she still needs treatment or not for persistent symptoms. This approach was to recognize the increased risk of breast cancer with use of HT, particularly longer use.

This new study now indicates that there is an increased risk of ovarian cancer even with short term use of HT. And ovarian cancer is particularly worrisome because it can often present silently , not revealing identifiable symptoms till it is quite advanced. Doctors may certainly have to re-think the "moderate hot flashes" benefit/risk ratio and obviously counsel patients who request HT for severe hot flashes. It's going to be a much tougher decision and there may be a need to re-evaluate screenng for ovarian cancer during its use.

The American Academy of Dermatologists along with other groups has now recognized the need for additional vitamin D but would like to see consumers obtain it from supplements and foods. All of the medical groups agreed that using sun exposure sans sunblock was not recommended to the risk of skin cancer. They did agree that when sunblock is used regularly, your need for vitamin D from foods and supplements increases. So ask your doctor what are the target goals of daily vitamin D that you should target and use food, supplements as your primary source.

Tuesday, July 14, 2009

There will always be another diet


If you watch the yearly cycle of new non-fiction books you will typically see a new round of self help/nutrition/fitness program books come out first of the year - because we are all so motivated after the end of the year food frenzy - and near summertime - because we all want to look better as we shed layers of clothes. Since there is no set time to "get healthy," because it really has never been connected to a seasonal theme or a holiday theme, releasing those books are a bit trickier.




There's also the problem of choosing a title for your more health-driven book. Go too , and you probably won't gain audience with serious book reviewers, columnist nor with the consumer seeking serious, science driven information. And yet, the books with the quirkiest and sexiest titles do very brisk sales -though sometimes what may actually propel those sales is a celebrtiy who picks up the book (think "Skinny Bitch"). On the other hand a dry title from a world recognized celebrity, or expert is pretty much going to sell like crazy. So are books that make promises you just want to believe or that seem ot offer strategies that seem a heck of a lot easier than those currently in use.


What about the books that offer really good content and honesty, even brutal honesty in their titles? I decided to call my book Fat Families Thin Families, hoping that the obesity crisis would guarantee its success. After all, people who are seriously overweight need to embrace their reality and then do something about it. After all, if anyone opened my book they would also see that the words "fat and thin" were really talking about habits and not just size of body. Well, it was a humbling lesson to learn that honesty and dollars spent on PR to make the book's availability known, and my experience in media - only sold a modest number of books.


But I've been given a second chance. My poublishers so believe in my message and content that we will release the book again, in softcover with.... a new title. Talk about agony!! NOW do I go sexy or catchy phrase or try to create a "can't pass this book up" title?? Or do I try to generate a new title, a bit less "in your face" that explains my program for lifestyle change, for the family, in a more simple approachable way? I guess this will be my stress and sleepless night initiator for the next several months. In the end, I did recently receive a wonderful book endorsement. An educator I met let me know that he was considering using my book as a textbook for a new course he was teaching. Nothing that Jennifer Aniston would shout about...but for this humble first time author, it was a really special moment.




I released a book in 2008 called Fat Families Thin Families, hoping that the ongoing burden of an obesity epidemic would fuel sales. After all, we need to recognize our girth, in order to seek programs that heal or at minimum help us.

Friday, July 10, 2009

Gotti passes kidney stones


Well John A. Gotti Jr.and I have something in common - we've both had kidney stones. I daresay the pain was something unique to him, albeit the pain of jail may be just a bit more sensitive....or maybe not. Because I must confess, the pain I experienced was, indeed, worse than childbirth - which I've done 2 times with zero, I repeat zero pain palliation. That's right, no epidural, no pain pills, absolutely nothing except some local injections just prior to an episiotomy. I'd compare the pain to the worst bowel movement I can ever imagine, but tolerable. I did have short labors, 6 and 7 hours respectively.


Now the kidney stone was a whole other matter. I was incredibly nauseous, throwing up numerous times, feeling urgency to urinate - nothing would come out - and there was excrutiating pain all over my abdomen - could not even pin point it if I tried. By the time I made it to the hospital (driven by a very distressed husband doctor) I had my arm out in the air, and this drug virgin was yelling, "Give me something, anything!!" A scan revealed the little stone right at the end of my ureter, ready we all hoped, to pass into my bladder. It did about 4 hours later.


The cause of my kidney stone was probably dehydration. I had traveled by air several times in the last month and I don't think I was hydrating sufficiently. Needless to say I do now. It's nice to know that scientists have found evidence of kidney stones in a 7,000 year old mummy. I wonder what they used for pain relief back then?? Kidney stone prevention involves drinking enough water daily, steer clear of calcium in pill form (if your doctor concurs), and if your urine is highly acidic you may be told to limit meat, fish and poultry - but that's OK, plant based proteins are good for you. Remember that if your urine is even a bit yellow, you're not drinking enough water or liquids.

Thursday, July 9, 2009

Water dangers


Are you a big fan of bottled water. If so, you're in for an apparent rude awakening, though frankly this awakening should have taken place quite awhile ago. The bottled water industry has very little regualtory oversight. So advertisers can suggest you are drinking spring water, and the company's definition of that concept and yours could be miles apart. Notwithstanding the reality that the water you are drinking could have contaminants, and PCBs leaching into the water from its plastic bottle. The harshest reality is one that I wrote about awhile ago. We are going to run out of available water if these companies are not stopped.


The movie "Flow" showcased in gritty detail the horrors that the 3 major water companies in Europe are perpetrating on countries like India. Apparently a company, with great ease, can come in, displace communities living off natural water sources and banish them to parched new patches of land, while the companies suck up the natural waters, unbalancing delicate eco-systems in the process. It's also happening in Michigan where a war continues to wage between the individulas living near natural water opportunities and companies who have staked a claim to those water with little legal red tape in their way.


So I compliment the media for raising this issue again, but I fault them for making it sound like it's a new story. This is actually a weary old story and unfortunately we seem to be making small inroads in terms of getting people to "give up the bottle" and "turn to tap" in communities where the water is regulated. Get a Brita and boldly venture into the world of reusable bottles!!

