Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

Subsidized School Lunches Save More Children from Malnutrition and Hunger

December 5th, 2011 at 1:06 pm by timigustafson
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The number of schoolchildren receiving free or subsidized meals is skyrocketing. Many come from families that until recently counted themselves as solidly middle-class. As the economy continues to sputter, the youngest members of society often suffer the greatest hardships.

The latest data released by the U.S. Department of Agriculture (USDA) show an increase of students qualifying for free or low-cost school lunches to 21 million (up from 18 million in 2007), a 17 percent rise. In some states, it is closer to 25 percent. The USDA, which administers the national school lunch program, reported that not since 1972 have so many children become eligible in such a short time.

Since its inception in 1946, the school lunch program has steadily expanded and has now a $10.8 billion annual budget, providing 32 million meals every day, 21 million of which are free or subsidized. Children from families of four with annual incomes of under $30K qualify for free meals, while subsidies are available to those from households with less than $42K.

Because of the increasing need, some school districts have added free breakfast- and even supper programs to prevent children from going hungry. But in most places funds are too limited to meet the demand.

These statistics reflect nothing less than a rapidly growing national crisis. The fact that millions and millions of children are dependant on government aid for food is a grave matter. The notoriously poor nutritional quality of many school lunches is lamentable enough. But what happens when children are not in school during vacation times with no access to regular meals? What happens to children who are continuously malnourished, missing out on key nutrients essential for their healthy growth and development?

Young children are most vulnerable to the effects of malnutrition. During growth spurts they need large amounts of calories, protein, fat, vitamins and other nutrients. The optimal development of the brain, the nervous system, musculature, bones and inner organs all depend on a healthy, balanced diet. Children are also more vulnerable to pollutants, toxins and chemicals than adults. Nutritionally inferior food products can be quite harmful to them.

Ideally, all children should be given the necessary means to grow up to their full potential. A healthy start can make that all the more possible. But that’s not what’s happening today for so many youngsters. Instead, childhood obesity is reaching crisis level. Often it’s the poorest kids who suffer from weight problems, not because they overeat, but because the junk food their parents can afford to buy them makes them sick. Only access to good nutrition at home and in schools could turn the tide.

Whether we want to acknowledge it or not, America is no longer the land of plenty we took for granted just a short while ago, certainly not for all, perhaps not for most. The question is what we are going to do about it. We can’t simply ignore the fact that millions of children in our midst don’t have enough or the right kind of food to eat. The damage that is being done to their health at a young age will continue to hold them back for the rest of their lives. We cannot ignore the dire consequences this will have for us all. A society full of sick people is not viable. Nothing less than the country’s future is at stake.

Asking to invest more money in the school lunch program to expand its services and improve its quality is not easy at a time when budget cuts and austerity measures are all the talk in Washington. But this is an emergency situation and we have to get our priorities straight. Americans have always pulled together when the country’s security was threatened. This is one these moments.

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.

Vision Loss at Old Age Becomes a Growing Concern

November 30th, 2011 at 5:17 pm by timigustafson
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Aging baby boomers worry more about losing their eyesight than almost any other disease, including heart attack, stroke and cancer. But most have little knowledge about the causes of age-related vision loss or prevention measures they could take, according to a recent report titled “Eye on the Boomer.” For the survey, which was sponsored by Bausch & Lomb, a global eye health company, 1001 randomly chosen participants, ages 45 to 65, were interviewed via telephone about their concerns for their vision. 78 percent said they valued good eyesight more than any other of their senses. But almost half of the respondents admitted they didn’t get annual eye exams. Even fewer were aware that the quality of their nutrition and lifestyle choices played an important role for their eye health.

“If people are at risk for heart disease, they typically make lifestyle modifications. This survey found that people are as concerned about their eyes but do not know the simple steps they need to incorporate into their daily lives to take care of them,” said Dr. Jeffrey Anshel, OD, FAAO, president of the Ocular Nutrition Society (ONS), which published the study.

According to the National Eye Institute (NEI), the number of Americans with vision problems will double over the next three decades as the baby boomer generation reaches old age. The growing demand for eye health services will add yet another significant burden on the health care system, especially since eye diseases are often related to diabetes, which is already reaching epidemic proportions in this country.

