Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

Reintroducing Cooking in American Households an Unlikely Prospect, Study Finds

May 18th, 2013 at 7:53 am by timigustafson
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Americans don’t like to cook. They don’t want to spend the time it takes for food shopping, food preparation and clean up, especially when it’s so much easier to stop for a quick bite at a restaurant or drive-thru or bring home some take-out. Yet, experts are convinced that making home cooking fashionable again would be one of the most effective steps we could take to address the nation’s obesity crisis.

The United States ranks at the bottom of industrialized countries not only in terms of time spent on meal preparation but also on consumption, according to surveys conducted by the Organization for Economic Cooperation and Development (OECD), an international group that analyzes economic data worldwide. In other words, we not only don’t cook, we also don’t set much time aside to enjoy our food. Instead, more and more of us skip breakfast, work through lunch and sustain ourselves throughout the day by snacking.

The percentage of calories from snacks in the American diet has doubled since the 1970s, as more people have turned into all-day grazers while foregoing sitdown meals on most days, a study by the National Health and Nutrition Examination Surveys (NHANES) found.

Over half of American adults say they have three or more snacks a day. Almost a third of children and adolescents eat chips, popcorn, pretzels and the likes on a daily basis. The amount of pizza eaten, both in restaurants and at home, has nearly tripled over the past thirty years. Meanwhile, the number of calories in pizzas has increased by 25 percent on average since the late 1970s. Over the same time period vegetable consumption has declined from 2.6 to just 1.9 servings per day – and that includes French fries.

The easiest way to turn these developments around would be to start preparing our meals from scratch again, says Mark Bittman, food writer and author of “Cooking Solves Everything: How Time in the Kitchen Can Save Your Health, Your Budget, and Even the Planet” (Kindle edition, 2011). Millions of Americans don’t ever cook. The rest cooks on occasion, often just microwaving. Many don’t bother with sitting down at the dinner table but rather eat in the car, at a counter, or in front of a screen. “And that’s a shame, because cooking is a basic essential, worthwhile and even enjoyable task,” he writes.

Bittman applauds others who are trying to get the message out about the many benefits of home cooking, like his fellow-book-author Michael Pollan who just published a new book on the same subject, titled, “Cooked: A Natural History of Transformation” (Penguin Press, 2013). In a review on the then upcoming publication he writes: “Cooking is probably the most important thing you can do to improve your diet.”

The reasons are obvious. If you are in charge of the ingredients that go into your food, you already are going to eat better because you won’t include extra fat, salt, sugar, preservatives, dyes and other additives. You also won’t eat as many highly caloric items like French fries, which are cumbersome to make at home. The same goes for pizza (made from scratch, not the ones you just heat up).

One of the central problems with cooking is that we don’t value it enough any more. We are used to having tasks like these done for us by outside service providers. But unlike getting your car or computer fixed by someone else, cooking is much more intimate. It connects us with our bodies, nature and loved ones.

Michael Pollan even thinks that the experience of cooking brings us closer to the most basic elements that surround us: fire, water, air and earth and also tightens our social and ecological relationships. All that has deeply transformational characteristics that can change us on multiple levels, but all for the better.

That is much to hope for – perhaps too much. Still, it is a fact that an increasing number of people are looking for ways to eat more healthily and also reduce stress on the environment, e.g. by cutting back on meat consumption and buying more produce from local farms. A rediscovery of home cooking would fit squarely within these trends. Whether it will be enough to transform or currently predominant way of life remains doubtful.

If you liked this article, you may also enjoy reading “Home Cooking for Healthy Eating” and “Tips for Leaner Cooking Techniques

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Most Restaurant Food Has Too Many Calories, Studies Find

May 15th, 2013 at 1:59 pm by timigustafson
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That too much fondness of fast food can cause weight problems is old news. But the idea that nearly all types of restaurants dish up meals that can expand your waistline has not been as widely discussed – until now.