Friday, July 3, 2009

Pregnancy weight contributes to daughter's obesity


It used to be that when a woman got pregnant, she was encouraged to "enjoy and feast." After all, she was going to gain weight anyway, so why not indulge on anything and everything you always wanted to eat?? Current studies not tell us what's at stake when a woman becomes pregnant. Certainly we know that it's vital to get certain vitamins like folic acid, in adequate amounts, in order to prevent neural tube deformities. Well now experts tell us even more is at stake.


If you are obese when you get pregnant and gain more weight, or if you simply gain too much weight during your pregnancy, the risk of your daughter becoming obese decades later is significant. This idea to go hog wild during pregnancy really needs to be discarded - for a variety of reasons. In addition to the health script (and weight script you are creating for your kids), you can also develop hypertension, diabetes and other health conditions if you gain too much weight and/or remain sedentary. So there's a risk to you as well as your babies. For those who struggle with weight issues - maybe knowing the stakes for your child will have more of an impact on your lifestyle choices. Certainly, obesity is a complex issue, but during pregnancy, it really does have significant dire consequences.


Pregnancy may be a time when you should justify the expense of working with a nutritionist and personal trainer, even if just to get an initial consult and recommendations. The health you preserve will be yours....and your child's.

Thursday, July 2, 2009

Prescription Drug Abuse


While there is no clear toxicology report from the Michael Jackson autopsy, it is clear that based on interviews with individuals who knew the singer, he had access to many prescription medications. We typically think of a "drug abuser" as someone who uses illict drugs. The reality in the US, is that abuse of prescription drugs is quite prevalent and we, as a society, seem to view that behavior differently. Many people seem to think that if you have a prescription, it seems to put the drug in another "league," meaning that if you choose to take more than recommended, it is somehow "acceptable...OK."


There is a prescription overdosing crisis in America today and it involves everything from people refusing to leave a doctor's office without an antibiotic if sick, to people seeing several physicians and getting multiple prescriptions for narcotics. The behavior seems especially prevalent among the rich and famous who seem to feel that the medication prescribing rules don't apply to them. In a way, they are correct, because no matter how many doctors they may have to go through, they will eventually find someone willing to prescribe drugs simply to be "part of the entourage." Or maybe the doctor says to himself, "if not me, then someone else, so why not me?" We call it a doctor enabler and the reality is, there are a fair number of them behind the scenes, often writing prescriptions for a famous person under multiple names. Usually opiods or pain medications are involved and the abuse potential is huge. Drug overdose is now the second leading casue of accidental death in the US.


We'll have to wait to hear if dangerous medications (prescriptions and "only for hospital use medications") were involved in MJ's death, or if a combination of several similar drugs caused respiratory depression and subsequent death. If it is a similar tragedy to Anna Nicole Smith and Heath Ledger, then the question that begs to be asked is - "How many more deaths?" Or because high profile, wealthy individuals are involved, is the reality that we cannot stop these terrible tragedies? Money, it seems, can indeed buy you anything....even premature death.

Tuesday, June 30, 2009

Tylenol...Aspirin..Ibuprofen


These common over-the counter drugs are treated like...well, like candy by some people, because of their easy accessibility. They are also often interchanged as treatments by the lay person, though each has very different side effects and each is metabolized differently. In the case of Tylenol, or acetaminophen, the liver is the target metabolizing organ and that translates to thousands of individuals with liver disease, failure, because of abuse of this popular pain reliever.


There is a maximum daily dose for every over-the-counter pain reliever. Exceed that dose, and do it chronically, and you have a recipe for serious health complications. Remember also, that in the case of Tylenol's active ingredient, it might be an ingredient in another pain pill you are taking. For example, Percocet has acetaminophen in it - so if you are also taking Tylenol, you may not even realize how much active ingredient you are getting in a day. Rule of thumb - if you need daily pain relief, and are self-medicating with over-the-counter medications - you need a doctor consult, or at minimum, a discussion with your local pharmacist. Just because it is over the counter, doesn't mean it is innocuous.

Monday, June 29, 2009

Billy May autopsy may teach heart lesson


Though preliminary autopsy results are not conclusive, it appears that the pitch king may have died from a heart event, more than likely an arrythmia related to prior heart disease. If you assess May from a health perspective, you can see he was overweight and much of his weight was what is called central obesity, fat carried in his abdomen. It's impossible to know, without asking close friends, family, if he managed stress well. Certainly stress can amplify inflammatory changes that are present and contributing to heart disease. If he traveled alot - he may have also had sleep deprivation, which again, can contribute to cortisol elevations and inflammatory changes.

The first sign of heart disease can unfortunately be a cardiac event - sudden death. Hypertension, or high blood pressure can be silent; so can increasing levels of plaque acumulation. If you are lucky, you are getting yearly physicals and some of these "silent issues" can be picked up early by tests. If you are still "lucky" you may experience headaches from high blood pressure or angina from clogged arteries trying to maintain blood flow when stressed, so you have early warning signs and can seek help. For as many as 30% of the population who have heart disease, you find out you have heart disease when you die - a terrible and often times avoidable outcome.

Since Mr. May was scheduled for hip surgery, I would think that he had been "cleared for surgery" however, sometimes that is done just before surgery. It's unclear if he was being treated for hypertension, cholesterol issues, weight issues or other health conditions. What is clear is that we can learn something from this initial autospy information. Heart disease is the #1 killer of men and women. As we age, risk of heart disease increases. It also increases if you carry excess weight, eat a highly processed diet, are sedentary, undergo high levels of stress, have diabetes or even pre-diabetes. Know your risk by learning the facts. Go to http://www.americanheart.org/.


You can also sign up for my free daily health tip at http://www.healthgal.com/ and pick up a copy of Fat Families Thin Families at http://www.amazon.com/.

Friday, June 26, 2009

Michael Jackson...Farrah Fawcett


As a medical and lifestyle journalist, I often try to find a health message in every story that comes across my desk. Farrah Fawcett recently asked at the end of her documentary, "what is your fight?" In her case, cancer invaded her body, and the media tried to invade her privacy. She fought both with an incredible tenacity, seeking both traditional and alternative treatments for her battle against cancer (what health practitioners often call the 1:2 punch); then proactively sought to undermine the invasion of her medical privacy, by herself sharing details of her diagnosis, and then helping to snare those at UCLA who sought to leak private medical details. Her fight was for dignity and extended quality of life.