Unfortunately, the diet most Americans adhere to lacks many essential nutrients that could help protect their eye health. For example, omega-3 fatty acids, richly found in salmon and other coldwater fish, are highly beneficial for the eyes. So are the carotenoids, lutein and zeaxanthin, which are present in eggs and many green leafy and collard vegetables. Both of these nutrients defend cells in the body from the damaging effects of so-called “free radicals” and protect the eyes from developing macular degeneration and cataracts.

Because of notoriously low consumption of fruits and vegetables, many Americans do not get sufficient amounts of carotenoids for most of their lives and the negative effects become apparent as they age. Smoking and high alcohol consumption can diminish carotenoid levels in the blood stream, adding to the damage. People who take cholesterol-lowering medications may be at risk of lacking carotenoids because of reduced nutrient absorption.

For these reasons and others, taking daily vitamin supplements to bridge nutritional gaps is highly recommended. Good supplemental sources for lutein and zeaxanthin come from marigold flowers. Preferable would be whole food sources like kale, spinach, turnips, broccoli, romaine lettuce, zucchini, Brussels sprouts and peas.

“As we grow older, the need for certain vitamins and nutrients to support the eye increases,” said Dr. Anshel. “Over the past couple decades, there has been a national focus on better nutrition and healthy living. This survey highlights the need for greater education on lifestyle modifications that baby boomers should be incorporating into their daily lives, including proper nutrition, to safeguard eye health as they age,” he added.

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.

A Civic Duty to Be Healthy

November 27th, 2011 at 11:11 am by timigustafson
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Soon the U.S. Supreme Court will decide whether making healthcare coverage mandatory for all Americans is constitutional or not. The principal question is whether the government should have the power to make people buy a particular product – in this case health insurance – regardless whether they want it or not.

Opponents of the new law argue that once Congress can force people to get insurance, it can make all sorts of other requirements as well, if it deems them necessary. Eventually, so the argument goes, this could lead to a future scenario where everyone will be required to eat healthy (e.g. lots of broccoli) and forego simple pleasures like smoking and drinking. So, beware of the “nanny state” before it’s too late.

The fact is that most Americans have been subject to a mandate to buy health insurance for a long time. It’s called Medicare. Contributions to the program are automatically deducted from people’s paycheck, whether they eventually will reap the benefits or not. That’s as mandatory as it gets.

In truth, it is quite clear that there are limits to what the government can do, says Einer Elhauge, professor of law at Harvard University and director of the Petrie-Flom Center in Health Law Policy. “If [Congress] tried to enact a law requiring Americans to eat broccoli, that would likely violate bodily integrity and the right to liberty. But the health insurance mandate does not require Americans to subject themselves to health care. It requires them only to buy insurance to cover the costs of any health care they get.”

But what about the private sector? Is it acceptable, for example, that employers coerce their workers into adopting healthier lifestyle habits, like asking them to quit smoking, exercise regularly and manage their weight?

More and more companies now require employees who smoke, are overweight or have high cholesterol to pay a greater share of their health care costs. According to Mercer, a consulting firm specializing in corporate health policies, about a third of companies with over 500 workers offer wellness programs and give other incentives like insurance discounts. But others, including industry giants like Wal-Mart, Home Depot, PepsiCo, Safeway, Lowe’s and General Mills have chosen a more punitive approach, they describe as “more stick, less carrot.” Wal-Mart, for example, demands “surcharges” of up to $2,000 per year for smokers among its workforce. Others set “health targets” that employees must meet to qualify for lower premiums. Those who fail to meet specific standards may be charged 20 to 50 percent of their policy costs.

Critics say that practices like these are thinly disguised ways to discriminate against less than perfectly healthy workers. Some people suffer from health problems that are not necessarily lifestyle-related and may not always be under their control, they say.

That may very well be. But tobacco users alone consume about 25 percent more health care services than non-tobacco users, according to Greg Rossiter, a spokesperson for Wal-Mart. “The increase in premiums […] is directly related to that fact,” he added.

The message is clear: If we are to succeed in making health care more accessible and affordable, we all must do our part. The employer-based insurance system we have now is not sustainable in the face of ever-rising costs. Nor is a private insurance industry that remains out of reach for tens of millions of Americans.

