Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

Food Allergies Among Children Dramatically on the Rise

June 21st, 2011 at 6:08 pm by timigustafson
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Childhood food allergies are apparently much more common in America than previously believed. A clinical study, recently published in the journal Pediatrics, found that about eight percent of children under the age of 18, almost 6 million, suffer from one or more food allergies. The numbers are twice as high as the latest data released by the Centers for Disease Control and Prevention (CDC) in 2007, which showed a rate of just under four percent, or about three million kids.

The new findings came from online interviews that included 40,000 households all over the United States. Participants were recruited through random telephone calls. Based on the information gathered from the survey, experts now believe that allergies among the young, including food allergies, are dramatically on the rise.

“Based on our data, about one in 13 children has a food allergy,“ says Dr. Ruchi Gupta, assistant professor of pediatrics at Northwestern University Feinberg School of Medicine in Chicago and lead author of the report. “What’s more, nearly two out of every five affected children suffer from a severe food allergy. For these children, accidental ingestion of an allergenic food may lead to difficulty breathing, a sharp drop in blood pressure, and even death.”

Dr. Gupta, who also works as a pediatrician at Chicago’s Children’s Memorial Hospital, acknowledges that her study provides only a snapshot of the prevalence of food allergies in America today and does not track developments over time. Still, she says, “eight percent is a pretty significant amount. […] We are seeing a lot more cases in schools than we used to see. It does seem that food allergy is on the rise.”

The CDC estimates that eight types of foods are responsible for 90 percent of all food allergies in children. They are milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat.

Allergy is a condition that occurs when a person’s immune system is hypersensitive or over-reactive. Ordinarily, the human immune system has the ability to distinguish between harmless substances in the environment and potentially harmful agents, such as viruses and bacteria. For a person with allergies, however, the immune system reacts swiftly and with great intensity to substances that are not dangerous as if they were. So, when an individual who has certain allergies eats, touches or inhales an allergen (a foreign substance he or she is allergic to), the immune system mistakenly responds with an all-out counterattack.

Many experts believe that the tendency to develop allergies is primarily hereditary. However, in addition to genetic traits, long-term exposure to certain health hazards in the environment, such as tobacco smoke, pesticides and other pollutants, can provoke allergic reactions. So can emotional factors and other stressors.

People who suffer from food intolerances are not necessarily allergic to these foods. The symptoms can be similar, but with intolerance the physical reactions are usually due to problems with digestion. For instance, people with lactose intolerance are unable to produce enough of a digestive enzyme needed to break down milk sugar. They are lactose intolerant, but the immune system is not involved in the resulting digestive distress.

There can be conditions, however, where food intolerances and allergies sort of overlap. Celiac disease, for example, generates an abnormal immune response to foods containing gluten, like wheat and some grain products. Despite of this, celiac disease is classified as a food intolerance, although it is triggered by autoimmune activity.

Another difference between food intolerances and allergies is that the symptoms of intolerances generally intensify with age, while those of allergies get worse with exposure.

Allergies should not be taken lightly, especially when children are affected. Possible reactions range from mild to severe. They include swelling of lips and face, hives, itching, flushing or eczema flare. The severest cases, known as anaphylaxis, are potentially life-threatening. Symptoms include wheezing, trouble breathing, vomiting, persistent coughing and dangerous swelling of the airways.

“Especially for kids with multiple food allergies, it complicates their lives and makes it really tough on these kids to avoid multiple foods to stay healthy and stay alive,” says Dr. Gupta.

Parents of children with serious food allergies are urged to always carry antihistamine as well as an epinephrine shot (EpiPen) with them. The most effective measure people can take against allergic reactions is avoidance. That means paying close attention to ingredient labels, taking precautions when eating at restaurants and bringing along one’s own food if safe alternatives are unavailable.

Many children outgrow their allergies or tolerate them better as they grow older, including those against milk, eggs and wheat, while peanuts, tree nuts and shellfish often remain a lifetime threat.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” which is available on her blog  http://www.timigustafson.com and at amazon.com. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format, also at www.amazon.com

Fast Food Chains Lobby for the Use of Food Stamps in Restaurants

June 19th, 2011 at 6:16 pm by timigustafson
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Yum! Brands, the parent company of several national fast food chains, including KFC, Pizza Hut and Taco Bell, is lobbying the Kentucky state government to allow the use of food stamps in its restaurants. If the change in the law passes, Kentucky will join a very short list of only three other states – Michigan, Arizona and California – that permit food stamps to be used this way.

As reported by the local newspaper, the Courier Journal, Louisville-based Yum! intends to accept so-called EBT cards for payment, which proponents say will provide a much needed service for food stamps recipients who otherwise have difficulties to find a ready-cooked meal.

Supporters of the petition, including advocacy groups for the homeless, argue that any restaurant business willing to accept food stamps should be allowed to participate in the program. Natalie Harris, a spokesperson for the Coalition for the Homeless, is strongly in favor of the idea. “For those […] who don’t live near a large grocery store and can’t afford a restaurant, sometimes their only option is the nearest gas station. […] This would allow people to get a reduced price meal at a small deli or a restaurant, and that does include fast-food restaurants.”

Of course, this is not only a concern for homeless people. Elderly and disabled people, who are unable to cook at home for whatever reasons, can’t get a prepared meal if they depend on government help to pay for it.

Currently, Kentucky provides support to the needy mainly through its Food Assistance Program, which does not (yet) cover fast food items. Opponents of the proposed law change want to keep it that way. They argue that the government should not help push more sales of junk food on poor people at the expense of their health. In the long run, it would adversely affect the well-being of entire communities and drive up health care costs for the state.