Two separate studies, one from the University of Toronto, Canada, the other from Tufts University, Boston, Massachusetts, found that most restaurant food is not all that superior to hamburgers and fries when it comes to calorie and fat content.

The researchers who conducted the Toronto study discovered that the average meal in 19 different restaurant chains contained 1,128 calories, or about 56 percent of the recommended daily intake of 2,000 calories for adults. Some popular fast food items have considerably less than that. And excessive amounts of calories are not only found in dinner entrées but in lunch and breakfast servings as well.

Besides calories, the authors of the study report also expressed concern over high salt, fat and cholesterol content, sometimes exceeding between 60 and 150 percent of the recommended limits.

For the Tufts study, the researchers focused on calories in meals purchased at independent and small chain restaurants, which are exempt from having to post nutritional information on their menus, as it is required of larger chains. The results showed even higher counts than what their bigger competitors offered – a whopping 1,327 calories on average.

More than 90 percent of the small chain eateries included in the study served portion sizes that covered at least one third of a day’s worth of calories. 10 percent went beyond that, and a few even exceeded the recommended calorie count of an entire day – on just one plate. (Perhaps Adam Richman of Man v. Food should pay them a visit.)

“Considering that more than half the restaurants in the U.S. are independent or small chain and won’t be covered by labeling requirements in the future, this is something consumers need to pay attention to,” said Dr. Lorien Urban, one of the researchers who was involved in the Tufts study.

But even calorie postings on menus and billboards where they are required by law have been proven to be unreliable in prior investigations by Tufts and others. In fact, fast food places with their largely automated apportioning methods can find it easier to determine accurate measurements than restaurants that rely on estimates by kitchen personnel. There is only so much accuracy you can expect when dishes are individually crafted by hand, said one executive of Olive Garden, a nationally operating restaurant chain.

Still, restaurant patrons don’t have to feel completely helpless if they want to exercise some measure of control over their calorie intake. Dr. Lisa Young, professor for nutrition at New York University (NYU) and author of the blog “The Portion Teller”, recommends following an easily applicable restaurant survival guide she has compiled for her readers.

Being aware that portion sizes in most restaurants have exponentially grown over the past few decades is an important start, she says. It may look like you’re getting more value for your money, but the fact is that you will likely overindulge when you’re faced with an overflowing plate. Instead, she advises to order only half portions whenever available, or just an appetizer. Or you can split one entrée with a dinner partner.

Choose a salad or soup if they offer healthier alternatives to, let’s say, meat dishes. But be careful with dressings and creams – that’s where extra, unnecessary calories come in.

Don’t forget that your drinks have calories, too, sometimes lots of them. Sodas are notorious for high sugar content, and so are fruit juices and milk shakes. Alcoholic beverages count as well. The more you have of these, the more likely you’ll lose your inhibitions and end up overeating, she warns.

Desserts, of course, are always hard to say ‘no’ to, but you are not without choices. A few pieces of fresh fruit can be refreshing and they come without much regret.

What matters most – especially if you eat out often – is to keep track of your consumption, just like you would on any weight management program, if necessary with the help of a food diary. With the necessary precautions, you should still be able to enjoy a nice meal that someone else prepared for you.

If you liked this article, you may also enjoy reading “Why You Need a Dining Out Strategy” and “A Restaurant Guide for Healthy Eating.”

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Baby Boomers – those born between 1946 through 1964 – will live longer than any other generation before them, but they will not necessarily be healthier. In fact, many are already burdened with more chronic illnesses such as heart disease, high blood pressure and diabetes than their parents and grandparents were. Most of these health problems are lifestyle-related and could be prevented through changes in diet, exercise and weight management, but for some reason these messages seem hard to get across.

A recent study conducted by the West Virginia University School of Medicine found that despite of better education and greater awareness in health matters as well as advancements in medicine, baby boomers will likely face more sickness in their twilight years than generations before them.