The Obama administration has emphasized from the start that affordability is an essential component of any health care mandate. But affordability depends in large parts on responsible use. We have a national health crisis on our hands with two thirds of Americans being overweight and one third being obese. We have a childhood obesity epidemic never known before in history. We have an array of lifestyle-related illnesses like diabetes, heart disease and cancer that could mostly be avoided with healthier diets and exercise.

“No longer can the public afford a system that shifts the burden of care for the uninsured onto those who have health insurance or onto the fragile health care infrastructure we have,” said Dr. Charles P. Mouton, professor at Howard University College of Medicine and chairman of the Department of Community and Family Medicine. Instead of accepting the fact that millions of our citizens seek routine medical care through hospital emergency rooms, we need to build a system that promotes health and wellness for all. At the same time, nobody should consider good health as a purely personal matter that is nobody’s business but his or hers. We all have a civic duty to maintain our health as best as we can and not unnecessarily burden society with the consequences of poor lifestyle choices. Only then we can hope to finally achieve a health care system that is just, viable and can be embraced by all.

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.

Rethinking the Meaning of Thanksgiving

November 23rd, 2011 at 1:10 pm by timigustafson
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As every child in America learns in kindergarten, Thanksgiving goes back the very beginning of our nation. It’s more than just another holiday. It’s our own unique creation myth, if you will.

As the story goes, the first white settlers, later called the “pilgrims,” landed near the tip of Cape Cod after crossing the Atlantic from Plymouth, England, on a small ship called the Mayflower. The first year after arriving on the new continent proved to be disastrous and only half of the passengers and crew members made it through the winter. A year later, in November 1621, the pilgrims had their first successful harvest and that called for a big celebration. They invited their native neighbors for a sumptuous meal and that was the beginning of a tradition that continues until today. Well, that’s the short version.

More historically correct would be that, although there were more Thanksgiving celebrations in the following years, it was President George Washington who first declared Thanksgiving as an official public holiday in 1789. By this, he called upon Americans to express their collective gratitude for the victorious conclusion of the war of independence. But only in 1817, the state of New York became the first to officially celebrate an annual Thanksgiving holiday. Other states followed the custom but observed it on different days. In 1863, at the height of the Civil War, President Abraham Lincoln reinterpreted the meaning of  Thanksgiving as a day to remember “all those who have become widows, orphans, mourners or sufferers in the lamentable civil strife and to heal the wounds of the nation.”

From then on, Thanksgiving was scheduled for the last Thursday in November, only to be moved up a week in 1939 by President Franklin Roosevelt to help stimulate retail sales during the Great Depression. The change didn’t last long and by the time America entered into World War II, Thanksgiving was back on the old schedule, where it remains until today.

Of course, none of these former causes for celebration really matter to most of us today. It’s a holiday, one we celebrate among others during the Season. It gives us a chance to sit down for a family dinner, an occasion that is becoming increasingly rare, if not altogether extinct.

That’s the upside. From a dietary perspective, Thanksgiving can be a nightmare. It’s estimated that a typical holiday meal packs a whopping 4,500 calories and 229 grams of fat that can stick to your ribs until resolution season. “Something about the holidays makes people think it’s okay to stuff themselves full of their favorite foods,” said Bob Harper, one of the trainers on the popular TV show “The Biggest Loser. And the food is not the only problem. People overeat and then watch football or fall asleep and don’t move an inch for the rest of the day.

So, what can be done to avoid the traditional overindulging this year? For starters, people need to get a better idea how many calories they are actually going to consume before they sit down to eat. During an experiment conducted by Weight Watchers®, clients were given paper plates and asked to “map out” their Thanksgiving meal. Most were shocked to learn they had piled on food worth four days of their calorie needs in one single helping!

Having an eating strategy beforehand can make a real difference. Think of the foods you enjoy the most, whether they are appetizers, main course items or desserts. Then eat a reasonable portion of your favorites and cut back on everything else.

“I like to compare eating to the use of a credit card,” said Connie Holt, a registered dietitian and associate professor of the School of Hospitality Management at Widener University in Chester, Pa. “If I have $100 to spend on Friday, I’m not going to spend it tomorrow. I’m going to hold on to it.” The same goes for calories. If Thanksgiving is the day you let loose a little, make sure you have some lean days before and after.

Also, it helps not to think of Thanksgiving only as an occasion for eating. There are a thousand other things you can do as well. After all, this is a time to be spent with family and friends. Nothing will keep you from going outside and getting some exercise, playing ball or going on a hike. In many places, there are opportunities to walk or run competitively for charitable causes. Even helping out at a homeless shelter or a church will be more rewarding than eating yourself silly. Happy Thanksgiving everyone!

