Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

Healthy Eating But Not Dieting Recommended for Pregnant Women

June 21st, 2012 at 6:38 am by timigustafson
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A new study on dietary recommendations for pregnant women concluded that healthy eating and calorie control during pregnancy can help prevent obstetric complications. Also, pregnant women who are overweight or obese can lose weight safely by improving their eating habits but not by dieting.

The study, which was funded by the National Institute for Health in the United Kingdom and published in the British Medical Journal (BMJ), was based on the results of research involving more than 7,000 women. Both in Europe and North America, up to 40 percent of women gain more than the normal amount of additional weight due to pregnancy, which can cause a number of health problems associated with excess weight.

The researchers said that following a healthy diet instead of “eating for two” can help prevent the risk of a host of complications during pregnancy. However, current guidelines do not advocate dieting for weight loss during that time. The National Institute for Health and Clinical Excellence (NICE) warns that calorie restriction for the purpose of weight loss during pregnancy may harm the health of the unborn child.

Observing healthy eating habits, of course, is important at any time in life, but it matters even more for women who are pregnant or plan to become pregnant. A low-calorie, nutrient-dense diet that includes lots of fresh fruit, vegetables, whole grains, low-fat dairy products and lean protein sources is beneficial for both mother and child. While there is no specific “pregnancy diet,” nutritional balance in both quality and quantity of the food an expecting mother eats is key.

Most women feel more often hungry than they did before their pregnancy, tempting them to overeat on occasion. To prevent this from happening, it is perfectly permissible to break with one’s usual eating pattern of three daily meals and nibble instead on several smaller servings throughout the day. Healthy snack foods can help with sudden hunger pangs. This approach can also work if nausea, food aversions or indigestion make it uncomfortable to eat and digest regular-size meals.

The most important issue is to eat as nutritionally healthy as possible. This includes having good sources of protein, calcium, folic acid and iron as well as vitamins and minerals. Going through pregnancy on a strictly vegetarian diet is possible as long as a sufficient supply of complete protein is maintained. To avoid nutritional gaps, it can be useful to take a multivitamin supplement. Before taking supplements, however, pregnant women should consult with their physician. The same goes for prescription drugs and over-the-counter medications.

There are also certain foods that should be restricted or completely avoided during pregnancy. For instance, raw seafood like oysters or sushi, undercooked meat, raw eggs (in dressings and sauces), unpasteurized milk and cheese made from unpasteurized milk are all potential carriers of bacteria that can harm a fetus. Some fish species (both wild-caught and farmed) may have high amounts of methyl-mercury from environmental pollution. It has been shown that traces of metals such as mercury in the food supply can be harmful to the developing brain and nervous system of fetuses and infants. For this reason, the U.S. Food and Drug Administration (FDA) advises pregnant women to limit their fish consumption to two serving per week.

Alcoholic beverages in any form should be completely avoided during pregnancy. Cutting back on caffeine, including coffee, tea, cacao, colas and even chocolate (ouch!) is also highly recommended. The best choices for drinks are plenty of water (non-chlorinated), fruit juices (made from real fruit) and low-fat or non-fat milk. Empty calories and excessively high amounts of sugar from sodas benefit neither the mother nor the baby and should be kept to a minimum.

Last but not least, it is a good idea to create a health-promoting environment. That includes a thorough inspection of the refrigerator and pantry. If necessary, nutritionally inferior items should be tossed out and replaced with better ones – before temptation strikes.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Marital Bliss Can Promote a Healthy Lifestyle

June 17th, 2012 at 12:11 pm by timigustafson
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Couples who eat and exercise together have a better chance to manage their weight and stay fit, according to a study from the University of Michigan School of Public Health. What matters most is good communication and a shared commitment to a health-promoting lifestyle.

When both partners take responsibility for their own as well as each other’s well-being, they have a much better chance to succeed in their efforts. If those goals are only pursued by one of the partners, it can be a frustrating experience.