The study found that the number of boomers who have high cholesterol has more than doubled compared to the previous generation. Nearly 40 percent are obese, an increase of over 10 percent in just 12 years. Less than half exercise regularly, and a rapidly growing number can’t walk without using a cane or a walker. Boomers are also reported to suffer more from mental illness and alcohol and drug addiction than their parents did. In other words, baby boomers appear to be heading for retirement in worse shape than those born before World War II.

According to a report by the National Bureau of Economic Research, a private nonprofit research organization specializing in economic studies, some of the lifestyle choices of this generation are resulting in “hazardous trends” in terms of health and aging. Especially the drastic increase in weight problems and obesity over the last few decades raise serious concerns about the future health and physical functioning of aging baby boomers, the report concludes.

At the same time, a large percentage is woefully unprepared for retirement in terms of finances and coverage of their health care needs. Nearly 90 percent are not sure they will have enough money to live out their years in comfort and financial security. 44 percent have little or no faith that they can sustain themselves without outside help, and 25 percent don’t think they will ever be able to retire, according to a survey by the Associated Press.

That is why health concerns are a priority for baby boomers not just per se but also for financial reasons. When Merrill Lynch, a wealth management company, asked in a recent survey thousands of Americans age 45 and older about their perspectives on retirement, the prospect of serious health problems topped the list of worries, followed by becoming a burden on loved ones and running out of money.

Health disruption is especially worrisome because it’s unpredictable, can be very expensive and can force people to retire earlier than they had planned or were ready to because of disabilities, says Dr. Ken Dychtwald, a gerontologist and bestselling book author who took part in conducting the survey.

The good news is that baby boomer retirees have more and better tools at their disposal to improve their health and age better than any of their predecessors. The keyword is prevention. Just as important as putting money aside for a rainy day is to take care of one’s health by eating right, exercising, staying within a healthy weight range and keeping the mind sharp. For this, it is never too soon or too late to start.

Undoubtedly, baby boomers are about to face many unprecedented challenges as they approach retirement in great numbers. But they are also well equipped to handle them with the same adventurous and pioneering spirit that got them through life so far.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Most Americans Don’t Exercise Enough – But Who Can Blame Them?

May 8th, 2013 at 1:01 pm by timigustafson
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Despite plenty of encouragement from the government and health experts to move more, Americans still find it hard to adopt a less sedentary lifestyle. Merely 20 percent are in compliance with the government’s recommendations for physical activity, which advise getting at least two and a half hours per week of moderately intense aerobic exercise like brisk walking as well as some strength training such as lifting weights or doing pushups.

The Physical Activity Guidelines for Americans, issued by the U.S. Department of Health and Human Services (HHS), call being physically active “one of the most important steps that Americans of all ages can take to improve their health.”

The Physical Activity Guidelines are meant to complement the Dietary Guidelines for Americans, a joint effort of the HHS and the U.S. Department of Agriculture (USDA). They are directed towards policy makers and health care professionals as well as the public at large.

According to a recent survey conducted by the Centers for Disease Control and Prevention (CDC) and published in the May 2013 issue of the journal Morbidity and Mortality Weekly Report, 52 percent of respondents to phone interviews reported meeting the recommended guidelines for aerobics, and 29 percent said they did with muscle-strength training.

The survey also came up with some other noticeable statistics. Less than a third of 18 to 24 year-olds met both aerobic and strength-training recommendations. Only 16 percent of over 65 year-olds came close. Hispanics did worse than other ethnicities. Education also seemed a contributing factor. Those with college degrees did on average better than those without. Normal-weight persons were more active than the overweight and obese. Americans living in the Northeast and the West outperformed Southerners. Colorado beat all other states. West Virginia and Tennessee came in last.

Similarly to the Dietary Guidelines, the Physical Activity Guidelines have been criticized as unrealistic and unattainable for many Americans, especially for low-income earners and those living in unwalkable and unsafe neighborhoods.