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.

Poor Nutrition in Schools Will Continue

November 20th, 2011 at 3:53 pm by timigustafson
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Last week, congressional legislators voted to block a proposal by the Department of Agriculture (USDA) to improve the nutritional quality of the nation’s school lunches, which the agency says contain too much junk food and not enough fresh produce.

The lawmakers named cost increases that would exceed the budget limitations of the coming agriculture spending bill as their main reason for keeping new school meal regulations from going into effect at this time. The USDA plan would have added $6.8 billion to the current expenditures, or about 14 cents per meal.

The proposed changes in the school lunch program would have been the first in 15 year. In keeping with the Obama administration’s commitment to reduce childhood obesity, the new rules would have altered the way schools get credit for serving more fresh fruits and vegetables and less processed items, like pizza, burgers and French fries. Schools that serve federally subsidized meals to students from low-income households are expected to be in compliance with the nutritional guidelines they receive from the government.

The USDA’s proposal was in large parts based on recommendations issued in 2009 by the Institute of Medicine (IOM) of the National Academy of Sciences (NAS). When the new guidelines were first made public last January, the Obama administration hailed the plan as an important tool “to stem the tide of childhood obesity and reduce future health care costs.”

But food manufacturers and even some school districts quickly objected to the new requirements, arguing that it was not the government’s place to specify what foods can or cannot be served in school cafeterias.

The USDA expressed disappointment over the derailing of its plan: “It is unfortunate that some in Congress chose to bow to special interests,” said a spokesperson for the agency.

While supporters of the congressional action called it “reasonable” and important to “prevent overly burdensome and costly regulations,” nutrition experts generally sided with the USDA and viewed it as a setback.

“It’s a shame that Congress seems more interested in protecting industry than protecting children’s health,” said Margo G. Wootan, director of nutrition policy at the Center for Science in the Public Interest (CSPI), a non-profit advocacy group. “At a time when child nutrition and childhood obesity are national health concerns, Congress should be supporting USDA and school efforts to serve healthier school meals, not undermining them,” she added.

Some points of contention over the USDA plan seem downright outlandish. For example, pizza makers insist that a quarter-cup of tomato paste per slice should count as one vegetable serving. The USDA says pizza toppings should be more in line with other fruit pastes and purees, which require higher amounts to be given credit as a serving.

Never mind such silly quibbling over minor details. The bottom line is that unhealthy food items have no place on a school lunch menu, no matter what the law calls them. While it makes sense to control costs in times of economic hardship, imposing austerity measures at the expense of our children’s health is not the way to go.

If school lunches continue to be of poor nutritional quality, a much higher price will have to be paid down the road in terms of health care costs. Meeting the nutritional needs of our youngsters today is an essential investment in our future as a country that should not be made a political football.

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.

Even Slightly Elevated Blood Pressure Poses Health Risks

November 16th, 2011 at 10:39 am by timigustafson
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If you think your blood pressure is normal, you may want to double-check with your doctor. According to new guidelines, blood pressure of 120/80 mmHg, which was until recently seen as within a healthy range, is now classified as elevated.

Scientists at the University of California, San Diego (UCSD) found that people under the age of 65 who were diagnosed with a condition called “prehypertension” had a 68 percent increased risk of suffering a stroke compared to those with normal readings.

Prehypertension is defined by the National Institutes of Health (NIH) as a systolic pressure (upper number) of 120 to 139 mmHg and a diastolic pressure (lower number) of 80 to 89. Higher readings than 140/90 are considered to be hypertension. Ideally, the normal range should be well below the prehypertension threshold.

When blood pressure rises, the heart has to work harder. If blood pressure remains chronically elevated, the risk of cardiovascular disease increases, which can eventually lead to heart attack, stroke or heart failure.

A primary risk factor is obesity. The greater the body mass, the more blood is needed to transport oxygen and nutrients. The higher volume of blood circulating through the blood vessels puts ever more force on the artery walls.

There are other causes as well. Atherosclerosis, the buildup of fatty deposits in the arteries, is quite common. Other contributing conditions are sleep apnea, kidney disease, thyroid disease and adrenal disease.