Married men, more than women, tend to make lifestyle changes “to keep the peace” rather than out of conviction, according to Dr. Derek Griffith, one of the authors of the study report. If men don’t like their wives’ food choices, they often make up for the deprivation when they are away from home, sometimes in form of binge eating. “The key to married men adopting a healthier diet is for couples to discuss and negotiate the new, healthier menu changes as a team,” he said.

Typically, both men and women tend to gain a small amount of weight after getting married. 10 to 15 percent of additional body weight is not unusual during the first two years of married life. “When you have these kinds of big life changes, your weight can go up,” said Dr. Dmitry Tumin, a sociologist at Ohio State University, who conducted an extensive study on the subject. He found that on average married women are 46 percent more likely to gain weight than women who remain single. Men are also more prone to weight gain after marriage but even more so after divorce. After the age of 30, the risk of weight gain is considerably greater for men than for women when they undergo changes in marital status. “As you get older, having a sudden change in your life like marriage or divorce is a bigger shock than it would have been when you were younger,” said Dr. Tumin.

The takeaway from these studies is that couples have a tremendous influence on each other’s health – for better or worse. It is not just a matter of who does the food shopping and home cooking but even what kind of furniture is chosen, how big the TV is and where it’s located, whether there’s room for fitness equipment in the house, etc, etc. One study found that even the size of the living room couch has a direct impact on its owners’ eating habits. The more comfortable people get, stretching out on the sofa or La-Z-Boy, the more snacks and junk food they’re likely to consume.

“Watching TV and snacking on junk food have become ‘complimentary behaviors’ for many people,” said Dr. David L. Katz, director of the Yale University Prevention Research Center. While watching TV, people don’t get any exercise, they see tons of food advertisements, which stimulates their appetite, and because they are distracted, they quickly lose control over their food intake. “It’s a perfect storm of unhealthy behavior,” he said.

The good news is that couples can encourage each other to make positive changes and lend support when sticking to a health regimen gets tough. Both partners should also be patient and forgiving when some of the inevitable lapses occur.

Instead of trying to “revolutionize” their entire lives, people should take on one or two manageable changes at a time. For instance, instead of tossing out a spouse’s less-than-healthy but beloved stash of snack foods and replacing it with green vegetables, it can be more helpful to add a few more nutritious items here and there and allow for a phase-out period for the rest.

The same goes for exercising. It makes no sense to start out with a bang when one or both partners haven’t been physically active for a while. If one is in worse shape than the other, consideration and patience are most important. Mutual encouragement and shared successes over time will lead to better results.

Last but not least, it is extremely important to acknowledge and applaud each other’s progress. Being seen by one’s partner as attractive and desirable is a crucial element of marriage that never changes. If wanting to look great in sexy lingerie or to make her melt in your strong arms is all the motivation you need, then that’s the way to go.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Cruise to Lose

June 13th, 2012 at 12:16 pm by timigustafson
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It is a common and often lamented phenomenon that people gain weight while on vacation. Especially cruises are known as food traps where travelers tend to quickly lose control over their calorie intake. With all the fantastic culinary displays, all included in the prepaid fare, how could anyone resist overindulging? Well, it depends on your itinerary. Nowadays, you may come home leaner and fitter than you left.

Just take Celebrity Cruises, for example. The 2,850-passenger “Celebrity Eclipse” offers highly intensive weight loss programs on the scale of NBC’s reality show, “The Biggest Loser.” Participants can join all-day exercise classes, wellness lectures and healthy cooking demonstrations. Bob Harper himself, one of the show’s principal trainers, has been hired to give keynote speeches about getting motivated and adopting a health-promoting lifestyle. Those who sign up for the “Loser Cruise” will also have access to special weight-loss-friendly meal choices that are not part of the regular menus on board.

It’s a great concept. You learn to eat better, lose weight, pick up a few tricks from professional health experts and still feel you’re on a vacation of a lifetime. Who says you can’t have it all?