Multiple studies have shown that walkability in residential areas has a significant impact on people’s health. One study found that residents of neighborhoods with sidewalks, bike paths and public parks had a much lower risk of becoming overweight or obese than those who lived in areas without such amenities.

But unfortunately, issues of walkability and bikeability are still not included in the planning processes of many cities around the country. Walk Score, a Seattle-based company that evaluates major cities and midsized towns in the U.S., releases annual rankings of the most, and least, walkable places and rates them on a scale from 0 (= “car-dependent”) to 100 (= “walker’s paradise”). While New York City and San Francisco routinely qualify as most pedestrian-friendly and are lauded for their extensive public transportation system, smaller towns, especially in rural areas, still make it hard to get around other than by driving your own vehicle.

Physical fitness – like weight control – is considered by many as a matter of personal choice and responsibility. And to a certain extent that is true. However, other factors such as income, residence, access to grocery outlets and opportunities to be physically active within reasonable distance have all been shown to be decisive. If too many of these elements are missing, no appeal to behavioral change will suffice.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Even Health-Conscious Consumers Find It Hard to Maintain a Healthy Diet

May 5th, 2013 at 1:47 pm by timigustafson
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It’s a proven fact that most people change their eating habits and lifestyle choices only after a serious health scare such as a heart attack or a diabetes diagnosis. Still, in many cases that may not be enough. Old habits tend to die hard, but often there are also not many alternatives to what they’ve been doing in terms of eating right and taking care of themselves.

A recent study found that most consumers after being confronted with a major health crisis were still influenced in their choices by factors other than what’s good for their health. For example, people can find it difficult to change their long established eating habits, says Dr. Yu Ma, an economics professor at Alberta School of Business and author of the study. Another highly influential factor is price, he says. If they get a good deal on a particular item, they will go for it, and if it’s too expensive, they will stay away, no matter how much they would benefit healthwise.

Another issue is what he calls the “health halo effect.” Most people divide foods simply into two categories: healthy and unhealthy, he says. If something is considered healthful, e.g. a salad or a breakfast cereal, as opposed to a cheeseburger or a sugar-laden donut, people tend to overindulge in the “healthy” stuff without much further thought. We have seen that phenomenon when, for example, fat-free cookies came on the market and many believed they could consume those in almost unlimited quantities because of the absence of fat. Of course, eliminating the fat did not make those cookies less caloric, and the results became apparent soon thereafter.

Another study, this one on heart attack and stroke patients, showed that nearly 15 percent did not alter their eating and lifestyle habits after the incident, including poor diet choices, lack of exercise and smoking. Less than half of all participants in the study reported having made at least one change, and less than a third said they made several improvements. Only 4 percent claimed they did everything that was recommended to them to prevent further deterioration of their health.

Much of the unwillingness or inability to make healthier diet and lifestyle choices can be blamed on the widespread confusion among the public due to the ceaseless onslaught of sometimes contradictory messages in the media about health matters. In addition, many of the warnings issued by experts are hard to heed by consumers who are oftentimes ignorant, if not intentionally kept in the dark, about the nutritional quality of their food supply. For instance, recommendations to avoid high fat, salt and sugar content may be well-meaning, but they are by and large useless when ingredients lists are hard to decipher or when restaurants aren’t required to follow any dietary guidelines or to post nutritional information on their menus.

“I think people are interested in making changes and they are heeding the warnings,” said Dr. Sara Bleich, an associate professor of health policy at the John Hopkins School of Public Health to NBCNews. “But when it comes to food, it’s much more complicated. Cereal, for example, has a tremendous amount of added sugar. And not everyone understands that breakfast foods like muffins and pastry, things that people don’t consider to be a dessert or an indulgence, pack a lot of sugar.” Similar concerns apply to salt in countless processed foods, many of which don’t even taste salty, and certain types of fats, some of which are obscured by arbitrary serving descriptions on food labels.