In 2010, Kentucky was ranked number seven in the U.S. in terms of obesity rates, with over 30 percent of obese adults. Childhood obesity and Type 2 diabetes are also on the rise here. Critics say these numbers will only go up if low-income families are enticed to spend their food stamps at hamburger joints.

Louisville, where Yum! is headquartered, has been in the news lately for other reasons as well. Ironically, one might say, the town wants to be known for its fight against obesity. In 2003, city hall received a grant from the Robert Wood Johnson Foundation to help with the construction of bicycle lanes and to develop a number of small “pocket parks” as part of its affordable housing projects. To motivate people to drive less and move their bodies more instead, wider and safer sidewalks are being built.

These may be humble beginnings, but they point in the right direction. Still, if these few well-meaning efforts remain sporadic and isolated, they will not make much of a dent. Access to decent food sources and opportunities to maintain a health-promoting lifestyle should not be so hard to come by, even in less than affluent communities.

If government can afford to subsidize big industries – and let’s face it, allowing fast food places to accept food stamps is ultimately a subsidy program for the corporations who own them – it can also show some support for small produce farms. Our taxes would be well spent by keeping healthy nutrition affordable for everyone and by investing in our local agriculture at the same time. Food stamps should be made welcome at all farmers markets and urban farms. We also need more grocery outlets in the so-called “food deserts,” the underserved communities in many inner cities.

These are not revolutionary ideas and they are not hard to implement. What is missing, mostly, is enough political will.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” which is available on her blog  http://www.timigustafson.com and at amazon.com. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format, also at www.amazon.com

Will Quitting Smoking Make You Fat?

June 14th, 2011 at 11:52 am by timigustafson
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Many smokers who want to quit are afraid they will gain weight, so they rather not kick the habit. The fear of getting fat after quitting is not altogether unwarranted. Many ex-smokers do put on some extra weight, about five pounds on average.

Now, scientists think they know why. Recent studies have shown that nicotine helps suppress appetite by activating certain receptors in the brain, especially those in the so-called “reward regions,” where we sense pleasure and from where many of us also develop addictions.

A team of researchers at Yale University School of Medicine now found that nicotine can also bind regulator neurons to these receptors, which send out satiety messages, much like the signals our brain receives when our stomach is full to make us stop eating.

This mechanism may explain why smokers are usually not as hungry when they smoke and why they tend to eat more after quitting.

Considering the implications of their study results, some scientist now hope to develop a drug that can simulate the effects of nicotine on the brain, thereby eliminating the health hazards commonly attributed to tobacco use. Appetite-controlling drugs, like cytisine, to help quitters avoid unwanted weight gain are already available in Eastern Europe but not in the U.S.

Developing drugs that target specific receptors in the brain is a difficult challenge. Some scientists involved in this kind of research have warned that even if drug treatments were to prove effective, they may also trigger some unwanted side effects. The reason is that the receptors in charge of regulating appetite are also closely connected to the body’s stress responses, which normally are only mobilized in times of acute danger. Activating these receptors on an ongoing basis through medication could lead to symptoms similar to chronic stress and, over time, to diseases like high blood pressure and heart disease.

Of course, everyone agrees that fear of gaining weight should not ever prevent smokers from quitting. Instead of waiting for a wonder drug that might help people stay slim, there are many better ways to regulate one’s appetite and manage one’s weight more naturally.

A good way to start is to be more conscious of the metabolism. Smoking raises the metabolic rate and also increases the heart rate up to 20 times of normal. This is one reason why many smokers suffer from high blood pressure and heart disease.

When smokers quit, their metabolism slows down considerably. It can take weeks or even months before metabolic levels stabilize at normal levels. Meanwhile, calories are being burned at a much lesser rate. At the same time, many recovering smokers eat more food to cope with withdrawal symptoms or boredom. Senses of taste and smell come back to life after quitting, which may increase appetite as well.

Alcohol is often used to “take the edge off” when the cravings become more intense. Alcoholic beverages, of course, have lots of calories, and all too often these are not taken into account.

Another reason for increase of food intake is what smokers call “oral gratification.” Many ex-smokers miss the feeling of “having something to do with their mouths and hands.” Frequent snacking often serves as a substitute to fill the void.

Many people reach for food for similar reasons smokers reach for cigarettes, namely to handle stress, to reward or comfort themselves, to pass time, deal with boredom or to be social. For smokers trying to quit, the choice of means may change but not necessarily their behavioral tendencies.

So, is there a special regimen for ex-smokers to avoid falling into the weight gain trap? Not really. Ultimately, they have to act just like the rest of us who try our best to stay in shape: Healthy eating, limiting portion sizes, no snacking, regular exercise, stress reduction and enough sleep. Following all these measures combined should render any wonder drug of the future obsolete right now.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” which is available on her blog  http://www.timigustafson.com and at amazon.com. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format, also at www.amazon.com

Let Sleeping Teenagers Lie

June 12th, 2011 at 6:11 pm by timigustafson
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As every parent of teenagers will tell you, the best time to have kids of that age around is in the evening. That’s when they are the most energetic, socially engaged, talkative and in good spirits. Getting them into bed at a reasonable time can be a challenge. Most teens don’t feel tired until past midnight. In the morning – well, that’s another story. Irritable, dead tired and unhappy, they head off to school for a bad start and struggle for hours to stay awake in class.

What many parents and teachers don’t know is that young adolescents are undergoing biological changes that deeply affect their circadian rhythm. To be sure, they still need lots of sleep during puberty and throughout adolescence, especially in times of rapid growth spurts. But their inner clock undergoes significant shifts that make their sleep needs quite different from any other age group.