Poor diet- and lifestyle choices are most often (at least in part) responsible for high blood pressure to occur. But even some medications, including birth control pills, cold remedies, painkillers and other prescription drugs can play a role. So can recreational drugs like cocaine and amphetamines.

There is no cure for high blood pressure, only treatment through medication and lifestyle measures like diet and exercise.

Prehypertension should be seen as a warning sign, according to Dr. Bruce Ovbiagele, a professor at UCSD and lead author of the study that lead to the revised guidelines. “This doesn’t mean that people with prehypertension should start taking anti-hypertensive drugs. Instead, they should modify their lifestyle, maintain an ideal weight and lower their sodium intake.”

The worst you can do is to ignore the numbers, said Dr. Ovbiagele. “You shouldn’t be deceived because nothing seems to be going on.” Because there are no specific symptoms for prehypertension or hypertension, people tend to think they can live with the condition.

Nothing could be further from the truth. If you are overweight, even moderately, shed the extra pounds as soon as possible. Exercise regularly. Nothing is better for your blood pressure and your heart than a rigorous workout several times a week (consult with your doctor if you already have elevated blood pressure and don’t currently exercise). Eat plenty of fruits, vegetables, whole grains, fish and low-fat dairy products. Avoid foods that are high in sodium like processed and packaged food items. Eat foods that are low-fat, low-cholesterol and free of trans fats and other unhealthy ingredients. Cut back on meat, especially red meat. Drink alcohol in only moderation, preferably red wine. Last but not least, manage your stress and get enough sleep.

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.

Nutrition Guidelines Remain Unnecessarily Hard to Decipher

November 2nd, 2011 at 10:39 am by timigustafson
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The recently updated Dietary Guidelines by the government, called “MyPlate,” were designed with simplicity and user-friendliness in mind. To a certain extent this has been achieved, although the jury is still out whether it will make Americans finally change their eating habits. So far, there is little evidence of that.

Critics say, the new concept – graphically represented by a dinner plate divided in four segments for different food groups and a smaller container for dairy products on the side – may be easier to understand than its predecessors (“Food Pyramid” and “MyPyramid”), but it may also oversimplify the intricacies of a healthy, balanced diet. People may be getting the message – eat more fruits, vegetables and whole grains and get less protein from animal food products – but they still don’t know what to look for once they navigate the supermarket aisles.

In Europe, and especially in Great Britain, governments have taken a different approach. It’s called “Traffic Light Labelling” (sic), and it’s just as intuitive and self-evident as it sounds. Processed and pre-packaged foods are labeled in ways that tell consumers at a glance about fat, saturated fat, sugar and salt content. Obviously, red means high, yellow means medium and green stands for low percentages of these ingredients. The more red indicators show up on a package, the less healthy the product is deemed to be, and, visa versa, more green means it’s a healthier choice.

Nutrition experts and consumer advocates have generally welcomed the traffic-light label approach and have called for making it the standard information system for nutrition facts.

Regretfully, the European Parliament’s food safety committee decided earlier this year that labeling food items with color codes should not be made mandatory for member states in the European Union (EU). “Color symbols have not got any scientific background and the limits and thresholds would be purely arbitrary. Sugar-free coke, for example, would get the ‘green light’ as it has no sugar. Natural apple juice, however, would get the ‘red light’ as it contains glucose,” said Renate Sommer, the lead author of the committee report.

Consumer and health groups expressed deep disappointment over the “watering down” of the traffic-lights labeling requirements by making them optional for food manufacturers to apply. They say an inconsistent labeling system will produce a patchwork of policies and guidelines that will confuse consumers even more.

Regardless of the EU’s decision, consumer advocacy groups keep pushing for more regulations. In response to an anti-obesity campaign by the British government, named “Call to Action,” activists say that much more needs to be done to curb the obesity crisis, which has reached proportions in Britain similar to the United States.

“Simply telling people what they already know – that they need to eat less and move more – is a complete cop-out,” said Jamie Oliver, celebrity chef and campaigner for the nutritional improvement of school lunch programs in both the U.K. and the U.S. “The country’s bill of health is shocking and the government’s strategy to turn that around is woefully inadequate,” he added.

“Our research along with independent studies testing the various food information labelling (sic) schemes indicate that consumers across the board – not just the better educated ones – find the traffic light approach the easiest to understand,” said Sue Davis, a policy advisor for the consumer advocacy group Which?