Michael Jackson's fight was against the pain of a burned scalp, broken leg, painful back AND against a lost chidhood that he seemed to forever pursue. His talent they say, will probably never be surpassed; his demons, obviously may now, never be conquered. I live close by to his family compound in Encino, and the helicopters relentlessly circle over his home. I imagine that one of the outcomes of his story may again be that of Anna Nicole Smith - enablers who were giving him serious medications, without closely monitoring the mixture of those drugs. He may have needed these medications, but when you mix anti-depressant drugs, pain killers and other prescription medications, there has to be clear respect and a "line in the sand" as to dosage, frequency of use and the understanding of their interactions.


Cardiac arrest can occur due to a variety of causes. In Farrah's case, her liver was failing and after that comes multiple organ failure. In Michael's case, we may not know for several weeks the cause of his heart's failure. What we can learn is "to fight our battles" be they health battles, work challenges, relationship struggles. And if we are faced with health challenges - be they physical or mental - we need to "fight the fight." At the end of the day all we have are our days on earth.

Thursday, June 25, 2009

Farrah Fawcett...Michael Jackson


Two deaths, two icons - one death expected, though it still came as a surprise this morning. After a long battle with rectal cancer, Farrah Fawcett finally succumbed to a disease that she had managed to thwart, a second time, for three long years. Later this afternoon came the shocking news that Michael Jackson, talent extraordinaire had suddenly died of an unconfirmed heart event. Only, fifty years old, that diagnosis in someone who did not seem to have a family history or chronic history of heart disease, seems inexplicable.


Heart disease is the #1 killer of men and women in the US. Health professionals know that heart disease can remain undiagnosed; precursors to heart disease like high blood pressure can remain silent for years. What is clear is the Michael Jackson was under stress, alot of stress for years. Lawsuits, money issues, the challenge to remain relevant in the music world - stress of that nature can cause cortisol changes and inflammatory changes that can damage organs slowly and insidiously. There will more than likely be an autopsy (a family member says that a doctor was called to the house last night but he left without suggesting a hospital visit) and final determination of exact cause of death. If there is a moral to this medical story it is that stress, even if not the ultimate cause, probably had a hand in this young death.

Wednesday, June 24, 2009

Air is a cancer risk


My son is currently interning in Shen Zhen, China, where air pollution is so bad - the sun is never seen. Though any remnants of his childhood asthma seemed to be in check for several years, we put him back on significant dosages of a multitude of medications 2 weeks before he left, and he planned on maintaining the regimen until returning home. Based on today's air pollution impact news, I guess I'm glad we don't live in Cerritos, California.


According to new research, 2.2 million people are living in cities where the air pollution may indeed be a very serious health risk. Many of the people assessed in this study - 847,000 - lived in New York. The worst single city is Cerritos, CA, which is situated between two main freeways. Experts who reviewed the risk that pollution creates, still admit the risk is lower than say, smoking. But the risk cannot be ignored, mostly because it impacts so many people. The government needs to address toxic pollution. Your kids are being exposed to it everyday, and cumulatively, will have many more years exposure than their parents - unless we do something about it....quickly.

Tuesday, June 23, 2009

Diabetes type 2.....denial


We need to stop this tide of diabetes type 2 (connected to obesity) that is sweeping through the child and teen population in the US. Experts say that there may have been some genetic mutations and body chemistry changes in the last several decades that seems to put us at a heightened risk of diabetes. But in order for this physiologic change to express itself - you have to do an awful lot of eating, of the wrong things, in the wrong portion sizes, coupled with an incredibly sedentary life. A recent USA Today headline offered that - most types of diabetes can be stopped in childhood. Well that requires that parents and kids to get off the ......denial locomotive.


If parents will be willing to model behaviors of good choices in eating and an active lifestyle, then that's the lesson their young children will learn. If parents have been yo-yo dieters, or have emotional relationships with food, or run their household like a fast food restaurant/candy store, showcasing the latest processed foods and treats, then they will encourage obesity and diabetes to come "a callin." If, on the other hand, parents seek help, and that can be in the form of a team of professionals, a single knowledgeable health professional, well reviewed (not trendy) books, guides and even online sources, then there is a chance we can break this horrendous obesity/diabetes statistic streak.


We need to stop being big losers and start using common sense, coupled with a recognition of the dire consequences of early obesity and diabetes. Scared straight is a better approach, followed by sensible habit changes and a hopeful but realistic outlook, that lead to long term health goals. Care enough to stop the early diabetes madness and let's save the children.


Specifically how can you start?


  • Clean out that frig and pantry completely, and re-stock with sensible guidelines

  • Get specific guidelines of what you and your kids should be eating, including servings from each food group and portion sizes

  • Cut sugar, sodium and processed foods

  • Drop the liquid calories

  • Get moving in enjoyable ways, but make sure you have daily exercise that raises your heart rate
  • Take your kids to the supermarket and experience "nutrition" with discussion, taste testing, weighing, and label reading

  • Turn off the TV, video, computer

  • Find a book like Fat Families Thin Families that offers strategies and ways to engage in a family lifestyle makeover.

Thursday, June 18, 2009

Soda tax: good or bad idea?


The controversey swirling around a soda tax really boils down to a simple question - will it help to curb purchase of the drink or impose extra cost with no real benefit or health payoff? Experts have sourced soda as one of the many foods that are contributing to an untenable obesity epidemic, among children and adults. And no doubt, along with trans fat, an excess of processed foods and snacks, high sodium foods, other sugary beverages, soda is indeed a daily part of most American diets. I've even witnessed babies getting soda in their bottles or sippy cups....parents, is that really necessary or a healthy way too feed your child?? The reality is that soda is far more an insidious evil than most of us realize.


Dentists say that the leading chronic childhood disease is tooth decay. Of course, many of the kids who suffer from this condition are poor children, underserved by dental health opportunities. But drinking soda daily - and most kids do by age 5 - can cause mouth decay across economic lines. So maybe we need a soda tax and a really good health campaign that hammers home the reality that soda can contribute to obesity and dental decay. I have a feeling that a 1-2 health punch message may, along with added cost in the form of a tax, curb the love affair we are allowing our kids and ourselves to have with "liquid candy."

