Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

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.

Preventive Care Must Be Included in Essential Health Benefits Package

October 12th, 2011 at 1:51 pm by timigustafson
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The central goal of last year’s health care reform was to provide coverage for tens of millions of Americans who are currently uninsured or uninsurable because of so-called pre-existing conditions. Under the new legislation, insurance companies will be prohibited from denying acceptance to applicants based on their health status or dropping beneficiaries when they get sick. Insurers will also have to cover a number of preventive measures like immunizations, routine medical check-ups and screenings for certain types of cancer.

Most details of the new benefits program remain sketchy to this point, however. The Department for Health and Human Services (HHS) has tasked the Institute of Medicine (IOM) to come up with guidelines to help determine what health benefits should be considered “essential” and should be included in all insurance plans.

In a long-awaited report, the IOM declined to list specific benefits but gave a framework instead by which the importance of services should be determined. In keeping with the current political climate and economic realities, the institute urged the government to consider affordability above all other criteria. “If the benefits are not affordable, fewer individuals will buy insurance. And if health care spending continues to rise so rapidly, the benefits will erode,” warned the 18-member expert panel that authored the report.

There was also concern that the federal government itself could face unsustainable expenditures if it was forced to subsidize millions of insurance premiums for beneficiaries who can’t afford paying for oversized benefits packages.

For all these reasons and others, the panel advised that benefits should be kept within the limits of a typical employer plan for small businesses – not large or medium-size corporations that are able to provide more generous coverage. As it is written now, the reform law has listed 10 categories of essential benefits that must be offered, some of which go well beyond the provisions of many existing employer plans, such as maternity leave, mental health treatment, pediatric dentistry, among others. By contrast, the panel wants regulators to only include services that are “medical in nature and that have been established to be effective using research.” Excluded should be all “treatments that have not been shown to work [and] services that are primarily educational.” Some of those treatments “not been shown to work,” according to the panel, could be common tests like mammograms and screening for prostate cancer.

Preventive measures as part of the final benefit package remain on shaky ground. House Republicans have already announced their plan to block a program called the “Prevention and Public Health Fund,” which is intended to financially support states and communities in their efforts to prevent diseases. It would pay for public health services that help fight obesity, heart disease, diabetes and cancer, increase vaccination and reduce smoking, alcohol and drug abuse, among other things. Many health organizations, including the American Cancer Society and the American Heart Association are in favor of the project, which will cost about $16 billion over ten years.

In any case, keeping Americans healthy will be more cost-effective than curing them. Unlike our traditional health care model, which is almost exclusively designed to treat illnesses and injuries, any new approach should look for strategies that identify and lower risk factors before serious consequences occur.

This thinking is by no means new, of course. Many employers have long recognized that keeping their workforce in good health is a vital part of controlling health care costs. Three out of four larger companies offer free preventive health services to their workers, according to a 2009 survey by Mercer, a benefits consulting firm. These include anti-smoking policies, access to exercise- and fitness facilities, weight management programs and more. “Wellness benefits” like these should be made available for small business employees as well.

Ultimately, it comes down to this simple question: Should we continue to invest almost exclusively in medical treatment or should we change the system in favor of prevention. On face value, I think, it’s a no-brainer. Even folk wisdom has it that an ounce of prevention is worth a pound of cure.

Preventive health care essentially means helping people to maintain good health. This includes getting them to exercise, manage their weight, eat right, quit or avoid smoking, abstain from drug-and alcohol abuse and keep blood pressure, diabetes and cholesterol levels under control. Health education and counseling can be instrumental to prevent most lifestyle-related illnesses.

Annual physicals and regular screenings matter greatly as well. Especially after a certain age, they should include monitoring blood pressure, cholesterol screening, pap smear tests, mammograms, PSA testing, colon cancer screening and CT scans for lung cancer.

Most diseases can be effectively treated as long as they are detected early enough. It shouldn’t be a question whether we can afford to offer preventive services to everyone. The truth is, we can’t afford not to. All alternatives will turn out to be much costlier.

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.