Undoubtedly, more and more people want to be better informed about nutritional health and be empowered to make the right choices. With growing consumer demand for further regulation and protection, that may be feasible over time. But for now, it’s an ongoing uphill battle, and most of us have to fend for ourselves as well as we can.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Investors Are Influencing How We Will Produce and Consume Food in the Future

May 1st, 2013 at 1:54 pm by timigustafson
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If you want to know how food will be manufactured, distributed and consumed tomorrow, just follow the money. Venture capital firms in Silicon Valley and elsewhere have begun shifting their almost exclusive focus on high-tech startups to more mundane enterprises such as food producers and food sellers. Is the food trade turning into the next gold rush? Maybe not right away. But there are developments on the horizon that will possibly change the food industry as we know it.

Last year, venture capitalists have reportedly poured over $350 million into startup companies that deal in one way or another with food. That’s a seven-fold increase from 2008.

Khosla Ventures an investment group founded by Vinod Khosla, a former CEO of Sun Microsystems, for example, has spent seed money on half a dozen food-related startups, especially the kind that seek to improve manufacturing methods in terms of nutritional quality and environmental impact.

One of Khosla’s beneficiaries is Hampton Creek Foods, a food technology company based in San Francisco that has developed a plant-based egg substitute. The idea is to give food manufacturers an alternative to using regular eggs in their products. “Beyond Eggs,” as they call their invention, can not only help to cut costs because it’s cheaper than eggs, it’s also safer and does not involve cruelty to animals.

Laying hens in industrial egg farms are confined to small wire cages that afford each a space smaller than a sheet of letter-sized paper. That’s not only hard on the hens but also increases the risk of disease outbreaks like Avian Flu and salmonella poisoning, says Josh Tetrick, the company’s founder and CEO.

And in terms of costs, industrial egg production is not sustainable either, he says. The reason why egg prices keep rising is that laying hens require enormous quantities of feed to generate this many eggs. “It’s an outdated and inefficient system that is a breeding ground for foodborne bacterial illnesses.”

Like Tetrick, his financial backers see a future in food safety and sustainability issues. “Part of the reason you’re seeing all these V.C.’s get interested in this is the food industry is not only massive, but like the energy industry, it is terribly broken in terms of its impact on the environment, health, animals,” he says.

Small startups are in a better position to come up with alternative solutions. Big Food will have a much harder time in the area of innovation. “I wouldn’t bet my money that Cargill or ConAgra are going to innovate here,” said Samir Kaul, a partner at Khosla, to the New York Times.

Not all investors in food-related startups want to get involved with the manufacturing side of the business, which is considered complex and not as profitable. Many are more comfortable with service-oriented ideas like how to better connect fledgling enterprises with customers through new technologies. But the field is widening.

Of course, food companies have enjoyed backing from risk-taking venture capitalists in the past. StarbucksP.F. Chang’s and Jamba Juice, all dominating in their respective markets now, could not have gotten off the ground without help from their early investors. But what seems different with this latest trend is that it takes place in a climate of changing consumer behavior. More than ever, people want to know what goes into their food, whom they can trust, how their choices affect their personal wellbeing as well as the environment. They are also aware they are not alone with their concerns.

For instance, the online service meetup.com has a category called “Food Startups,” which helps facilitate meetings between food lovers, entrepreneurs, investors, activists, food critics, journalists, bloggers and everyone else who is passionate about food and technology. If you don’t feel represented by any of the existing meetup groups, you can also start your own. Who knows, perhaps you’ll get a little backing for your ideas, too.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Use of Pesticides Continues to Make Some Foods Unsafe for Consumption

April 28th, 2013 at 4:58 pm by timigustafson
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An apple a day used to keep the doctor away, at least according to folk wisdom. But not any more – unless it’s organically grown. Apples top the list of foods contaminated with pesticides, says the Environmental Working Group (EWG), an environmental health research and advocacy organization, in its annual report called “The Dirty Dozen™.”