In the past, parents assumed that their youngsters were sleepy in the morning because they stayed up too late the night before. And so did the experts. “We thought it was entirely psychosocial, “says Dr. Mary Carskadon, professor of chronobiology at the Department for Psychology and Human Behavior at Brown University School of Medicine. “We’ve learned in the past couple of years that there’s a biological process involved as well.”

Her research has shown that the early morning is not a time when most teenagers can be expected to participate effectively in class. In a clinical study, conducted by her and her colleagues, she found that half of 40 participating high school students who began school at 7:20 a.m. were “pathologically sleepy.” “These kids may be up and at school, but I’m convinced their brains are back on the pillow at home.”

Dr. Carskadon goes as far as calling the scheduling of early classes in schools “abusive.” “As a result, a good night’s sleep is increasingly missing from their frantic lives,” she says.

On weekends, teenagers tend to fall back into their “natural rhythm” of staying up late and sleeping in. But by Monday, their sleep pattern must adopt again to school hours. Many teens can’t shake the jet lag-like effect of these changes fast enough and can become seriously sleep-deprived.

According to Dr. Carskadon, trying to make up for lost sleep on weekends can possibly do more harm than good. She says, “this solution can backfire for teenagers because it further distorts their biological clocks and can make it even harder for them to get up on time during the school week.”

The consequences of chronic sleep deprivation for adolescents are not limited to constantly feeling tired and being unable to digest information in the classroom. Emotional stress and depression may also result, just as they do among adults. The National Sleep Foundation warns that getting insufficient sleep over long periods of time can be dangerous for teenagers in a number of ways, including increased risk of traffic accidents, risk of psychiatric conditions and substance abuse, and also risk of weight gain and obesity. The latter effects of long-term sleep deprivation have been shown in a number of clinical studies, including one prominent survey by Harvard researchers who found that at least two factors play a role in weight gain due to lack of sleep: Snacking at night and possibly changes in hormones responsible for regulating appetite.

Complying with sleep needs is just as vital to the health and well-being of teenagers as it is for younger children. Teenagers may actually need more sleep than they required in previous years. But school, afternoon activities, jobs and social pressures all conspire against getting a proper amount of rest. Parents, teachers and foremost teenagers themselves often forget to put sleep ahead of other priorities.

Most experts agree that teenagers should get at least 9 to 9 ½ hours of nightly sleep, compared to 7 to 8 hours recommended for adults. That means that adolescents should be in bed no later than by 9 p.m., at least on weeknights. Of course, that does neither match with their circadian rhythm nor their social activities.

Some have suggested that classes could start later in the morning, and a number of schools have begun experimenting with later schedules. Others say that most kids are overburdened with homework, jobs and after-school activities, which must be reduced to allow for enough rest time.

Fortunately, there are measures every family can take to promote better sleep hygiene at home. Here are some recommendations that are easy to implement:

• Maintain consistency of sleep and wake times, including on weekends.
• Create a sleep-conducive bedtime routine and sleep environment, like taking hot baths, dimming the lights, reading or listening to soothing music.
• Make sure that all mattresses and pillows are comfortable.
• Set an alarm clock, so you don’t have to worry about oversleeping.
• Don’t eat or snack later than 3 hours before bed. Avoid sugary sodas, caffeine, alcohol and other stimulating drinks in the evening.
• Don’t watch TV, play video games or work on the computer in the bedroom and allow no homework in bed. Keep sleeping spaces uncluttered.
• Do not exercise later than 2 hours before sleep.
• Make sleep a priority, so your bedtime does not get pushed back every time something else comes up.

• Tara Aronson, “Wake Up, Sleepy Teens,” Parent’s Press, 1997
• Jane E. Brody, “A Good Night’s Sleep Isn’t a Luxury; It’s a Necessity,” The New York Times, 5/11/2011
• Jane E. Brody, “Zombie Prevention: Your Child’s Sleep,” The New York Times, 5/24/2011
• National Sleep Foundation, “Adolescent Sleep Needs and Patters,” www.sleepfoundation.org
• Andrea Peterson, “Strategies to Encourage Healthy Sleep in Kids,” The Wall Street Journal, 1/18/2011

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” which is available on her blog  http://www.timigustafson.com and at amazon.com. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format, also at www.amazon.com

The Simpler, the Better

June 8th, 2011 at 5:10 pm by timigustafson
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When the First Lady, Michelle Obama, unveiled the new logo of the government guidelines for healthy eating in a news conference last week, the design, called “MyPlate,” was widely praised for its simplicity and intuitiveness.

As it has been widely reported, the new graphic is meant to replace the old “Food Pyramid,” including its latest version, the so-called “MyPyramid.” In a radical departure from the traditional triangle, this one resembles a dinner plate split into four sections for vegetables, fruit, grains and protein. A smaller circle for dairy products is placed next to it.

Mrs. Obama emphasized in her introduction speech that she wanted to see “a quick, simple reminder for all of us to be more mindful of the foods we’re eating.” She went on to say that because “we’re all bombarded with so many dietary messages, it’s hard to find time to sort through all this information, but we do have time to take a look at our kid’s plates. If the plate looks like the symbol, with lots of fruits and vegetables, then we’re good, it’s as simple as that.”

Indeed, the symbol looks quite a bit like one of the trays used in school cafeterias with divided segments for different food items. Several sample sets were also put together for the press to show how healthy meals should look like: Green beans, broccoli, slices of mandarin orange, whole-wheat bread, some sort of white meat and a glass of milk on the side.

Dr. Marion Nestle, professor of nutrition at New York University, was quick to point out that “Americans aren’t used to eating this way.” No doubt about that. A lot of people will ask, where’s the beef? Piling half your dinner plate with fruit and vegetables and another quarter with whole grains is not what most families have done in the past and may not find palatable any time soon.