To make diet and lifestyle changes, it is important to get away from your everyday environment once in a while, said Harper. “The biggest obstacles to healthy living are bad habits we fall into over the years. We hope that people will jump at the chance to take a fun vacation and learn how easy it is to adopt a healthy, active lifestyle.”

Celebrity is not the only cruise line that has discovered this new travel niche. Royal Caribbean’s star ship, “Freedom of the Seas,” has one of the largest and most sophisticated spa and fitness centers at sea today. A 17,000-square-foot workout arena, a rock-climbing wall, ice rink, luxury spa and boxing ring offer a playground the size of a supermarket. Cunard’s Queen Mary 2 with its Canyon Ranch SpaClub® and Costa Cruise Line’s Costa Concordia, whose spa and fitness center covers two entire decks, are even larger.

And it’s not just the mega-ships that do their utmost to accommodate a new breed of fitness seeking passengers. Smaller-size ship operators follow suit, too. Windstar Cruises, best known for its dramatic display of white triangular sails, has expanded its fitness facilities and provides many healthy meal options, including all vegetarian menus.

Obviously, the opportunities for breaking some sweat are not limited to onboard activities. Cruise operators offer programs in almost any sports category imaginable, including many onshore daytrips for hiking, biking, horseback riding, kayaking, rafting, climbing and more.

The bottom line is that getting heavier on vacation is no longer as inevitable as it once seemed to be. “With all the exercise offerings on board of today’s cruise ships, you no longer have to leave your workout regimen at home,” said Anita Dunham-Potter, a travel columnist. “Health and fitness is the new wave in cruising, and that’s something to jump up and down about.”

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Long Commutes Are Hazardous to Drivers’ Health, Study Finds

June 10th, 2012 at 1:27 pm by timigustafson
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Driving long distances on congested roads is part of the daily grind for millions of Americans. Commuting between the home in the suburbs and the workplace downtown has been a common phenomenon since the 50s and 60s and the hassle has only become worse ever since.

In a recently published study, researchers from the Washington University in St. Louis, Missouri, tried to shed some light on the impact of commuting on drivers’ health and found that driving long distances on a twice-daily basis can substantially increase the risk of developing weight problems, heart disease and lung disease.

“The study was the first to show that long commutes can take away from exercise and are associated with higher weight, lower fitness levels and higher blood pressure, and all of these are strong predictors of cardiovascular disease, diabetes and some cancers,” said Dr. Christine Hoehner, the lead researcher of the study, which was published in the American Journal of Preventive Medicine.

The research was conducted in the areas of Dallas-Fort Worth and Austin, Texas, where most people go to work by car. The more time they spend behind the wheel, the less opportunities they have to do other things, including activities that would benefit their physical health. That is bound to have consequences over time, Dr. Hoehner suggested.

She and her colleagues also tested commuters’ heart and lung health, blood pressure, cholesterol levels, triglycerides and blood sugar. Those who traveled more than 10 miles each way showed higher risk levels in most categories. “It looks like the threshold was a commute distance of 10 miles for blood pressure,” she said. The risk of becoming obese increased at 15 miles or more daily commute.

It’s not just the sedentary lifestyle that comes with long distance commuting. Driving on congested highways is also a source of considerable stress. People are locked in a situation they absolutely hate but can do little about. And the same scenario repeats itself five days a week.

“Learning how to cope with the stress of commuting could help limit the negative health effects,” said Dr. Redford Williams, professor of medicine and director of the Behavioral Medicine Research Center at Duke University. But that is a difficult undertaking because people feel they have almost no control. In the current economy, most workers are forced to take jobs where they can find them, even if it means driving for an hour and a half or longer every single day.