An easy to understand and unified labeling system would certainly be helpful for making better dietary decisions, regardless in what country. Our current system in the U.S. obviously doesn’t work. We have more information available than ever, but we also seem to be more confused and helpless than ever before. Our current nutrition label system requires us to decipher the meaning of numbers, percentages, scientific terminology and illogical apportionments. Interpreting mathematical values or comparing chemical compounds is not what people usually do when they try to find something to eat.

“The focus on nutrients is probably inevitable but it distracts from the real issue, which is whether you’re getting real food or not,” said Michael Pollan, author of bestselling books, including “The Omnivore’s Dilemma.”

Eating right to stay healthy and fit should not be so complicated, in fact it should not be complicated at all – more like understanding the meaning of a traffic light.

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.

Anxiety Disorders Are Sharply on the Rise

October 23rd, 2011 at 11:31 am by timigustafson
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It’s getting harder to feel good about life in America. According to data collected by the Census Bureau, the average income of Americans has fallen by almost 10 percent since the beginning of the recession of 2008. Some experts say the financial crisis has been as traumatic and anxiety-producing for millions of Americans as the events of 9/11/2001. While people back then were fearful of another terrorist attack, they are now experiencing profound existential angst about their future.

More than 40 million people suffer from anxiety disorders in this country, estimates the Anxiety Disorders Association of America (ADAA) based on prescription drug sales. Younger generations seem to be most affected.

“It used to be that if you got a good education, you would get a good job. But today, young people are uncertain about finding a job, they have a lot more debt, they are working while studying, finishing later, more fatigued and some are starting families while still in school, and juggling all of this causes a great deal of stress,” said Dr. Katy Kamkar, a clinical psychologist at the Centre for Addiction and Mental Health in Toronto, Canada.

So, are our times more stressful and anxiety-ridden than, let’s say, the Great Depression era in the 1930s? In a way yes, according to Dr. Jean Twenge, a professor at San Diego State University and author of “Generation Me.” “Anxiety rates have risen steadily over the past seven decades, during good economic times and bad,” she said.

Dr. Twenge sees at least some of the reasons in the deep cultural shifts we as a society have undergone since the 1960s. “Recent generations have been told over and over again: You can be anything you want to be, you can have the big job title, you can have the big bank account, and in the case of women, you can have the perfect body. That puts a lot on a person’s shoulder – and it is also not really true. That disconnect creates a lot of anxiety about how hard you need to work […] and a deep fear of failure.”

And it’s not only that people have impossibly high expectations that are bound to be frustrated at some point in their lives. The world keeps changing so fast that many feel left behind even at a relatively young age.

Reconsidering one’s values and making changes to one’s lifestyle is not easy. It’s hard if not impossible to get off the train once you’re on it. “People feel they should always be on, and that they could be called upon at any moment to do something,” said Dr. Susan Nolen-Hoeksema, a professor of psychology at Yale University who specializes in stress and women’s health. “Our e-mail and iPhones are constantly pinging, which keeps anxiety heightened all the time.”

Experiencing anxiety every now and then is – like stress – a natural phenomenon and not necessarily a bad one. It’s an emotional reaction that helps us recognize actual threats or problems and deal with them. If kept at a healthy level, anxiety can help us to be more focused and perform better. However, if it grows out of proportion, it can become quickly counter-productive and, in extreme cases, even debilitating. “Generally, we say anxiety is not normal when it lasts days beyond a specific stressful event, or when it interferes with a person’s life,” said Dr. Terri Moffit, a professor of psychology and neuroscience at Duke University in North Carolina.

The term “anxiety disorder” refers to anxiety as a chronic condition. It can take on different forms. There is generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder (a.k.a. social phobia) and specific phobias.

Anxiety and fear are often used interchangeably. But in clinical usage, they have clearly distinct meanings. Anxiety is defined as a negative emotional state for which the cause is either not identified or perceived to be beyond a person’s control. Fear, on the other hand, is an emotional and physiological response to a concrete external threat. Phobias, which are responses of fear or discomfort triggered by specific stimuli or situations, are also considered to be anxiety disorders.

Anxiety often goes hand in hand with clinical depression and other mental disorders. It is estimated that about 60 percent of people suffering from chronic depression experience regular bouts of anxiety as well.