Still, the driving principle of keeping the message as simple and as user-friendly as possible is the right move. Ceaselessly bombarding the public with often contradictory health news has not led to better education but to more confusion and loss of interest.

We do have to accept that fact that the public is still largely ignorant about making healthy food choices. Nutrition experts may feel uncomfortable with that thought, however, considering the ever-growing obesity epidemic, it is clear that the messages of the past have not yet gotten through. Encouraging basic questions like “What is a vegetable?” and answering them with sincerity should not be dismissed as trivial or even demeaning. After all, we once had a president who earnestly believed that tomato ketchup belonged to that food group.

As a health counselor, I have learned this lesson many times over: The simpler dietary guidelines are explained to people, the more likely they will be followed and continue to be followed over time.

Strengths and Weaknesses
The MyPlate guidelines are the strongest where the recommendations and warnings are presented in the plainest language. For instance: “Enjoy your food, but eat less.” Or, “Avoid oversized portions.” (Remember that next time you eat out.) Or, “Drink water instead of sugary drinks.”

The latter cannot be stressed enough. It is common knowledge that sodas contribute significantly to our national health malaise, especially among children. “If Americans would heed that advice alone,” says Dr. Andrew Weil, MD, founder and director of the Arizona Center for Integrative Medicine, “the obesity and diabetes epidemics would begin to abate overnight.”

Unfortunately, this desirable level of clarity is not always kept up throughout the guidelines. For example, the section called “Protein” is quite confusing. As Professor Nestle has pointed out, protein is not a food, it’s a nutrient, like carbohydrate or fat. Most Americans think of meat when they look for protein sources. But you can get protein from other animal foods as well, like fish and poultry and also from plant products like beans.

The idea that a healthy meal should include milk or yogurt (preferably low-fat) is questionable as well. Most consumers believe that dairy products are important sources for calcium, which is true – but they are not the only ones. Canned salmon or sardines with bones, broccoli, kidney beans, almond nuts and tofu are all calcium providers.

In the “Fruits” section, no distinction is being made between whole fruits and fruit juices or smoothies. “This ignores the fact that the glycemic load – an indication of how quickly a food is converted to blood sugar – is far higher in fruit juices than in fruits,” says Dr. Weil. It would be better to emphasize the superior benefits of whole fruits, also because the fiber slows down digestion, which helps to stabilize blood sugar levels and prevents overindulgence. For similar reasons, whole grains are preferable to refined versions.

Regrettably, the guidelines encourage reducing sodium intake only from some notoriously salty items, like canned soups and frozen meals, but they don’t name snacks and processed foods. At times, it seems that the government is trying to make its point without directly wanting to criticize the food industry for its manufacturing processes.

All in all, I agree with Professor Nestle’s assessment that the new guidelines are leaning in the right direction, but still keep pulling punches. That said, considering how far we have come over the years, some real progress has been made here. Let’s hope we can keep up the momentum.

If you enjoyed this article, you may also want to read “Farewell to the Old Food Pyramid.”

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” which is available on her blog  http://www.timigustafson.com and at amazon.com. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format, also at www.amazon.com

Farewell to the Old Food Pyramid

June 2nd, 2011 at 8:44 am by timigustafson
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For a generation of American school children, parents and consumers it was supposed to be the instantly recognizable icon for healthy eating: “The Food Guide Pyramid.” No more. Today, the government has unveiled a new symbol. Unlike the familiar triangular shape, the new graphic consists of a circular plate, divided in four colored segments for fruits, vegetables, grains and proteins. In addition, there is a smaller circle for dairy products, suggesting that a glass of low-fat milk or a cup of yogurt has also a place in a health-promoting diet.

The goal of the “MyPlate,” as the new guidelines are called, is to help consumers balance calories, increase consumption of healthy foods and reduce lesser healthy ones.

The central message is kept as simple and straightforward as possible to avoid further confusion of an already confused public: Enjoy food but eat less of it; avoid oversized portion sizes; eat lots of fruits and vegetables as well as whole grains; switch to low-fat or fat-free dairy products; cut back on sodium intake and drink water instead of sugary drinks.

Out with the old, in with the new
Why do we need a new symbol to communicate the government’s dietary recommendations? “The pyramid really does not capture the public’s attention anymore,” said Robert C. Post, Deputy Director of the Department of Agriculture’s Center for Nutrition Policy and Promotion in a recent interview with WebMD.com (5/26/2011). “What we learned is not just giving information… [but to] give people the tools and the opportunities to take action.”

Few nutrition experts will miss the current emblem called “Mypyramid.” “Good riddance” is also the prevailing sentiment among consumer advocates. From the time of its release, it was criticized as too confusing and deeply flawed for its lack of specific information. “It’s going to be hard not to do better than the current pyramid, which basically conveys no useful information,” said Walter C. Willett, MD of Harvard School of Public Health in the New York Times (5/28/2011).

With the new circular design, the government wants to provide today’s consumers with fast, easy to grasp information about the basics of healthy eating. “We need to get consumers’ attention,” said Mr. Post. He stressed that the new icon can only serve as a “visual cue” to help people make better dietary choices.

Historical background
The idea of illustrating nutritional guidelines in form of a pyramid-shaped graphic goes back to the Swedish cookbook author, Anna Britt Agnsäter, whose work was publicized by the Swedish government in 1974. The concept was adopted with slight modifications by the U.S.D.A. in 1992 and renamed as the “American Food Guide Pyramid.”