The listing of foods that may have toxic levels of pesticides is part of the group’s Shopper’s Guide to Pesticide in Produce, which draws its data from tests conducted by the U.S. Department of Agriculture (USDA) and the Food and Drug Administration (FDA).

Even after washing, more than two thirds of the tens of thousands of food samples tested by the agencies showed pesticide residues. The most contaminated fruits were apples, strawberries, grapes, peaches and imported nectarines. Among vegetables, the most contaminated were celery, spinach, sweet bell peppers, cucumbers, potatoes, cherry tomatoes and hot peppers.

The contamination levels varied significantly between different foods. Potatoes had a higher total weight of pesticides than any other food crop. A single grape tested for 15 different pesticides. So did sweet bell peppers.

Corn, which is widely used as an ingredient in processed foods, does not appear in the EWG’s guide because as such it’s no longer considered a fresh vegetable. Neither is soy. Still, concern over pesticide contamination should also include processed items.

In addition to its notorious “Dirty Dozen™” rating, the EWG also publishes a list of the least contaminated foods, called the “Clean Fifteen™.” These show the lowest levels of pesticide residues and are generally safe for consumption. They include pineapple, papaya, mango, kiwi, cantaloupe, grapefruit, corn, onion, avocado, frozen sweet peas, cabbage, asparagus, eggplant, sweet potatoes and mushrooms.

Pesticides have long been linked to a number of health concerns, particularly to developmental problems in young children. Some pesticides have been found to be carcinogenic, according to the Environmental Protection Agency (EPA).

There are currently about 350 different pesticides registered with the government and permitted for use on food crops. Among the most toxic ones are organophosphate, a potent neurotoxin that can adversely affect brain development in children, even at low doses; and organochlorine, a once widely used pesticide that is now officially banned but still persists in the environment and continues to pollute plant foods grown in contaminated soil.

Particularly disconcerting is that pesticides have been found in processed baby food. For example, green beans used for baby food tested positive for five pesticides, including organophosphate, and pears showed more than twice as many.

While there is only so much consumers can do to protect themselves and their loved ones against the exposure to pesticides and other toxins in their food supply, it is important to have the information available that allows for better-informed choices. Buying organically grown produce may be the best option, but it’s not affordable for everyone. Mixing both organic and regular foods can be a workable compromise, thereby avoiding the worst offenders and limiting the damage to your budget with the rest.

In addition, you may also want to visit your local farmers market once in a while. Ask the farmers about their farming methods and whether they use pesticides. Some small farms may not be certified “organic” because of the costs involved but still adhere to eco-friendly procedures.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Lifestyle-Related Ills Tend to Multiply with Age, Study Finds

April 24th, 2013 at 7:13 am by timigustafson
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Seniors who suffer from chronic health conditions like high blood pressure or heart disease often develop a host of other, seemingly unrelated health problems, including cognitive impairment like memory loss and dementia, according to a new study based on data collected by the National Center for Health Statistics.

For the study, the researchers analyzed the medical records of hundreds of thousands of seniors residing in assisted-living facilities and found that most had at least one chronic health condition. What was more alarming, however, was that many had overlapping ailments. While high blood pressure and heart disease were most common, nearly half of the assisted-living residents showed signs of dementia.

“These findings suggest a vulnerable population with a high burden of functional and cognitive impairment,” the authors of the study report wrote.

Many studies have suggested a link between vascular disease and dementia, particularly Alzheimer’s, said Dr. P. Murali Doraiswamy, a professor for psychiatry and behavioral sciences at Duke University’s Institute for Brain Sciences (DIBS). Therefore it may not be possible to treat dementia without treating vascular problems, he added.