Sexual dysfunctions are quite common among men and women with anxiety disorders, although it cannot always be determined whether anxiety causes the dysfunction or whether they both result from a common cause.

Treatment options for anxiety disorders include psychotherapy (e.g. cognitive-behavioral therapy), medication and lifestyle changes.

Exercise has been shown to help with stress management and can have positive effects on anxiety reduction as well. So can dietary changes. “Eating too much of the wrong kind of foods produces an inflammation effect that can cause disease in the brain,” said Dr. David Heber, director of the Center for Human Nutrition at the University of California Los Angeles (UCLA). Sufferers from chronic anxiety have reported that cutting back on starchy foods and eating more fresh fruits and vegetables has made a significant difference not only for their physical- but also their emotional well-being.

Controlling and, if necessary, reducing consumption of caffeine and alcohol is equally as important. Caffeine can increase anxiety and trigger panic attacks. While alcohol may make you feel more relaxed for the moment, it can also contribute to depression.

Relaxation techniques, yoga, meditation, breathing exercises, massage and other soothing treatments are all highly recommended to counterbalance anxiety. They may not always suffice, but they are always helpful. Just by being able to turn off the noise once in a while, both body and mind can relax, heal and rejuvenate.

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.

Americans Are More Realistic About the Quality of Their Diet

October 19th, 2011 at 1:37 pm by timigustafson
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Over the last 20 years, Americans have become increasingly aware that their diet plays a significant role for their health. They also have become more disillusioned about the nutritional quality of the foods they are actually eating. Despite of these changes in awareness, most people’s eating habits have largely remained unchanged and the obesity crisis has worsened. These are the findings of a study report issued by the Economic Research Service of the U.S. Department of Agriculture (USDA).

The objective of the study was to see how Americans are responding to the stepped-up educational efforts by the government and advocacy groups to improve the nutritional health of the public. For this purpose, researchers compared data from two surveys that were conducted between 1989 to 1991 and 2005 to 2008.

“Although the actual healthfulness of diets has not changed much in the last 15 years, there has been a large and significant decrease in the percentage of Americans who rate their diets as Excellent or Very Good,” said the report. “These changes provide a snapshot of consumers’ increased dietary realism and, perhaps, receptiveness to dietary guidance, and they also suggest the possibility that a changed information environment has affected consumers’ perception.”

The comparison of the two surveys clearly shows that a significantly higher percentage of people who were asked to rate the quality of their diets grew more pessimistic over time. 8.6 percent (down from 13.2) were inclined to call their diet Excellent and 23.3 percent (down from 27.8) thought it was Very Good. The percentage of those who considered their eating habits as Good stayed roughly the same – 40.7 percent (up from 39.3).

The researchers concede that an “optimistic bias” about their diet still prevails among Americans. While nutrition experts have learned a great deal about the nutritional quality (or lack thereof) of the typical American diet, most consumers’ perception remains inaccurate. Our diets continue to be too high in calories, fats (especially saturated fats), sodium and added sugar. They are also too low in fiber, whole grains, fresh vegetables and important micronutrients, according to the report. The reason is not that people willfully ignore the dietary advice they’re given. They just misjudge their own actions.

Still, the overall rise in awareness is encouraging. Especially overweight people seem to realize more that their eating habits wreak havoc on their health. Among overweight people, the percentage of those who rated their diets as Excellent or Very Good declined by 12 points since the first survey.

The researchers also looked at other data connected with diet. For example, they found a significant relationship between household income and diet quality perception. Those who believed their diets to be Excellent or Very Good were on average financially better off than those who considered their diets as Poor. The dramatic rise of food prices in recent years has certainly contributed to this discrepancy, although to what degree has not become altogether clear in this study.

Lack of access to healthy food resources in some rural areas and low-income inner-city neighborhoods seems to be a remarkably insignificant factor. The so-called food deserts, where travel time to a supermarket or grocery store exceeds 15 minutes, did not affect diet choices as much as previously thought.

More important was the fact that consumers eat most of their meals away from home. Home-cooking and eating together as a family are rapidly becoming a thing of the past. Again, the percentage of people recognizing these trends as a potential problem is increasing, but there is little effort or even knowledge of how to make the necessary changes to reverse them. Remarkably, those who rate their eating habits as Poor spend on average a larger fraction of their food budget on restaurant food than those who say they have healthier diets.