Like the Swedish original, the American version was meant to represent a hierarchical order of foods in terms of recommended daily intake. Foods to be consumed in larger quantities were placed closest to the wider base of the pyramid, while those to be eaten in smaller amounts were placed closer to the tapering top.

Since its inception, several updates have been made to the pyramid, both by the government and private researchers. The MyPyramid, released in 2005, was widely seen as a departure from the original concept. In essence, only the triangular shape survived. The familiar structure was turned on its side, with vertical, brightly colored strips symbolizing different food groups. To emphasize the importance of physical exercise, a graphic symbolizing a person running up a staircase was added.

Other versions
A more detailed approach to structuring dietary guidelines was taken by Dr. Willett with his “Healthy Eating Pyramid.” Essentially, he tried to break up the different food groups by nutritional quality and also with regards to sources of protein, carbohydrate and fat content. Whole grains, vegetables, fruit and plant oils are at the base of his hierarchy, while red meat, refined grains, animal fats and sweets are at the top, meaning to be eaten only sparingly.

By contrast, the “Atkins Lifestyle Food Guide Pyramid” by Dr. Robert C. Atkins, MD favors protein sources, such as poultry, fish, beef and pork as the dominant food group, ahead of vegetables, fruits, dairy products and grain foods, the latter of which he considers among the least desirable food items.

A favorite of many nutrition experts, myself included, is the “Mediterranean Diet,” which is not commonly depicted in form of a pyramid. Still, the preferences are clearly distinguishable. At the base are pasta, breads, rice, whole grains and potatoes. One layer up are vegetables, fruits, beans, legumes and nuts. Olive oil is used deliberately and for a number of purposes. Less so are dairy products, eggs, poultry and fish. Desserts and sweets are rare treats. Beef and pork are only served occasionally and in small portions.

The bottom line
Whether the new icon combined with the recently updated guidelines will be effective in the ongoing struggle against America’s obesity crisis remains to be seen. What matters most is that people understand the causal connections between their eating habits and their overall health prospects. The essential information has been available for many years, but the message hasn’t caught up with our prevailing lifestyles. Not yet. Lets give this latest initiative a chance.

If you enjoyed this article, you may also want to read “The New Government Guidelines for Healthy Nutrition.”

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” which is available on her blog  http://www.timigustafson.com and at amazon.com. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format, also at www.amazon.com

Remember the line in the movie Forrest Gump? “Life is like a box of chocolate – you never know what you’re going to get.” According to a recently released report by Oceana, an international advocacy group for the protection of the world’s oceans, that is exactly what happens every time you go to the fish market. Food scientists are discovering rampant labeling fraud of seafood among retailers and restaurants, leaving consumers uncertain about their purchases.

The researchers involved in the Oceana study, “Bait and Switch: How Seafood Hurts our Oceans, our Wallets and our Health,” suspect that fish and shellfish is mislabeled up to 70 percent of the time. They say that consumers are routinely given little or no information about where and when seafood is harvested. And worse, the information that is provided is frequently misleading or intentionally false.

This is a problem that affects millions of seafood lovers in America and around the world. While the U.S. government stresses the dietary health benefits of fish, it doesn’t make the necessary efforts to effectively regulate the fishing industry or even to enforce already existing laws.

Most of the seafood consumed in America is imported. With hundreds of different fish- and shellfish species for sale, it is unrealistic to expect Americans to make informed choices on their own. Consumers have to rely blindly on the information they are given. Yet, according to the report, only two percent of the imports get inspected in terms of origin and health safety.

Even sporadic DNA testing has confirmed that false labeling is widespread. The Food and Drug Administration (F.D.A.) found during only one year of random port inspections that at least a third of fish imports were mislabeled.

Certain fish species are more easily misidentified than others. For instance, the label “Red Snapper” may stand for Catfish, Rockfish, Tilapia, Nile Perch, Mahi Mahi or Atlantic Cod (among others). “Grouper” may also be Catfish, Hake, Tilapia, Pollock or Nile Perch. “Bluefin Tuna” can include Bigeye Tuna or Yellowfin Tuna. “Salmon” may come from a fish farm, although it explicitly says “wild-caught” on the label.

Especially the wild and farmed varieties of salmon are not always visually distinguishable. Salmon from aquaculture would normally look somewhat grayish but is often given dietary supplements and artificial dyes to match the typical pink color of the wild cousins. The considerable price differences between the wild and the farmed versions can make it very tempting to commit labeling fraud.

Fish fillets are even harder to identify. Many look alike without the unique features and markings of skin, head and tail. Processing also masks the identity of shellfish. Clams and mussels get easily mixed up when sold without their shells.

Most imported seafood is processed before it’s shipped. Only about one fifth arrives whole or gutted. Whether it is sold in cans or served in small cuts in sushi bars, it is impossible to tell what exactly you are eating simply by looking at it.

Seafood is traded internationally more than any other food. In fact, most of it is transported around the globe, crossing numerous borders before reaching the end-consumer. This makes it complicated if not impossible to keep track of its journey from the water to the plate. “The increasing complexity and globalization of seafood markets have exacerbated fraud, both deliberate and unintentional,” says the report.

Illegal fishing operations have many ways to exploit the complexity of the international seafood trade and are able to effectively “launder” unlawful catches in the regular processing and distribution channels. “In addition to mislabeling and smuggling of illegally caught fish, other forms of seafood fraud include falsifying documentation, bribery and corruption,” according to the report.

Illegal practices cannot easily be stopped. Most fish caught in the open seas is processed right away on board of giant processing vessels before it comes ashore for further processing and packaging. At the time of labeling, the true origin and often the identity of the catch may have been obscured long before it reaches the market. The report concludes that “seafood fraud can happen at each step of the supply chain. Mislabeled fish found in restaurants may have been mislabeled by the restaurant, but the restaurant may rely on the distributors, who may change the label and the price to increase their profits. Mislabeling is driven in part by economic incentives to imitate a more expensive product or avoid tariffs on particular species.”