Wednesday, June 17, 2009

Swine flu...Pregnancy...Diabetes...Herpes...HIV...Depression...STDs...Obesity


No, today's column is not about all of the above diseases and conditions. It's about the fact that the number of adults who seek health information on the internet has doubled in the past 2 years. That "ties" the internet with books and magazines for third place, when it comes to sources adults use for health information. First place is still held by doctors/health professionals and second place is usually friends and family.


Half of current online health searches are done for someone else's health issue, and quite often information is gleaned from blogs or online comments made by others (this is now being called "passive consumption"). It's obvious that the internet is open 24 hours a day and you can remain anonymous while seeking information. You can also get information from sources worldwide, and you can use the internet to assess a recommendation made to you by a doctor.


The key is to use reputable websites like those sourced from the FDA, CDC, WHO and also expert-based, reviewed medical sites like WebMD, Intelihealth, Mayo Clinic. I write for healthcentral.com, a website that sets up "connections" devoted to specific individual conditions and illnesses.

Tuesday, June 16, 2009

New fast food fare...Kids health...Project vitality...Cupcake rage


I am heartened to see that not only Subway is offering healthier menu options, but now other fast food chains have climbed on the bandwagon AND....parents and kids are taking note. In general there seems to have been a shift in food choices: colas, chicken nuggets/strips, French fries and hot dog sales are down, while soup, grilled chicken sandwiches, yogurt, carrots, milk and fruit purchases are up. Interestingly enough, so are the sales of orange and grapefruit soda. Do you really think they are healthier??? Think again. You can now get smaller burgers and apples that look like French fries, reduced sodium chicken tenders, calcium fortified apple juice and fat-free chocolate milk at Burger King. Mcdonalds offers yogurt and apples and Wendy's kids meals now have mandarin oranges. It's a start, but obviously parents need to help their kids to find and embrace these healthier choices and portion sizes. It does seem that fast food corporations are getting the message that we need to offer these food shifts. The choice is up to us.


Though there are raging epidemics of obesity and diabetes among kids, on a larger evaluation scale, parents seem to be "doing right" healthwise, by their kids. Specifically we are choosing to breastfeed way more than moms did in the late 80's; SIDS (sudden infant death syndrome) statistics are down when compared to this time in 2004; we are still doing well when it comes to kid vaccinations, especially against chicken pox; more pregnant women are taking folic acid, and significantly less married-pregnant women are smoking when compared to statistics in 2005. We still need to work on lifestyle related issues and conditions like obesity/diabetes.


Albert Lea, a town of 18,000 has accepted the challenge and help from Vitality Project, a new organization that involves the AARP and a National Geographic explorer/documentary producer. The goal? To use his latest documentary findings - habits of communities that embrace health and enjoy longevity - and implement them in a US city. In this case, Albert Lea, MN, is the first recipient of the Vitality Project organizers, who arrived one month ago, to help implement healthier habits. There is already a virtual schoolbus, groups of kids who walk to school with seniors and their parents, better food offerings at truck stops (smaller portion, healthier choices), a shift in the community to eating more produce, empasizing physical activity and social activities, and a community generally coming together to find purpose and meaning in their lives. City officials are encouraged to fund more bike paths, garden plots and farmer's markets; citizens are encouraged to form walking and biking clubs; school and business cafeterias, grocery stores and restaurants are asked to revamp their food choices; motivational seminars round out the new regimen. The big question? Once the Vitality Project organizers leave, can the town sustain the changes.


Finally, the champion of healthy eating, MeMe Roth has stuck her controversial and big mouth into the school scene again, and the subject is cupcakes and birthday celebrations at school. Let's face it - if you add up all the "celebratory foods" your kids are exposed to - it's way (or weigh) too much!! Do the math - 30 kids in school means 30 "parties - then you go to the "outside school" parties, then the holiday school and outside holiday school parties and graduation and anniversary and "summer has come" and "I got 100 on my test" and "it's a special weekend" and "I fell down" and "my friend made fun of me" celebrations (with treats)....face it parents - the kids are getting way too many "happy/sad/celebratory "treats, and frankly, you are defining celebration (and emotional therapy) as only possible if treats are present. So why not compromise with one celebration a month in school to cover all the birthdays in that month (it will also help parents to pool the costs in these trying times)? And why not start celebrating and treating highs and lows with something other than food (some of the time)? As for MeMe, me-thinks she needs to continue her battle with a bit more grace and a bit less attitude. Let's get the job done withsome reasonable and elegant discussion. I'll throw in brownies made with....prune puree.

Monday, June 15, 2009

H1N1 vaccine...Teach yourself fullness...Join "vitality project"


In the news today:

(1) Novartis AG has used cell technology, rather than traditional egg technology, to produce the first batch of H1N1 vaccine. The company will probably be able to have the vaccine ready for sale after September. The first batch will be used for pre-clinical evaluation and testing, and is currently being considered for clinical trials. Currently Novartis has an order from HHS for $289 million dollars worth of vaccine.

(2) Dr. Louis Aronne, director of the Comprehensive Weight Control Progtram, at New York Presbyterian-Weill Cornell Medical Center, has released a new book which suggests that weight loss is not about will power or priorities-it's about your body, brains and hormones. His assertion that you need to "teach your belly to be full" is not new, nutritionists and dieticians for years have been extolling the notion that you need to have certain daily habits, in place, without fluctuation, to support long term weight loss. His tips include:


  • Eat a protein based breakfast daily (stimulates metabolism/prevents major blood sugar fluctuations

  • Eat a salad before each meal (watch the dressing)

  • Exercise in the am to stimulate your metabolic rate AND to "get it done"

  • Watch less TV

  • Get adequate sleep or look at sleep and certain medications as a possible contributor to your weight issues

My book, Fat Families Thin Families, offers those same recommendations but I also strongly asert that you need to create a home "team" environment that offers mostly healthy foods, acknowledges portion control, AND that asks everyone to climb on the "healthy habit train" whether or not you need to lose weight. Good health patterns are not soley about weight.


The Vitality Project is coming to Albert Lea, Minnesota, care of a collaberation between AARP and author/producer Dan Buettner. It's goal is to take the habits of communities around the world who seem to live "long and healthy lives" and bring them to the American obesity scene. The Minnesota community is "teaming up" (just like my book suggests), as a super-large family, to change lots of habits and environmental flaws in the community. Kids now walk to school as "virtual buses," accompanied by seniors and parents, schools are emphasizing nutrition, truck stop restaurants are offering healthier, portion controlled fare, and the general approach is to walk more, eat more fruits and vegetables and stay productive/enjoy life.