While not much can be changed about traffic situations on an individual basis – other than moving closer to the workplace, which is not always a realistic option – long-distance drivers can benefit from getting a workout or at least going on a swift walk around the block during lunchtime. Also, people who like to eat in the car while driving (a common phenomenon among commuters) may reconsider their habits, especially since most of the food choices for the road are less than healthy, i.e. fast food and snack items.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

High Taxes on Sodas Could Reduce Obesity Rates, Experts Say

June 1st, 2012 at 12:21 pm by timigustafson
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Imposing hefty taxes on sodas could curb consumption and make a significant difference in the fight against the current obesity crisis, according to health experts from Oxford University in England. The authors of a study published in the British Medical Journal (BMJ) proposed a tax rate of 20 percent or more on sugary drinks, which are widely considered a major cause for weight gain both in Europe and North America.

“We’ve tried other measures to reduce obesity and they haven’t worked,” said Dr. Mike Rayner, director of the British Heart Foundation, a research group at Oxford University and lead author of the study report.

For the study, Dr. Rayner and his colleagues examined taxation policies on sodas in other countries as well, including the United States. They found that small to modest tax rates of one to eight percent were insufficient to make consumers change their buying habits. But when some cafeterias on high school and college campuses introduced price hikes of 35 percent or more, consumption dropped almost immediately. Taxes on sweetened or carbonated drinks should be on par with tax rates on other unhealthy products like tobacco or alcohol because they are equally as threatening to public health, the study concluded.

The concept of reducing consumption through heavy taxation is not only being applied to sodas in some parts of Europe. Denmark has taxes for saturated fat, Norway taxes sugar and chocolate. High taxes on alcohol are common throughout Europe. A spokesperson for the National Obesity Forum (NOF), an advocacy group of health care professionals in the United Kingdom, said that taxation at high levels would be an incentive for soda manufacturers to reformulate their products.

In the U.S., “cold, bubbly, sweet soda, long the American Champagne, is becoming product non grata in more places these days,” according to the New York Times (5/15/2012). “Schools are removing sugary soft drinks from vending machines and local governments are stepping up efforts to take them out of public facilities as the nation’s concerns about obesity and its costs grow.”

Some school districts have taken up initiatives to reduce or outright eliminate soda consumption among their students. One example is a small town named Faulkton in South Dakota where soda containers are no longer tolerated on school campuses, even if they were purchased outside or brought from home.

“This is really important because sugary drinks are the number one source of calories in our diets,” said health advocate Dr. Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest (CSPI). “We get more calories from sodas and sugary drinks than any other individual food – cake, cookies, pizza, anything.”

The American Beverage Association (ABA) rejects such characterization. “Singling out one set of products in such an overly simplistic manner only undermines efforts to combat this complex issue,” it said in a written statement. The ABA and other industry groups have long objected to imposing taxes on their products, claiming that such measures would damage the industry and lead to job losses.

On the other hand, companies like Coca Cola and PepsiCo have changed their packaging formats in recent years and offer now a wider variety of sizes from 7.5-ounce mini cans to 2-liter plastic bottles. They also raised prices, which turned into higher profits. Especially sales of mini cans are, as one representative put it, “on fire.”

It is hard to miss the irony that the same industries that have obsessively opposed taxes on their products to curb consumption are now cashing in on the message first conveyed by health advocates that less is more.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

World Health Organization Sets New Targets for Reducing Chronic Diseases

May 26th, 2012 at 4:34 pm by timigustafson
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The World Health Organization (WHO) has set a number of targets for reducing so-called non-communicable diseases (NCDs) by 25 percent by 2025. NCDs are chronic illnesses largely caused by dietary and lifestyle factors. They include obesity, heart disease, diabetes, some types of cancers and chronic respiratory illnesses that combined have become the leading causes of death globally, according to the agency.

Chronic diseases account for 36 million deaths annually, over 60 percent of all human mortality. They continue to accelerate globally and are advancing across all regions, affecting all socioeconomic classes. It is expected that almost three-quarters of all deaths will be caused by chronic diseases by 2020.