Seafood fraud can threaten human health
Seafood is extremely perishable. Proper handling and refrigeration are essential for quality and safety. Improper procedures can result in serious health risks for consumers. Looks, smells and tastes are not necessarily sufficient to determine quality because fish may contain toxins or allergens and still show no signs of spoilage.

Industrial pollutants like mercury, lead, PCBs and dioxin are even harder to detect. Unfortunately, nearly all fish and shellfish available on the market today contain traces of these toxins, with some species showing enough concentration to be harmful to humans, especially pregnant women and young children.

Farmed fish can carry antibiotics and dyes that are not present in the wild. Excessive use of antibiotics in aquaculture can lead to the spread of drug-resistant bacteria.

Allergens in seafood pose a serious and sometimes life-threatening risk. Fish and shellfish are among the most common food allergies in America. Failure to detect these potentially fatal health hazards is part of the many dangers resulting from labeling fraud.

Conservation measures are seriously harmed by seafood fraud
Overfishing and capture of species already threatened by extinction hurt all conservation efforts. Widespread concealment of illegally caught fish through multiple transfers, falsified documentation and underreporting makes responsible oversight and management of fishing industries around the world nearly impossible. It is estimated that as much as one fifth of reported catches worldwide come from illegal fishing. The U.S. is especially vulnerable to become “an easy target for dumping illegal, poor quality and unpopular seafood because controls are few and far between,” says the report.

One of the main obstacles in the fight against seafood fraud is that the U.S. government does not require complete traceability of fish imports. By contrast, the European Union has a system of catch certification in place to eliminate illegal imports and exports to and from the continent.

Insufficient inspections and enforcement of existing laws
To date, no single federal agency is in charge of combating seafood fraud. What makes matters worse is that federal agencies don’t even exercise the legal powers they have. The few regulatory efforts in place remain “uncoordinated and ineffectual,” according to the report. Instead of taking a concerted approach, agencies operate within a “patchwork of overlapping and outdated laws.” For instance, the Food and Drug Administration (F.D.A.) is responsible for ensuring the safety and proper labeling of all seafood sold in the U.S. Misinformation and false advertising, however, can only be addressed by the Federal Trade Commission (F.T.C.). The inspecting and policing of seafood imports is left to the U.S. Customs and Border Protection Agency (C.B.P.). Only the U.S. Department of Agriculture (U.S.D.A.) has the authority to force seafood companies to list all countries of origin on seafood labels, which is still not happening today despite of regulations that were put into law years ago. In other words, it’s a maze of bureaucracy that gets in the way of meaningful reform.

The Oceana report is especially damning with regards to the F.D.A.’s performance or lack thereof. “Current efforts […] to combat seafood fraud are wholly inadequate. There is no comprehensive inspection system comparable to even the most basic requirements for meat and poultry. […] The F.D.A. publicly acknowledges that it devotes ‘minimal resources to detecting and preventing fraud.’ Even more concerning, enforcement efforts are virtually nonexistent.”

Only two percent of imported seafood is inspected for health and safety risks and much less for the purpose of fraud investigation. Despite the fact that the F.D.A. has the legal authority to prevent any and all illegal food items from entering the country, shady import businesses can feel quite confident that fraudulent practices will remain undetected for a long time to come.

There are a few other inspection- and safety programs, some initiated or endorsed by the seafood industry. However, most of these are voluntary and unlikely to be followed by those engaging in fraudulent practices.

The technology for testing is already here
Genetic testing of seafood is available and relatively cheap. Commercial laboratories charge up to 20 dollars per DNA analysis, but the actual costs per test are much lower. The F.D.A. has recently purchased gene sequencing equipment for five field labs and hopes to increase testing by the end of the year. Still, most of the current work is being done by individual scientists and advocacy groups like Oceana, not by regulators and law enforcement. To date, there is still no national study on the scope and the implications of seafood fraud and that is a serious public health concern.

If you enjoyed this article, you may also want to read “What You Should Know About Seafood” and “Genetically Altered Salmon and Other Engineered Food.”

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

Benefits of Drugs Raising HDL (Good) Cholesterol Found Questionable

May 27th, 2011 at 4:51 pm by timigustafson
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A just released study on the benefits of HDL (the “good”) cholesterol-raising drugs has shown disappointing results. While lowering LDL (bad) cholesterol levels plays an important role in the treatment of heart disease, doctors have long believed that taking active measures to increase HDL levels as well would yield additional benefits.

As widely reported in the press, these expectations now seem unwarranted. The interim analysis of the study shows that a high dose of niacin, a B vitamin credited with the ability to increase high-density lipoprotein (HDL) in the bloodstream, taken in combination with statins does little if anything more to prevent heart attacks and strokes.

Sponsorship for the study, called AIM-HIGH trial, was shared by the U.S. government and Abbot Laboratories, a pharmaceutical company that makes Niaspan, a drug widely prescribed to heart disease patients as an HDL booster. During the trial that was originally scheduled to last 32 months, 3414 participants with heart- and vascular disease were treated with Zocor, a low-density lipoprotein (LDL) lowering statin.

While all participants were given the statin, one group received also Niaspan and another one a placebo. The study was concluded 18 month early when it became clear that Niaspan did not provide the significant advantages it was supposed to. Although the drug raised HDL levels as expected, the effects did not translate into measurable improvements of heart problems.