Don’t Grow Old Alone

October 9th, 2011 at 3:23 pm by timigustafson
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People who are lonely and isolated in their senior years tend to be in poorer physical and mental health than their contemporaries who are in loving relationships. These are the findings of a recent study published in the Journal of Health and Social Behavior that investigated links between social connections and health in older adults.

“Feelings of loneliness and isolation can affect older adults’ health in a number of ways. They can, for example, create stress, lower self-esteem or contribute to depression, all of which can have physical health consequences – either by affecting a person’s lifestyle choices or through direct effects on the body,” said Dr. Erin York Cornwell, a sociology professor at Cornell University and lead author of the study report.

Social isolation may even shorten your life expectancy, according to Dr. James Lynch, author of “The Broken Heart: The Medical Consequences of Loneliness.” Human beings are social creatures throughout their lives. As people grow older, their need for social interaction remains the same, but their ability to satisfy this need may become diminished: They retire and lose contact with former co-workers; their children grow up and move away; they become widowed or divorced; their circle of friends shrinks. As a result, many elders find themselves increasingly deprived of the important benefits of companionship. Life becomes less satisfying and loses its meaning. Consequences are often severe depression and lack of will to live.

“Suicide is more common among older Americans than any other age group,” according to Jane E. Brody, a columnist for the New York Times who writes on issues of personal health. “While people 65 and older account for 12 percent of the population, they represent 16 percent to 25 percent of the suicides. Four out of five suicides in older adults are men. And among white men over 85, the suicide rate – 50 per 100,000 men – is six times that of the general population.

Older widowers and divorcees are at the highest risk. When wives die or move away, their husbands’ social connections often cease as well, especially when the women did most of the social networking. “Men are poorly prepared for retirement and don’t know how to fill in the hours and maintain a sense of usefulness when they stop working,” said Dr. Martha L. Bruce, a professor of sociology and psychiatry at Weill Medical College of Cornell University.

“Many older people despair over the quality of their lives at the end of life. [We] think that sadness is a hallmark of depression. But more often in older people it’s anhedonia – they’re not enjoying life,” Dr. Bruce added.

Conversely, having loved ones to spend time with, making new friends and sharing experiences and interests with others can help decrease the susceptibility to loneliness, depression and illness. Nurturing new relationships and even falling in love again can bring back a renewed zest for life. Research has shown that seniors who remain sexually active enjoy better physical and emotional health than those who do not, according to Dr. Andrew Weil, professor of medicine and director of the Program for Integrative Medicine at the University of Arizona and best-selling author of numerous books on health and wellness, including “Healthy Aging – A Lifelong Guide to Your Physical and Spiritual Well-being.” “The youth culture would have us believe that sexual pleasure is the birthright of the young, that old people shouldn’t be thinking about sex, and that imagining old people having sex is distasteful. None of this is true. [Physical contact] is a basic requirement for optimum health,” he added. “This need does not diminish with age.”

Thankfully, the baby boomers are less inhibited in this regard than previous generations may have been. Today’s 55-plus crowd definitely does not think the party is over any time soon. And they know where to look for love in all the right places – via the Internet, of course. Memberships of dating sites are booming, and the older demographics are growing the fastest. “With so many older Americans unattached, living independently into their later years, and increasingly comfortable using the Internet, they too are logging on for love,” observed Stephanie Rosenbloom in an article for the New York Times (10/6/2011), titled “Second Love at First Click.” Not everyone is looking for true love, let alone marriage. But companionship and romance are in high demand and the dating industry is happy to help.

Living longer and healthier as we grow older through sound nutrition, physical exercise and mental activity is very important, but it’s only a worthy goal if the experience is enjoyable and gratifying – and that includes love.

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.

Breakfast – The Most Important Meal of the Day

October 5th, 2011 at 12:48 pm by timigustafson
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My grandmother used to say: Never start your day before you had breakfast – and if you have to, at least eat something.” Granny knew nothing about the intricacies of modern-day dietetics, but her folksy philosophy was right on the money. Yes, you should not leave home in the morning on an empty stomach. So at least eat something, or even better, get a highly nutritious boost that fuels your body for the day ahead.