Chronic diseases are defined as illnesses of long duration and generally slow progression. They are also considered as largely preventable by positive dietary and lifestyle changes.

One of the leading causes is obesity, which has doubled worldwide since 1980. Weight problems are the fifth leading risk factor for all deaths. At least 2.8 million adults die each year as a result from being overweight. In addition, 44 percent of diabetes rates, 23 percent of heart disease rates and up to 41 percent of cancer rates are attributable to weight problems. Obesity is now linked to more deaths worldwide than underweight.

Especially worrisome is the continuing rise of childhood obesity. In 2010, more than 40 million children under the age of five (!) were overweight. Almost 35 million of these live in developing countries. Most impoverished children who have weight problems are also severely malnourished.

Leading causes of unhealthy weight gain are poor diets based on energy-dense foods that are high in fat, salt and sugars but low in nutrients. A worldwide decrease in physical activity due to sedentary lifestyles, increasing urbanization and changing modes of work and transportation also plays a role.

To change the current trends, improvements must take place on several levels, according to WHO recommendations, including individual responsibility, education, social environments as well as quality and affordability of food supply. “Individual responsibility can only have its full effect where people have access to a healthy lifestyle. Supportive environments and communities are fundamental in shaping people’s choices. The food industry can play a significant role in promoting healthy diets by reducing fat, sugar and salt content of processed foods, ensuring that healthy and nutritious choices are available and affordable to all customers and by practicing responsible marketing.”

The “WHO Global Strategy on Diet, Physical Activity and Health,” which was first introduced by the World Health Assembly in 2004, calls for actions needed to support healthy eating habits and regular physical activity. The agency “calls upon all stakeholders to take action at global, regional and local levels to improve diets and physical activity patterns at the population level.” For this, an action plan was developed for the prevention and control of NCDs as a roadmap to establish and strengthen more initiatives on local, national and international platforms.

Although the targets set by the WHO are not binding and lack in many ways specificity, similar initiatives have shown some degree of effectiveness in the past. For instance in 1987, the World Health Assembly created the first “World No Tobacco Day” to draw global attention to the health effects of smoking. It is commemorated every year on May 31 as an occasion to help reduce worldwide tobacco use. In 2005, the agency released the “Framework Convention on Tobacco Control” (FCTC) with similar goals.

Tobacco use is still the second most common cause of death in the world, after hypertension, being responsible for killing one in 10 adults every year. Obviously, we have a long way to go, but progress has been made. Hopefully, WHO’s continuing efforts will increase awareness of the seriousness of chronic diseases as well.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.


Diabetes Dramatically on the Rise Among Teenagers

May 23rd, 2012 at 2:23 pm by timigustafson
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Nearly a quarter of American children and adolescents is developing type 2 diabetes or has already the disease, according to a study by the Centers for Disease Control and Prevention (CDC), published in the journal Pediatrics. Diabetes and other metabolic conditions seem to spread more rapidly among the young and are harder to treat than in adults.

The study also found that over 50 percent of overweight and obese teenagers had at least one risk factor for cardiovascular disease such as high cholesterol and high blood pressure. Prediabetes and diabetes rates rose faster than other lifestyle-related diseases among adolescents. “This was unexpected, especially since obesity has been leveling off,” said Dr. Ashleigh May, a researcher at the CDC and lead author of the study report.

The term “prediabetes” refers to higher than normal blood sugar levels and the possibility of developing type 2 diabetes and other risks factors for heart disease, stroke and kidney disease, according to the CDC.

Not too long ago, type 2 diabetes was known as adult onset diabetes because it was virtually unheard of affecting children. But with the growing childhood obesity epidemic in recent years, more youngsters are being diagnosed with the disease every year.