The effectiveness of Zocor was not called into question. The researchers emphasized that patients who were using Niaspan should not stop taking the drug without consulting with their physicians first.

Abbot Laboratories says it remains confident about the effectiveness of its product even after the study, insisting that “Based on its long history of clinical evidence, Niaspan remains an important agent for patients with blood lipid problems.”

The Food and Drug Administration (F.D.A.) has announced it will review the study but has not yet revised its former findings and recommendations.

Still, the new results will probably change the ways physicians treat their heart disease patients from hereon in. And not all patients are unhappy about being taken off the drug either. Niacin, the active ingredient in Niaspan, can cause a number of unpleasant side effects, including flushing and headaches. But because it was widely seen as a potentially life-saving medicine, the downsides were deemed acceptable.

In 2006, another pharmaceutical company, Pfizer, reportedly halted the development of its own HDL-raising drug “after studies showed that the medicine increased the risk of death.” (New York Times 5/27/2011)

The fact that HDL (“good”) cholesterol helps to “sweep up” LDL (“bad”) cholesterol in the bloodstream remains unchanged, of course. The importance of keeping both LDL levels down and HDL levels up is not in dispute.

Less known in the public arena is that niacin is not only present in HDL-raising drugs but also in many foods we all consume every day, including dairy products, lean meats, poultry, fish, nuts, eggs and enriched breads and cereals.

What this means is that diet- and lifestyle changes can significantly help increase HDL levels “naturally.” For instance, drinking three cups of orange juice a day can increase HDL by over 20 percent, according to one British study. Replacing saturated with monounsaturated fats and eliminating trans fats can not only reduce LDL but also boost HDL. So does drinking alcohol in moderation, especially red wine. Two to three servings per day of soluble fiber, found in oats, rice, dried beans and many fruits and vegetables can offer similar benefits. And, of course, regular physical exercise, in particular aerobics, not smoking and consistent weight management are among the best measures you can take to keep your cholesterol in check both ways.

Some foods containing niacin:
White-meat chicken, 3.5 oz, cooked: 13.4 mg of niacin
Mackerel, 3.5 oz, cooked: 10.7 mg
Trout, 3.5 oz, cooked: 8.8 mg
Salmon, 3.5 oz, cooked: 8 mg
Veal, 3.5 oz, cooked: 8 mg
Chicken, dark meat, 3.5 oz, cooked: 7.1 mg
Lamb, 3.5 oz, cooked: 6.6 mg
Turkey, white meat, 3.5 oz, cooked: 6.2 mg
Ground beef, 3.5 oz, cooked: 5.3 mg
Peanuts, ¼ cup: 5.3 mg
Pork, 3.5 oz, cooked: 4.8 mg
Peanut butter, 2 tablespoons: 4.4 mg
Beef steak, 3.5 oz, cooked: 4.1 mg
(Source: WebMD.com)

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

A Better Way to Watch TV

May 24th, 2011 at 6:33 pm by timigustafson
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Watching TV and playing video games has long been named as one of the culprits for our national obesity crisis. Our sedentary lifestyle habits certainly deserve some of the blame and there is no shortage of advice on how to wean us from our most beloved pastime.

The average American stays glued to the tube between four to six hours daily. Parents may complain about the almost addictive attitude their kids have towards video games, but, of course, adults surfing channels for hours on end are no different.

The fact that so many of us spend excessive amounts of time in front of the screen suggests that the experience is different from other activities that hold our attention to a far lesser degree.

Clinical studies have suggested that there are behavioral and neurological connections between the events we see on the screen and our ability to pay attention. “The kind of concentration that [especially] children bring to video games and television… is sustained with frequent intermittent rewards,” says Dr. Christopher Lucas, professor of child psychiatry at New York University School of Medicine.

In other words, watching TV shows and playing video games may be so popular because they offer more frequent rewards than other activities. The neurological explanation is that the brain releases dopamine, a neurotransmitter in charge of pleasure experience. Our attention span is prolonged by the constant gratification we receive from suspenseful movies, funny sitcoms or challenging contest games. Watching or interacting with any of these might serve as a kind of dopamine-enhancing self-medication.

Encouraging people to push the switch-off button and do something else may be the obvious answer but perhaps not the only one. Trying to deny ourselves what gives us pleasure rarely works over time. Sometimes, indulging in what comes naturally can be a smarter solution.

For me, a recent visit to a computer store was a real eye-opener in this regard. The place was packed with kids and teenagers who were not there to buy laptops and tablets but to play – not video games where you just use your thumbs but athletic games that require full body action. Of course, I am talking about the highly popular Kinect game series that runs on the Xbox 360 player from Microsoft.

For all those who are new at this, like myself, here is a brief description of how it works: Kinect uses motion sensors that track the movements of every part of a person’s body –arms, legs, knees, head, hips and so on. The collected data allow a computer to produce a kind of “digital skeleton,” which is then fed into a video game environment. Players can view their actions in real time on screen in form of an avatar, an electronic image that corresponds to the players’ performance.

Some of the scenarios are highly imaginative. As a health care professional and fitness buff, I was immediately drawn to a game titled “Your Shape,” which promises calorie burn-off while having nothing but fun. It comes with a “personal trainer” and a dynamic exercise program for every health- and fitness level.

For the specific purpose of weight loss, Kinect offers another workout program called “The Biggest Loser,” which features trainer-guided exercise- and nutrition tips based on the popular TV show on NBC.

If that doesn’t sound especially appealing, there is a large selection of athletic sports to choose from, and also less strenuous activities, like dancing, golf or bowling.

Do I think that this is the solution to ending America’s notoriously sedentary lifestyle? No, of course not. But it can be a helpful tool.