Friday, June 12, 2009

Adult Immunizations...H1N1 Flu...in the news


The increasing incidence of whooping cough in adults tells us that we need to really focus in on adult vaccinations or boosters. It is so clear that when you have a baby, there are a series of vaccinations and re-vaccinations that need to be given during their lifestime. As adults, we seem to forget that some of the protection these vaccinations give us is not lifelong. Tetanus seems to be the only booster shot routinely discussed by adults and their doctors. That means that if you are under the care of a physician, and seeing him once a year for a general health check (or for ongoing disease), you need to review your childhood vaccination schedule and determine if you are indeed, due for some boosters. Every city public health agency has the immunization schedule for adults and kids, so if you do not have a regular doctor, you can access this document and decide if you do need to go into a doctor's office for some shots. The danger of having whooping cough is that if you come in contact with an infant not yet immunized, you can infect the child, for whom this disease can be life-threatening.


The latest H1N1 victim in NY was an 11 year old Brooklyn public school student, who did have a pre-existing heart condition. That brings New York City's death from H1N1 total, to 15. Almost all of the deaths were among people who had pre-existing health issues including obesity, asthma, heart disease, diabetes whch explains the viruses ability to compromise those who already struggle with somewhat serious health conditions. With the official name H1N1 pandemic, the CDC and WHO have now clarified the global import (not virulence) of this virus. Understandably, parents are concerned about the seriousness of this virus, and it is certainly imperative that children and teens with any of the above mentioned health situations be in touch with their doctors immediately, if they believe they have contracted the H1N1 flu.

Thursday, June 11, 2009

It's a pandemic....obesity is the top news


It's official that the H1N1 flu has been catagorized as a pandemic - the first global flu epidemic in 41 years. Infections continue to climb in the United States, Europe, Australia, South America and in Hong Kong, schools are officially closed for 2 weeks n response to flu numbers. The recommendations remain the same: wash hands frequently, sneeze and cough into your sleeve and not your hands, stay home if you are sick and avoid sick individuals when possible. If you suspect a complication or if you have ongoing chronic health issues - seek medical help immediately. Tamiflu is still the treatment of choice to reduce symptoms and shorten duration of illness.


Several headlines in the news pertain to obesity:


The diabestes drug, exenatide, when combined with diet and exercise, helped non-diabetic obese patients lose more weight than similar individuals who just received diet and exercise instruction and support. Many doctors feel that drug therapy is an important element of treatment for obesity. Expected drug side effects include mild/moderate nausea and diarrhea (these symptoms were not contributory to the weight loss). The drug seems to decrease food intake because patients feel fuller.


Obese women who suffer with PCOS (polycystic ovarian syndrome) seem to lose weight and do well when their doctors give them diet advice and continue to advise and follow up on them. Many doctors feel ill equipped, pressed for time or fear losing patients if they offer such advice. This study shows that doctors should "give it a try" and offer general advice on diet and exercise after finding a way to broach the subject of their patients weight. Metformin, a diabetes oral drug, can help some of these women maximize their weight loss.


Children who are depressed can exhibit increased levels of the stress hormone, cortisol, another confirmation that obesity and depression can be linked in kids as well as adults. This study confirmed that abnormalities of cortisol play a direct role in both obesity and depression. Doctors should screen obese children for depression and kids with depression should be screened for eating disorders and the possibility of a high risk for developing serious weight gain.


Breast feeding is one of the greatest "health gifts" you can bestow upon your child, and the longer the better. But if mom is choosing to eat high fructose containing foods on a regular basis, mostly in the form of sweetened drinks, during pregnancy and/or breast feeding, then they may be more likely to have children, especially sons, who will be prone to becoming overweight. The actual mechanism may be an induced risk for an unbalanced metabolism, that makes the children susceptible to overeating and becoming overweight.


If your vitamin D levels are within normal limits at the start of a diet, new research shows that you will have more successful weight loss on that lower calorie diet. If you maintain those vitamin D levels or increase them, you may have more success with losing that resistant abdominal fat. In general, experts feel that we all need to target higher daily intake of vitamin D.


It seems that brown fat is a good fat to have, and adults and especially women do have some stores of this fat. This information may help scientists to figure out ways to maintain or even increase our stores of brown fat, which in turn, may help us to lose weight effectively or to maintain a healthy weight.


When choosing a diet, recent research show, a moderate carb diet may be your best choice. Of course, the carb choices you make should include fruits, vegetables, and high fiber/whole grain choices as your primary, portion controlled carb choices.


Wednesday, June 10, 2009

Weightlifting for ......back pain?


Almost everyone has had an episode of back pain. Most of us have been spared the "excrutiating back injury" or the chronic remnants of pain from an old injury. The old school of thought for treatment of back pain was: bed rest, pain killers and anti-inflammatory agents and "hope for the best." There has been research over the years to suggest that movement restriction can actually cause stiffness and excacerbate the situation, so the newer recommendation was to use bed rest for the very acute stage of injury and pain, and then to slowly begin movement, with medications as necessary. Now, another researchers weighs in with a new study and weightlifiting seems to be the key.


Pushing those sore muscles with weight training and improving overall body strength may reduce back pain and the chronicity of the back pain. In this study of 240 men and women, weightlifting enhanced quality of by as much as 28%, and the more frequent the training, the better the results. The participants had no surgery, and none of them suffered from damaged vertebrae or nerve root problems. Most of the men and women had lower back pain as a result of injury to soft tissue of the lower back. The theory behind the strengthening (of the whole body) is that we tend to injure our backs when we are fatigued, so making our body's strong in general will help us avoid a sudden injury. Also, when you use your back for specific tasks, it still involves using your core or abdominal muscles, bracing with your legs and then having your arms work to possibly lift something or move something. So all body parts are involved and all body parts need to be strong.