Even normal-weight children are not completely safe. Of those thinner kids, 37 percent have at least one heart risk factor, said Dr. May. “Anyone who’s eating a diet high in sugar and fat will likely have problems, even if it isn’t apparent in their weight,” said Dr. Dorothy Becker, chief of endocrinology and diabetes at Children’s Hospital of Pittsburgh. “If they don’t make a change, then they’ll carry all of these risk factors into adulthood, and that’s like having a ticking time bomb over your head. You don’t necessarily know when it’s going to go off, but it’s likely that it will,” she added.

Dr. Mark Hyman, chairman of the Institute for Functional Medicine and founder of The UltraWellness Center as well as bestselling author of “The Blood Sugar Solution,” agrees. “One in three children born today will have diabetes in their lifetime. We are raising the first generation of Americans to live sicker and die younger than their parents. Life expectancy is actually declining for the first time in human history,” he warned.

Even the distinction between prediabetes and diabetes he considers as meaningless. “Prediabetes is not ‘pre’ anything,” he said. “It is a deadly disease driving our biggest killers – heart attacks, strokes, cancer, dementia and more. So if your doctor has diagnosed you with prediabetes or metabolic syndrome, don’t think that you are only at risk for something “in the future,” such as diabetes or heart attack. The problem is happening right know.”

In response to study reports like these, the American Academy of Pediatrics (AAP) has recommended that children and adolescents undergo regular check-ups of their blood pressure and cholesterol levels.

The good news is that these developments are largely reversible and avoidable in the future through dietary changes and lifestyle improvements. “The big message here is that children and teenagers need more help with following a healthy diet and staying physically active,” said Dr. May.

Obviously parents are the first line of defense when it comes to their children’s health and well-being. But society has a role to play as well – nutrition and health education in all public schools being one of them.

In all likelihood this latest CDC study will be dismissed (like most others) in the public discourse as just another “doomsday” report that can be ignored. In truth, however, an entire generation’s future is at stake. If we continue on the path we are currently on, we are going to become a nation where being sick is normal and good health is the rare exception. It doesn’t have to come to that.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

The True Cost of Healthy Eating

May 17th, 2012 at 5:10 pm by timigustafson
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A common argument why Americans don’t eat better is that healthy food costs too much. A new study by the U.S. Department of Agriculture (USDA) attempts to dispel this widely held belief by comparing the prices of healthy and less healthy foods. When analyzing costs per calorie, per edible gram and per average portion sizes, some highly nutritious foods such as grains, vegetables, fruits and dairy products turn out to be cheaper than protein foods like meats and processed items, which are typically higher in saturated fat, added sugars and sodium.

For the study, the researchers looked into nearly 4,500 different food items. “Healthy foods” were defined as products containing at least half a serving of one of the major food groups recommended by the Dietary Guidelines for Americans of 2010, including vegetables, fruits, grains, dairy and proteins, as well as only moderate amounts of saturated fats, added sugars and sodium.

The takeaway from the study is that contrary to popular belief, it can actually cost more to eat badly, said Elisa Zied, a Registered Dietitian and regular contributor to MSNBC. “Comparing the costs of commonly available foods is important because, at a time when two-thirds of Americans are overweight or obese and many low-income families struggle to control their grocery bills, the belief that healthier foods are always pricier adds to the problem. Although many variables – personal preferences, convenience and cultural factors – play a role in what we buy at the supermarket, cost may play an even greater role in our food choices,” she said.

While I agree with this assessment, it seems to me that these variables cannot easily be changed. Poor eating habits can only be improved with education. Many people who eat unhealthy foods on a regular basis don’t really know what makes these foods detrimental to their health. They just eat what they like and what they are used to. The same goes for convenience and culture. If a fast food restaurant or a food truck is just around the corner, but the next supermarket is miles away, guess what most folks will go for?

Also, the reputation of health food stores to be overly pricey is well deserved. Why, for example, is Whole Foods Market often called “Whole Paycheck Market”? Even if not every item in the store is excessively expensive, perception matters, and price-conscious consumers won’t even try shopping there.