But that may be easier said than done. “We don’t universally do a great job of how we treat conditions that overlap, for example Alzheimer’s and high blood pressure,” said Dr. Cythia M. Boyd, an associate professor of geriatric medicine at the John Hopkins University Center on Aging and Health, to the New York Times. “Much of the way we practice medicine is looking at disease by disease. We aren’t doing enough thinking about how to add them together and really integrate care.”

What makes things more complicated is that most doctors are not sufficiently trained in preventing or reducing lifestyle-related illnesses – not in the general public and certainly not in older patients – other than through medicating. For instance, the importance of nutrition as a part of preventive care is rarely ever mentioned in medical schools. The approximate time devoted to nutrition science over the first two years of medical education is six hours, which is clearly inadequate, according to the National Academy of Sciences. The same goes for other health-promoting measures such as exercise, especially for the aging population.

Yet many studies have provided compelling evidence that diet and exercise play a significant role for physical and mental health at any time in life but increasingly so as we age.

For example, a more recent study from Britain concluded that the so-called “Western diet,” which typically includes fried, sweet and processed foods, red meat, refined grains and high-fat dairy products, increases the risk of chronic diseases, which in turn can adversely affect both physical and mental health in later years. Eating a Western diet makes it less likely to have an ideal aging process, says Dr. Tasnime Akbaraly, a researcher at the University College of London and lead author of the study report. Conversely, making dietary improvements can yield multiple benefits in this regard.

There is also further evidence that exercise can give a boost to the aging brain. Scientists at the University of British Columbia found that older women who suffered from mild cognitive impairment could improve their memory through weight training and brisk walking.

The connections between physical and mental decline may not yet be completely understood, but it seems clear that chronic diseases play a major role in the process. While these are widespread, the encouraging news is that many, if not all, are preventable by healthier lifestyle choices.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Testosterone Treatment for Older Men Shows Only Limited Benefits, Study Finds

April 21st, 2013 at 12:27 pm by timigustafson
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What is a guy to do when he starts feeling his age? What if he’s less energetic, less playful, less romantically inclined than he used to be? Should he accept it all as an inevitable part of life or should he fight back?

If you watch television at all, you cannot miss the onslaught of ads directed at male baby boomers who wonder where all their mojo has gone. Could it be low testosterone, “low T,” as the abbreviation goes? If so, the advertisers assert that hormone therapy, or more specifically testosterone replacement therapy, can do the trick.

Sales of prescription hormones have more than doubled since 2008, reaching $1.6 billion last year, not including supplements purchased over the counter, according to IMS Health, Inc., a company that analyzes healthcare-related data.

Men are bombarded by these advertising campaigns, urging them to ask their doctor about low testosterone, says Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City, in an interview on the subject with WebMD. So they come complaining about feeling fatigued, weak, depressed and without sex drive, which are all common symptoms of a drop in testosterone.

Testosterone levels can be determined by a simple blood test. A normal testosterone range is between 300 and 1,200 nanograms per deciliter (ng/dL) of blood. Less than 300 is considered low T.

In Dr. Mezitis’ estimation, about a quarter to a third of the patients he tests have levels below normal. But in most cases, the symptoms have other causes. While lower levels are to be expected with aging, he says, lower than normal scores can have a number of different reasons, including diabetes, high blood pressure and coronary artery disease.

Testosterone is a hormone responsible for a man’s libido, sperm production, and also for muscle and bone strength. A gradual decline in testosterone usually begins after the age of 30. Other health problems in addition to natural aging may accelerate the process.

Treatment for low T. comes in multiple forms, including injections, patches, pellets, tablets and gels.

Ideally, the goal would be to keep testosterone at levels consistent with those of a 25-year-old male. But hoping for that kind of rejuvenation may be a stretch.

A new study found that older men who used testosterone gels saw small improvements in their muscle-to-fat-ratio, but not too many noticeable benefits to their physical wellbeing in terms of energy, flexibility and endurance.