There are countless reasons why both adults and kids spend too many hours on the couch every day. In many families there is not enough time and energy left for much else after a grueling workday and long commutes. Playing outside the house or on a nearby playground may not always be safe for kids who are on their own.

As they become more affordable, these new technologies may indeed provide some alternative outlet. Isn’t it better to do something for our health in the virtual world if it helps us to avoid getting sick in the real one?

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

Most Americans are concerned with their weight and are changing their food choices. Although losing weight remains a key priority for most adults, a surprising number of consumers are now less concerned about the amount of food they eat than they were a few years ago. If these statements sound contradictory to you, it is because they are. Both food manufacturers and health care industry try hard to make sense of America’s eating habits. Not a week goes by without another survey reporting the discovery of new trends in consumers’ behavior. The picture is anything but clear.

It is true that many more Americans have become interested in healthy eating. Concerns about food safety have definitely increased, and for good reasons. In response to several outbreaks of food-related illnesses in recent years, there is now greater demand for organic food products, even if it means paying higher prices. But for most of the population, nutritional quality is still not a priority when it comes to food choices.

Most Americans don’t eat enough fresh fruits and vegetables according to the United States Department of Agriculture (USDA), which recommends five servings of each in its dietary guidelines. Milk and eggs are being consumed in lesser amounts, but cheese is more popular than ever. Meat, poultry and fish consumption continues to rise. The overall fat content in the average American diet is undiminished.

Americans love their snacks. According to USDA studies, almost 20 percent of daily calorie supply comes from snack food in this country. Half of younger adults skip breakfast on most days, a quarter goes without lunch, and home-cooked dinners are becoming the exception rather than the rule even among families with young children. Especially kids suffer in growing numbers from malnutrition and weight problems due to unhealthy eating patterns.

Working men and women eat on average 25 percent of their meals away from home. That doesn’t mean the other 75 percent are being made from scratch. Fast food, pizza, take-outs and frozen dinners are the preferred choices of those with busy lifestyles. Pre-packaged meals, so-called “convenience foods,” became available in the 1950s when women started to enter the work force in large numbers and being a full-time “homemaker” was no longer attractive or financially feasible. The invention of the microwave, the omnipresence of fast food chains and a growing appetite for cheap food to go all fed into these trends and continue to do so.

While many aspects of these lifestyle changes are positive, the downsides are quite devastating. We are in the midst of a national obesity epidemic that has reached crisis level. Childhood obesity has become by far the greatest health threat to the country’s future.

And yet, there is growing evidence that Americans are getting fed up with dieting and weight loss. Finding themselves ceaselessly barraged with often contradictory information and expert advice, people become less enlightened and instead more confused and helpless. Others feel increasingly resentful about being lectured on what they see as their private business. As important as good health may be to them, many Americans find it too arduous and time-consuming to follow suit in their diet.

The number of people who say they watch their food intake at least occasionally for weight management and fitness purposes is stagnant, according to reports by three leading weight loss companies. “People are just saying: The hell with it. I’m going to eat whatever I feel like,” said one spokesperson for Marketdata Enterprises, a research firm specializing in data gathering for the weight loss market.

According to a survey conducted by the American Dietetic Association (A.D.A.), over 80 percent of Americans now rate nutrition as “only moderately important” to them. Most experts agree that people are clearly moving away from being obsessed with being thin. Some have suggested that the aging Baby Boomers are at least one of the reasons. When folks get older, they are more set in their ways, which is also reflected in their eating habits.

“I think there is some cultural backlash to our societal urge to live forever,” said John Lyons, a psychologist at Northwestern University. “It’s like a realization of one’s limits and an acceptance, something you see in the 40s to 50s age group. Maybe you just accept your lot and do the best you can.”

Not surprisingly, support groups for overweight people are emerging all over the country. Demand for better protection of the rights of the obese is getting louder and keeps gathering followers. Obesity has been stigmatized for far too long in our society, they say, and it’s time to question what counts as the ideal body image. Of course, this is a valid point. Many people with serious weight problems suffer from low self-esteem and other emotional distresses, which often complicate their efforts to lose weight in the first place.

Still, it is plain to see that the continuing obesity crisis is not a sustainable situation. Throwing our hands up and walking away in resignation is not an option. Too much is at stake here. There is no way that we will ever be able to provide affordable health care for everyone if the health of vast parts of the population continues to deteriorate at this pace. We won’t be able to dig ourselves out of this crisis, no matter what health care model we try to follow.

The necessary lifestyle changes will not happen without awareness and recognition of the consequences we will face if we continue on the current path. Unfortunately, the immediate forecast is not hopeful.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

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About timigustafson

About Timi Gustafson, R.D. As a clinical dietitian, health counselor, book author, syndicated newspaper columnist and, as of late, blogger, she has been able to reach millions of people, addressing their concerns about issues of health, lifestyle and nutrition. As Co-founder and Director of Nutrition Services for Cyberdiet.com (now Mediconsult.com), she created the first nutrition-related interactive website on the Internet in 1995. Many of the features you find on her blog, www.timigustafson.com, are based on the pioneering work of those days. Today, her goals remain the same: Helping people to achieve optimal health of body and mind. She received a Bachelor of Science degree in Clinical Nutrition and Dietetics from San José State University in California and completed a Clinical Dietetic Internship at the University of California Medical Center in San Francisco. She is a registered dietitian and Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Academy of Nutrition and Dietetics, a member of the Diabetes Care and Education, Dietitians in Business and Communications, Healthy Aging, Sports, Cardiovascular and Wellness Nutrition, and the Vegetarian Nutrition Practice Groups. For more information about Timi Gustafson R.D. please visit: www.timigustafson.com

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