Once you have the injury, movement helps you to avoid stiffening and then the overall atrength moves help to substantially reduce injury as the back (and other areas) get stronger. The researcher's approach was to gradually introduce weight workouts and then after several weeks, begin a heavier, more demanding work out. The goal - lifting about 75%-80% of maximum lift ability, so the end point of the exercise plan is challenging, but not dangerous or unreasonable.
For more information on nutrition and exercise and family wellness check out:

Tuesday, June 9, 2009

Sleep....aging....and a sugar is a sugar


In today's news, it becomes clear that getting your zzzs...or not...has a host of health implications. Want to avoid the risk for high blood pressure? Then it's important to get adequate sleep, and that means restful, good quality sleep. Another area of your life impacted by sleep is your wrinkle destiny. Yes, adequate sleep can help to delay premature wrinkles. I've also heard that sleeping on silk sheets and pillowcases, and trying to sleep on your back is another good habit (still working on those). Finally, cumulative poor sleep patterns can hasten your risk of developing diabetes type 2, especially in the presence of other risk factors.

And about those sugars. though I am strongly in favor of waving the "HFCS (high fructose corn syrup) red flag," because it is so strongly present in processed foods, it is scientifically delusional to think that other sugars are somehow significantly superior. America is struggling with obesity, because we, as a nation, have totally lost our ability to assess portion size and we are simply eating too many foods high in fat, sodium and sugars (of any kind). We also eat way too much meat-based protein and we don't exercise enough. That being said, it is clear that gaining and losing weight is an extremely difficult endeavor, complicated by entrenched habits and emotional cues, as well as some contribution of genetic and familial destiny. Most of us cannot simply "willpower our way" to sustained weight loss. It requires behavior modification, a diet and exercise plan that stays in place after you hit "goal weight," and utilizing health professionals either full time or part time to enable our education and progress.

Monday, June 8, 2009

CA takes a giant leap regulating child-care center food


NY has led the way to a certain extent, on city-wide and state-wide changes, that impact the health of those individuals who live there. There are smoking bans, a recent requirement to post full nutritional breakdowns at fast food chains and city-wide efforts to maintain walking and running paths. California also has made an effort to promote healthful living, with no-smoking bans, and now a new bill has been proposed by Assemblywoman Julia Brownely (D-Santa Monica) to require child-care centers to follow certain minimal nutrition standards.


Specifically the bill, AB 627, would require that child-care centers:


  • Serve low fat or fat free milk (not whole milk) to children over age 2

  • Limit the use of sugary cereals

  • Eliminate sweetened drinks

  • Eliminate deep frying any foods

The bill would also establish an 18 month pilot program to evaluate the impact of implementing stronger nutrition and physical activity standards. Since child care centers, churches, community centers and other services may be locations that routinely serve more than one meal a day to chilkdren, these are places where quality of nutrition needs to be evaluated and then changed or modified based on assessments. There are better choices than fried potatoes, fruit in canned syrup, whole milk and other processed foods - and any increased expenditures for healthier food choices, can be offset with creative purchasing and bulk product opportunities.


Right now 350,000 children age 5 and under at least part time, if not full time, in child care. Los Angeles county 2230 child-care centers and 7800 family child-care centers. Those in favor of the bill feel that any center that gets federal funds, should have to comply with certain nutrition standards. Additionally, it is felt that these eating patterns establish lifelong adult patterns - so this intervention may help to impact and shift eating patterns and choices to healthier ones, long term. Currently 20.7% of the country's pre-schoolers are obese and 25% of kids ages 2-5 in California overweight or obese. A bill like this may be imperative, and currently only West Virginia and Michigan require that child-care centers in their respective states comply with federal dietary guidelines.. If the bill is passed, compliance would be required starting January of 2011, though no specific penalties would be imposed for non-compliance.

Friday, June 5, 2009

Antioxidants...yo-yo dieting...Kelly Clarkson


In the news today was an interesting study regarding anti-oxidant supplements and the beneficial impact of exercise on insulin levels. Exercise has a very positive impact on our health, and when it comes to diabetes, it is both a weapon to prevent the risk and a weapon to reduce the severity of the disease. Eating fruits and vegetables, that are rich in anti-oxidants, is considered another key to preventing diabetes or managing it if you have the disease. But this new study showed that taking anti-oxidants like vitamin C and E actually blunts the beneficial impact of the exercise on insulin levels. This may be one of the many cases where vitamins sourced from food behave differently when they are taken as manufactured supplements. Always choose foods over supplements when it comes to vitamins. there are cases when we cannot get enough vitamins from food, and then your doctor can determine which supplements you need. (Source, Journal Watch General Medicine, June 4, 2009;citation http://dx.doi.org/10.1073/pnas.0903485106)


There are alot of opinions regarding weight cycling or yo-yo dieting. Many experts and health professionals feel that an increasing/decreasing/increasing again burden of weight, can impact the heart negatively. Others say, keep trying to lose the weight, even if you have some weight gains and losses and gains again - overall, it is better to keep trying to get the excess weight off. A new study suggests that weight cycling does not increase mortality in middle-aged or older women. So the conclusion would be that you should persist in dieting and trying to get excess weight off, especially if you have risk factors for disease or frank disease. Hiring a personal trainer and/or nutritionist and allowing them to work as a team to help you (and your doctor) is one approach that might reduce the yo-yo dieting cycle, especially if you continue the relationship during early months after you hit goal weight.


Kelly Clarkson does not seem to be able to escape the weight discussion that fills the tabloids. In fact, she is "tired of hearing the fat joke." It's been going on for seven years, ever since she became the first American Idol and started her music career. She has always admitted to loving food and says she is just fine with her body. I cannot imagine the pressure of scrutiny that most high profile individuals are forced to endure. It's almost impossible to "feel pretty" when the measuring stick is so daunting. The reality is that most healthy people do not have picture perfect bodies. If they are well nourished with great energy stores they will appear clear eyed and energetic but they may not be size 4, nor perfectly proportioned and they may have cellulite. Healthy does not equal skinny. It does mean that you should know if your weight is in a safe range for your height and it does mean that your blood sugar, cholesterol, blood pressure and waist measurement should all be "healthy numbers." Let's let Kelly make that personal determination on her own.




Thursday, June 4, 2009

Obesity...Food...Fiber


Today's news covers a road range of topics all under the "food and weight" sector.