The USDA study is a laudable attempt to shed more light on the true costs of food and, consequently, the affordability of healthy eating. But it’s a theoretical exercise with few practical implications. People don’t calculate like this. They buy the kind of food they can afford and they don’t want to drive long distances to find it. Those who have to get by on a limited budget have to consider expenses for gasoline and electricity as well. Even home-cooking is not cheap when you include energy costs. Plus it’s time consuming and adds to the daily workload (not to mention that you have to learn a few skills with the skillet).

Having said that, it should be pointed out more often to consumers that the costs of fast food, pizza and TV dinners are by no means negligible. A family dinner for four from the drive-through can easily set you back 30 bucks or more. For a similar amount, you could get, for example, a green salad, a whole chicken with some vegetable side dishes, and fruit for dessert. The difference is that a whole lot more preparation goes into a meal made from scratch, and it may be less fun than digging into a pizza that has just been delivered to your door. But those are the real calculations we have to consider before America’s eating habits can change for the better.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Stigmatization Makes It Harder to Overcome Obesity

May 16th, 2012 at 11:46 am by timigustafson
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Obesity rates may be on the rise worldwide, but thinness continues to be the standard for physical beauty and attractiveness. Conversely, obesity is often linked with poor body image and low self-esteem, which only adds to the struggle with weight and weight-related health problems.

“Modern Western culture emphasizes thinness, denigrates excess weight and stigmatizes obese individuals, making it likely that obese people internalize these messages and feel badly about their physical presence that brands them,” said Dr. Kelly D. Brownell and Dr. Marlene B. Schwartz of the Rudd Center for Food Policy and Obesity at Yale University in a study report on obesity and body image.

Prejudices against the overweight seem to develop early. One study found that children as young as three years of age believed fat people were “mean, stupid, ugly, and had few friends.” A majority of adults responded similarly, associating obesity with self-indulgence, laziness and lack of discipline. One poll conducted by Reuters found that over 60 percent of respondents believed the current obesity epidemic was caused by personal diet and lifestyle choices alone. Half supported the idea of charging obese patients higher health care premiums.

Views like these are also reflected in the job market, where obese candidates on average fare much poorer than their slender peers, according to a report on the subject by Reuters (5/11/2012). Statistically, obese workers receive lower wages, are more often passed over for promotions, and are less perceived to have leadership potential than their slimmer colleagues.

The effects of stigmatizing obesity have not yet received wide attention in our society. Unlike discrimination based on race, gender, religion or sexual orientation, exhibiting bias against the overweight is not illegal and would in any case be difficult to prove. One of the reasons for this discrepancy may be cultural. Many of us like to think that hard work leads to success and that failure results from weakness. The same applies to our standards of health and beauty. We each are responsible for our own well-being, so the thinking goes, and if we don’t manage, we have only ourselves to blame. So it shouldn’t come as a surprise that obesity, especially when it’s seen as a self-inflicted disorder, is judged so harshly, even in moral terms.

Fat people are increasingly becoming scapegoats for all sorts of cultural ills, said Dr. Linda Bacon, a nutrition researcher and author of “Health at Every Size: The Surprising Truth About Your Weight.” “There is an atmosphere now where it’s O.K. to blame everything on weight. We have this strong believe that it’s their fault, that it’s all about gluttony,” she said.

Even health care professionals are sometimes found to have prejudicial attitudes towards heavier patients, as studies have shown. In one survey, more than half of the interviewed doctors said obese people were “less likely to comply with treatment.” Consequently, they tend to spend less time with them and, as a result of feeling embarrassed and disrespected, the patients themselves avoid seeking the care they need.

In sharp contrast to many popular views on the causes of obesity, the Institute of Medicine (IOM) has recently published a report that identified the increasingly “obesogenic” environment we live in as the root of the crisis, rather than individual behavior.