Clearly, this report does not unveil any great secrets. Most of its observations are unsurprising. Still, one can take comfort in the thought that the information given to the public seems to register, even if that does not (yet) lead to decisive action. We can only hope there will be a tipping point in the not so distant future.

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 Confusing News About Vitamin Supplements

October 16th, 2011 at 2:59 pm by timigustafson
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Two independent studies suggest that taking a daily dose of vitamin supplements may not be as health-promoting as previously believed and may even be harmful. Their findings are only the latest in a series of clinical study reports that have questioned the benefits of the popular nutrition-enhancers.

In one study, researchers from the University of Minnesota followed over 38,000 women in an still ongoing survey called the “Iowa Women’s Health Study.” The participants were in their early 60s when the project was started in 1986. The focus of this study was on the women’s use of vitamin supplements for about 18 years on average.

As it turns out, the women who took daily doses of supplements had a higher mortality rate by two and a half percent compared to those who didn’t take any.

“Our study, as well as other similar studies, have provided very little evidence that commonly used dietary supplements would help to prevent diseases,” said Dr. Jaako Mursu, an epidemiologist at the University of Minnesota School of Public Health and lead author of the study report, which was published in the Archives of Internal Medicine (10/11/2011). “We would advise people to reconsider whether they need to use supplements, and put more emphasis on a healthy diet instead,” he added.

Dr. Mursu admitted that the study was not designed to determine if there was a specific cause for the increased mortality risk of the supplement users. The study did however distinguish between the different kinds of supplements the participants took. For example, the women who took iron supplements had a four percent higher probability of dying. Others who used multivitamins, folic acid, vitamin B6, magnesium and zinc also showed higher rates. Only calcium seemed to have a positive effect, decreasing the risk for most women who took it.

A second study, sponsored by the National Cancer Institute (NCI), found that men who took daily a high dose of vitamin E ran a 17 percent greater risk of developing prostate cancer. These results, which were published in the Journal of the American Medical Association (JAMA), came as a surprise, considering that vitamin E was believed to be actually helpful in the prevention of prostate cancer.

The vitamin E study, named the “SELECT” trial, began in 2001. It was designed as a double-blind, placebo-controlled research project, the highest standard in scientific testing. The initial goal was to find out how vitamin E and selenium (a mineral mostly found in soil) can reduce the risk of prostate cancer.

“I was surprised by the results of this trial,” said Dr. Eric Klein, an urologist at the Cleveland Clinic and the national coordinator of the study. “There really is not any compelling evidence that taking these dietary supplements above and beyond a normal dietary intake is helpful in any way, and this is evidence that it could be harmful.”

The increase in health risks could be derived from the high concentration of nutritional compounds that many supplements contain. Most of these micronutrients are present in much smaller amounts in regular foods, so they can become toxic when they are consumed over long periods of time and accumulate in the body, according to Dr. Mursu.

While vitamins and minerals are necessary for healthy nutrition, excess intake can create serious problems. It is also important that consumers understand the differences between the supplements they are taking.

For example, overdosing on water-soluble vitamins like vitamin C and B-complex is possible but unlikely. Excessive amounts pass through the system and get eliminated in the urine.

Fat-soluble vitamins like vitamins A, D, E and K, on the other hand, are stored in fat cells and can eventually build up to toxic levels. Minerals like calcium, chloride, chromium, copper, fluoride, iodine, iron, magnesium, manganese, molybdenum, phosphorus, potassium, selenium, sodium and zinc are absorbed in the body as well and can become harmful to the liver and kidneys. Some supplements can interfere with medications a person is taking and also negatively affect the metabolism of other nutrients.

For these reasons and others, many nutrition experts warn that supplements should not be considered as a substitute for a well-balanced diet, notwithstanding their enormous popularity. Over half of American adults take at least one supplement a day. It is estimated that vitamin and supplement sales in the U.S. amount to $20 billion plus per year.

It’s tempting to rely on supplements. In our fast-food culture, it may even sound reasonable to take extra vitamins to make up for nutritional deficiencies. Ironically, the people who use the most supplements are the ones who already eat the healthiest. So, they may want to reconsider. But for the millions of Americans who adhere to a less than perfect diet, it makes good sense to keep adding a basic multivitamin a day.

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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