Kellogs is adding fiber to its kid targetted cereals, namely Froot Loops and Apples Jacks, with other kid favorite selections to follow. By 2010 most of the kid line will have at least 3 grams of fiber/per serving. Fiber inclusion seems to be what consumers are demanding. Let me point out that 3 grams of fiber is pretty puny if you are only choosing cereal as your daily source of fiber. Certainly Bran Buds, Wheat Germ and other cereals are far better choices to even mix in with your favorite cereal in order to target more than 3 grams of fiber at breakfast. Another "boost the fiber option" is to add 1/2 cup of berries. Of course, you should also be choosing whole grain/high fiber breads at lunchtime, and whole grain side dishes for dinner. And no insult to Frito-Lay, but their recent effort to adress this consumer request, has resulted in a new campaign of SmartFood snacks, and it is really a camoflage approachto get you to somehow justify a poor snack choice - by adding in a small amount of fiber to the food. Snacks should taste good and be good for you and my "super snack" list would include nuts, fat free yogurt, small smoothies made with fresh fruit and soy milk, cut up vegetables and hummus or bean dip (if you crave a crunch) or fruit plus a small serving of low fat cheese - not chips with added fiber. Really.........


Wherever fast food is a "new option" (like in Bulgaria), consumers say that would rather add in exercise than give up the fast food delight. New "fast food love" is tough to abandon according to some new statistics. In the US people admitted to eating junk food when they are down, trying to exercise to compensate for bad eating/health habits, while fewer admit to "eating whatever they want." And how often do we weigh ourselves here in the US? In this study, on average, 5% weigh daily, 10% once every couple of days, 13% once a week, 7% whever they feel their clothes are getting tighter, 19% not at all.


Finally a new weight reduction surgery is coming to the US - and it is less invasive. Doctors will soon be able to pass a somewhat thick tube down your throat and position staples in the stomach, that will create a narrowed passage, slowing food transit and making you feel full faster, with less food. Candidates are showing marked weight loss outside the US with this new surgical approach, and test subjects in the US are also having weight loss success.

Wednesday, June 3, 2009

Gastronomic Bombs


The Center for Science in the Public Interest puts out lists of foods that they deem "true offenders" of our health. The CSPI calls them Xtreme Eating (opportunities) and makes it clear that even if you follow a healthy diet most of the time - these eating splurges are so unhealthy that they jeopardize your health "in the moment," possibly putting you at risk for a sudden heart attack or stroke (especially if you already have strong risk factors for disease).


So what made their short list this year??



  • Applebee's Quesadilla Burger with 1820 calories, 45 grams of saturated fat and 4410 mgs. of sodium

  • Olive Garden's Tour of Italy with 1450 calories, 33 grams of fat and 3830 mgs. of sodium

  • The Cheesecake Factory Fried Macaroni and Cheese with 1570 calories, 69 grams of saturated fat and 1860 mgs. sodium.

The key here is to understand that a small food splurge is one thing; eating a meal that has an enormous dose of saturated fat and/or sodium and or big dose of calories to boot is asking for a "health crisis on a silver platter."

Tuesday, June 2, 2009

Gardasil and Bio-identical Hormones


Recent testing seems to reveal that using the HPV vaccine (Gardasil) in young women ages 24-40, who show no signs of HPV, may have a significant protective effect. Since this group is at high risk for HPV (considered a risk for cervical cancer) exposure, this new application to safeguard a significant part of the female population from contracting HPV. The caveat is that you have to be tested to make sure that the cost of the vaccine is warranted, since many women in this age group may have already contracted HPV. If you have HPV, the vaccine offers no benefits.


Many women fail to realize that bio-identical hormones are not regulated by the FDA. The testing done to determine your bio-identical hormone needs is not standardized. And the bio-identical hormones have their own benefits and risks - this is not an innocuous treatment. Purity and inconsistency of doses is also a significant problem in this industry, and this can offer additional risk to patients.

Monday, June 1, 2009

Tamoxifen..Lung cancer..Anti-depressants..Hormone therapy


In the news today, researchers have found additional troubling news about hormone therapy. Studies indicate that lung cancer seems to be more fatal in women taking hormone therapy (estrogen-progestin combination). Smokers currently taking HT should be weaned off, and those thinking about taking hormones should be discouraged, based on these new findings. If HT is used, the lowest dose for the shortest period should be used in these female smokers. Researchers are planning to take a look at those women just using estrogen, to see whether it alone, without progestin, causes the same higher rate of lung cancer fatalities. Lung cancer is the world's top cancer killer with more than 162,000 deaths in the US last year.

Breast cancer survivors who take Tamoxifen should be cautious in their choice of anti-depressant use. A new report found that Prozac, Paxil and Zoloft can interfere with the benefits of the Tamoxifen, wiping out it therapeutic effect completely. This puts those women at a higher rate of breast cancer recurrence. Since not all anti-depressants confound the Tamoxifen benefits, doctors should carefully assess the anti-depressant choice.

Friday, May 29, 2009

Weight Gain Guidelines for Pregnancy


I've already covered the new concept (though we nutritionists have been counseling this for years) of "not eating for two" when it comes to pregnancy. The simplest reason is that you really do not want to face all those extra unnecessary pounds to lose after the birth (though so many celebs share how they lose it in "weeks"). The more important reasons include the health risk the extra weight poses to you, and its impact on the baby's health, both short term and longterm). So what's the new guide for weight gain?

A normal weight woman (BMI 18.5-24.5) should gain between 25 and 35 pounds.

An overweight woman (BMI 25 - 29.9) shoud keep weight gain below 25 pounds (15-20 pounds is a good goal)

Someone signifcantly overweight (BMI 30+) should gain 11 - 20 pounds. Frankly some doctors and researchers say, no weight gain is necessary and any weight gain increases certain health risks already present.

An under-weight woman (BMI less than 18.5) can gain 28-40 pounds.

One important message? If you are seriously overweight, losing weight is not a safe option if you are already pregnant. Just work with a dietician/nutritionist to maximize the number and quality of the calories you are eating, and get a doctor's OK to start a walking program. Another caveat? If a person is already overweight it may be a strong challenge to keep them from gaining those extra unwarranted pregnancy pounds, but appealing to their desire to have a healthy baby could help alot in the motivation area.

Thursday, May 28, 2009

A Calorie is a Calorie BUT.....


There are still some issues to consider when figuring out an eating plan. Yes, recent research says a calorie is a calorie BUT:

(1) Some people do not burn carbohydrates quite efficiently or easily but they do burn fat efficiently, while for others the reverse is true. So the components of those calories you eat may be very important if you are trying to drop weight.