Dr. Rebecca Puhl, a psychologist at Yale’s Rudd Center, agrees with the IOM’s conclusions, but she warns that “as long as we have this belief that obese people are lazy and lacking in discipline, it will be hard to get support for policies that change the environment, which are likely to have a much larger impact than trying to change individuals.”

People suffering from emotional distress in connection with weight problems are much less likely to succeed in their efforts to improve their health. Dissatisfaction with one’s size or body type can produce great amounts of stress. The results can be eating disorders like binge eating or bulimia, social isolation, depression and other psychological dysfunctions. Comprehensive counseling and support from family members, friends and people with similar experiences can be lifesaving. For our society in general, a shift in attitude would help as well.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

More Americans Suffer from Asthma

May 13th, 2012 at 2:06 pm by timigustafson
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Asthma rates in the United States have been on the rise over the past decade and are now at an all-time high, according to the Centers for Disease Control and Prevention (CDC). Almost 26 million Americans had asthma in 2010, the last time data on the disease were reported. Seven million of those were children and adolescents.

According to the CDC, asthma ranks among the leading chronic illnesses affecting young people. It is one of the most frequent causes of school absenteeism. About 10 percent of school children miss classes because of asthma at least once a year.

Especially low-income populations are at an increased risk. 11.2 percent of Americans living below the poverty line are reportedly affected. Females seem more prone to developing the disease than males.

Asthma is a chronic inflammatory disorder of the airways. This can include narrowing of the bronchial tubes, swelling of the bronchial tube lining and an increase of mucus secretion to the point where the airways become blocked. In case of a so-called asthma attack, a person’s airways are so obstructed that it becomes difficult to breath, which can lead to a life-threatening situation. Thanks to faster intervention and preventive treatments, death rates in connection with asthma have dropped by a third compared to 10 years ago.

Asthma is often misdiagnosed as allergies. Not all people who experience allergy symptoms have asthma. Like allergies, asthma is associated with exposure to allergens and also smoking, chemicals and air pollution.

Identifying and controlling potential triggers of asthma attacks is crucial for effective treatment. Although there is no known cure or even prevention of asthma, multiple steps can be taken to limit exposure to allergens and other irritants.

The CDC recommends the creation of more asthma-friendly environments such as schools by implementing policies and procedures that allow students to successfully manage their asthma. These can include providing access to asthma care clinicians and school nurses, educational and awareness-building programs, training of teachers and school staff, community outreach and so forth.

In the home, it is recommended to keep dust and dirt from accumulating. Dust mites are notorious asthma attack triggers. Ventilation and air filtering is equally as important. Pet animals can be a significant source of allergens and should be kept away from asthma sufferers. Exposure to a whole range of potential irritants, including tobacco smoke, wood and coal fire smoke, strong odors from cooking, household chemicals, paint fumes and cosmetic products should be avoided as well.

Even dietary precautions may be necessary. Some food-borne allergens can become triggers and it is crucial to identify and eliminate them as much as possible. Some people may be able to tolerate smaller amounts of foods they are allergic to. Only experience can determine the limits.

There is no medication that can cure asthma. But medications are available to control asthma symptoms. There are different types and they come in different forms such as pills, aerosol inhalers, powder inhalers, liquids and injections.

The two main types of medications are anti-inflammatories and bronchodilators. Anti-inflammatories reduce swelling and mucus production in the airways. They can lower the intensity of asthma symptoms and allow for better airflow. Bronchodilators relax the muscles around the airways, thereby easing breathing. Bronchodilators are especially effective during asthma attacks.

The primary purpose of taking asthma medications is to control and relieve. Most asthma medications must be taken regularly, often daily. So-called reliever or rescue medicines are only to be used during acute attacks.

How often an asthma patient has to take medications depends on the severity of his or her symptoms. Some are affected only during certain times of the year, e.g. in the spring. However, no one should experiment with asthma medication dosages without prior consultation with a doctor.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

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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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