Based on these findings, it is not altogether clear what testosterone therapy can do in addition to physical exercise, said Dr. Kerry Hildreth of the University of Colorado School of Medicine in Aurora, the lead author of the study in an interview with Reuters. The therapy may be “widely used in people where it really may not be appropriate or may not provide the benefits that people think it’s going to,” she added.

There are also concerns over side effects. Skin irritations such as acne and rashes as well as premature balding and breast development have been reported in cases of prolonged use of testosterone boosters. There are also risks of liver damage.

Besides the physiological effects, there can be a psychological impact as well. Mood swings, irritability and aggressive behavior have been noticed.

To maintain physical vigor at an advanced age, regular exercise, especially strength and endurance training, may still be the best way to go. As the study mentioned above showed, testosterone therapy brought few if any advantages beyond what could be achieved by exercising alone. In addition, I would advocate a healthy diet and stress management, both issues that grow in importance with aging.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

What Makes Us Stray from Eating Right?

April 18th, 2013 at 11:15 am by timigustafson
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Part of our ongoing struggle with weight problems is that most of us eat without thinking, according to Brian Wansink, professor for marketing at Cornell University and author of the landmark book, “Mindless Eating – Why We Eat More Than We Think” (Bantam Books, 2006). “Distractions of all kinds make us eat, forget how much we eat, and extend how long we eat – even when we are not hungry,” he writes.

Although distractions are easy to come by in our busy lives, it doesn’t mean that we keep munching all day long without noticing, although for some that may be the case. Mostly, however, we tend to fall into the mindless eating trap when we are relaxing, for example on a vacation, over a nice dinner out, or when we get a little tipsy. That’s when our control mechanisms seem to break down the fastest.

“Vacations take us away from our regular routine,” says Lori Rice, a nutritionist and health and travel writer. “This is beneficial to our mental wellness because we experience new scenery and can rejuvenate ourselves, but it also can take us away from our healthy habits.”

Of course, you should allow for some splurges when you go on a holiday, but don’t use it as an excuse for getting completely off track, only to be sorry later on for the damage you’ve done to yourself, she advises.

Especially on cruises, vacationers tend to throw all caution to the wind. When the food you’ve already paid for is laid out so seductively, it can take considerable willpower to resist temptations. Seeing your fellow-travelers indulging with abandoned pleasure doesn’t help either.

But even the atmosphere in a simple eatery can lead to overeating. You don’t even have to like the food all that much. A nice ambience with candlelight and soft music can have you dig in more than you should, says Wansink who has conducted numerous experiments on people’s behavior in restaurants, from fast food joints to high-end establishments. We follow our expectations, he says. If we expect to have a good time, or it’s a special occasion, we will make the most of it. And that often means too much of a good thing.

Another factor is alcohol. As a recent study found out, most people eat more unhealthy foods on days they drink. When participants in the research had two or three alcoholic drinks with their meals, they consumed on average 100 to 200 more calories from food (not the drinks) than when they had none. The types of food they chose also changed. Both male and female participants ate about nine percent more fat when they drank alcohol.

The best way to counteract these tendencies is obviously to increase awareness. But instead of becoming your own party-pooper every time you are ready to let loose a bit, it might be more helpful to set a few parameters upfront.

For example, if weight gain is a regular occurrence when you are away from home, you may want to choose a kind of travel that challenges you to be more physically active and less exposed to culinary pleasures.

If you have a lot of time to kill at airports and hotels, be sure you don’t fall for convenience stands, vending machines and snack bars. Instead, bring some healthy snacks and lots of water, in case you need a quick energy boost or get dehydrated.

When it comes to alcohol consumption, you are the only one who can judge your responses. For some, there is a fine line between relaxing and becoming uninhibited or losing control. A lot of people also don’t know or don’t think about how many calories are in their drinks.

Perhaps a good way of keeping things together is to ask yourself: How do I want to feel when this is all over? Will it be an altogether great memory or will I have to deal with regrets and start over?

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit http://www.timigustafson.com

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