(2) Obviously the quality of the calories can have a great impact on your health - so you can't compare a diet of 1600 calories of highly processed food to a 1600 calorie diet of high fiber, healthy fat choices, healthy protein choices. They aren't "equals" in terms of health.

(3) I still suspect - and I'm sure science would support another reality - if the diet, however cautious in calories, is highly processed, you will have blood sugar swings that won't feel good and you may be more at risk for relentless hunger with those huge blood sugar downswings. Which means....eating more than you're supposed to eat.

So the bottom line?
If you are trying to lose weight you absolutely do need to count calories. At the same time, considering choices like high fiber/whole grains when it comes to carbs, fruits and veggies, monounsaturated and polyunsaturated fats, lean and also non-meat proteins and fat free dairy products can go a long way in satisfying taste, being economical, promoting health and even being "green."

Wednesday, May 27, 2009

Flu, Bathroom habits, Kids and Exercise



According to the CDC to date, there have been 7,927 cases of H1N1 flu in the US, with 11 deaths. There is still no easy predictability of how virulent this flu strain will be, nor its potential to mutate or become dormant. What is being postulated is that one of the impacts of this new strain may be that more people will take the yearly flu shot once it becomes available in the fall.




Apparently we spend alot of time in the bathroom - close to a cumulative amount of 8 days a year. What are we doing in there?? Well, no suprise, sitting and reading on the toilet (not me...I'm a swifty evacuator myself), beautification, bathing/showering and contemplation. For me, that means looking in the mirror for long periods of time and bemoaning my new wrinkles and lines (Clairol is taking care of the gray hairs!!) I also spend alot of time cleaning the mirrors which get "clouded" by the air freshener that my husband judiciously sprays before, during and after.....




Finally, new research suggests that kids typically abandon any significant exercise they may have been engaged in, around 7th grade. In my book, Fat Families Thin Families, I point out that girls around that age no longer find sweating "cool," and boys start to engage in long hours of video gaming, computer time and TV time. Maybe if girl tennis figures like the William sisters, Sharapova, and others were to show how their sweating achieves fabulous physiques and some basketball stars like LeBron and Kobe inspired teen boys to "move and be cool," we'd shift this unfortunate inertia phenomenon.








Tuesday, May 26, 2009

Lot of Health News Today


According to a report in my local Daily News, the latest "Biggest Loser" who is an almost boomer gives new hope to older people - you can, in fact, lose weight, even if you are older (who thinks these story lines up....kids??). She only had to work out 2 hrs in the am, 2 hrs at noon, and 2 hrs in the pm to keep the weight coming off after leaving the ranch. And of course, continue to eat a low calorie diet.


My thoughts?? I am older than she is and I do not consider myself "older folk" yet. I have helped women and men much older than this contestant lose weight and keep it off - without 6 hour a day workouts. Many of my 50+ women clients look much younger than she does, in part, because they did not lose their volume so rapidly. It is insane to think that other than a bit of inspiration and a great deal of entertainment value - this Loser approach to weight loss is intelligent, viable, and has a better long term track record than....sensible dieting and sensible exercise. Six hours a day???Seriously....nothing further need be said.


Since hypertension in kids is a growing problem, due to obesity and high salt diets, a new approach to diagnosing high blood pressure in kids may help prevent certain young patients from a missed or incorrect diagnosis. A researcher/pediatrician from Case Western Reserve University has re-vamped the current chart and schedules that dictates safe and unsafe blood pressure parmeters in children/teens. Doctors will now be able to dagnose pediatric and teen hypertension more easily and be able to offer lifestyle change recommendations or medications when needed.


Finally, the concept of "eating for 2" needs to be reserved for very few in our pregnant population. Women who are carrying extra weight or are seriously overweight might even need to avoid gaining weight during pregnancy. And healthy women may need only a bit more food daily to safely support their growing baby. Too many women are eating too many calories and gaining way to much weight in the name of "having a healthy baby." And this weight and higher calorie pregnancy diets, may actually be harmful to the growing fetus, putting a baby at risk later in life for health issues. So talk to a dietician if you are pregnant and make sure you also get in daily exercise. Walk for you and your baby!!

Thursday, May 21, 2009

Flip Flops and Baseball Hats and More


Apparently we wearers of flip flops and baseball hats need to be more vigilant about putting on sunblock. Doctors are seeing increased melanoma statistics, because we are wearing these 2 articles of clothing and NOT slathering sunblock on the tops of our exposed feet or our exposed ear tips. Big no-no AND we need to remember our kids wear flip flops and baseball hats too.

Stop buying those expensive sports drinks to re-fuel after workouts. First of all, we should all be budgeting, and these drinks are costly. Secondly, new research shows that whole grain cereal with fat free milk is a great post-workout refueling snack. Remember, portion control is the key - a cup of cereal with 6-8 ounces of skim milk should do the trick AND help you to save big bucks.

Finally a new diet book, Skinny Chicks Don't Eat Salad is out, and I'm sure it has some great recommendations BUT I will keep hoping the day will come when we all embrace the idea of a "family wellness plan" instead of another adult dieting plan. Just wishful thinking on my part.

Wednesday, May 20, 2009

News About Pregnant Mommies, Soda and M....ore



The latest news suggests that women who are significantly overweight and then get pregnant, should not, I repeat should not target additional weight gain in order to have a healthy baby. New research shows what I have always suspected - that there is enough "excess fat" to support the baby, and any additional weight gain will put added stress on the mother's heart and other organs, lead to a higher risk of insulin resistance and possible gestational diabetes, and pose risk for maternal hypertension.

If you are overweight you should work with a dietician or nutritionist AND consider starting a walking program with a fitness trainer monitoring and guiding you. Your OB and these professionals need to be your support team.

Drinking as much soda (diet or regular) as we Americans do (more than 600 cans/year), can put us at risk of a potassium imbalance, which can in turn put us at risk of serious health consequences. The culprits seem to be the sweeteners in regular soda and/or the caffeine (in both diet and regular soda). To bottom line it- A cup or two of soda a day won't create this issue, but more than that, and you are not only asking for weight gain (with diet or regualr soda consumption, though the mechanisms are different)- you are also incurring health risks. Drink zero calorie flavored waters, unsweetened iced tea and one serving of juice/daily.