Breakfast cultures can differ tremendously, not only between countries and ethnicities but also within families. Having been brought up in England, I have maintained some of my early habits and preferences throughout my life. I don’t eat kippers (smoked herring) anymore, but I still like my cup of tea with a biscuit as soon as I get out of bed, as I did as a kid. My own children, both born and raised in America, would never dream of having anything else than coffee and cereal, and perhaps pancakes on weekends. For them, as for many Americans, convenience and efficiency matter most.

That wasn’t always the case. In the early 1800s, our forbearers ate their main meal at midday and a lighter supper in the evening, as it’s still the case in many European countries. Breakfast was not a separately prepared meal but consisted mostly of leftovers and was served cold so as to not require making a fire, describes Elizabeth Giddens in an article for the New York Times Magazine (10/2/2011), titled “How Has Breakfast Evolved.”

By the mid 19th century, working men no longer had the time to go home for lunch, so having a hearty breakfast became important. To endure long hours of hard labor until dinner – mostly of the physical kind like construction, manufacturing and agriculture – they needed to consume as many calories as possible.

Only in the early 20th century, certain foods like eggs, sausages, bacon and pancakes became distinguished breakfast staples. It was also around that time that the breakfast cereal was invented. “Few foods have transformed the American table quite so significantly as cereal,” said Giddens. And with more and more women entering the workforce in the 1950s and 1960s, cereal became the breakfast of choice for many families because it required almost no preparation.

Today, breakfast as a regular meal has almost ceased to exist. More and more people skip breakfast for a variety of reasons. They say they are too pressed for time, don’t like breakfast food or are not hungry in the morning. The problem is that going without food between dinner and next day’s lunchtime means eighteen hours of fasting, which leads to a state of semistarvation that can eventually create a number of serious health risks.

Research has shown that taking time for breakfast is more valuable for your health than a few extra minutes of sleep. A nutritious morning meal will refresh you and recharge your body better than your snooze can.

Choosing the right kind of food for breakfast matters greatly. You don’t have to stick to “traditional” breakfast items. During my many travels, I’ve encountered all sorts of breakfast styles, many of which I never heard of before but found absolutely delicious.

Fruit for breakfast is always a good choice. It provides many important vitamins and other essential nutrients. Cereal can be a good source of fiber. Hot cereal like oatmeal is preferable. Make sure you’re getting a brand that contains only whole grains and no added sugar. For protein, have some eggs (egg white only), yogurt or milk (both non-fat or low-fat). Vegetables are great, but they are not to everyone’s taste. I sometimes like tomatoes or beets as a side dish.

If you are not used to eating an elaborate breakfast, start small. Not being hungry in the morning may be the result of a heavy meal for dinner or a late snack the night before. When that happens, your stomach keeps digesting while you’re asleep. When you wake up, your blood sugar level is at the lowest and you feel sluggish and irritable, which also affects your appetite. So, instead of forcing down food you are not used to and don’t enjoy, have a piece of whole-wheat toast and some fruit and gradually add more items over time.

Some people skip breakfast to lose weight. It’s a bad idea! Research has shown time and again that skipping meals, especially breakfast, can make weight control more difficult. Avoiding regular meals makes the temptation of unhealthy snacking harder to resist, which, of course, defeats the purpose of dieting. “Eating breakfast prevents you from bottoming out and getting too hungry,” said Susan Kraus Ms, RD, a registered dietitian at Hackensack University Medical Center in New Jersey. “Without eating breakfast, you’re more vulnerable to cravings and less likely to make healthy choices in the morning and throughout the day. That’s a disaster – whether you’re on a diet or just eating for good health.”

By contrast, eating a healthy meal before you start your day keeps you satisfied and your metabolism running smoothly. It also helps you to stay focused and perform at your best. It prevents you from running out of energy and making poor eating decisions.

If this is true for adults, it matters even more for growing children. Numerous studies have shown that kids who skip breakfast regularly do less well at school than those who don’t. Pediatricians and nutrition experts urge parents who are unable to feed their kids a wholesome breakfast at home to enroll them in a school breakfast program. It’s one of the best investments they can make in their 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.

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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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