Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

A Rickshaw for Your Living Room?

December 21st, 2011 at 1:41 pm by timigustafson
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While searching for a few more gift ideas for family and friends, I came across a catalog that seemed to specialize in items I had never considered or even seen before. A rickshaw for $2,200 from a company named “Anthropologie” got my attention. Not that I was about to buy a full-size rickshaw for myself or loved ones. None of us would have any good use for it. Also, the one in the catalog was obviously meant to be displayed in a home, like a piece of furniture or an art object rather than a means of transportation, although you could probably take it for a spin around the neighborhood a few times, if you were so inclined.

I understand that for the gift industry to come up with new ideas year after year must be extremely challenging. It takes true genius to invent things that are so attractive that people just can’t imagine living without them. Eventually, some of this is bound to venture into the absurd.

Don’t get me wrong. I think many of today’s popular gifts are great. I-pods, smart phones, tablets, video games (especially the ones that make you move) – I’m for all of that. I’m not opposed to nice possessions. I’ve had my share and still do. I don’t even have a personal aversion against rickshaws. Far from it. They hold plenty of dear memories for me. During my travels in India and China, rickshaw rides were often the fastest, cheapest and most convenient way to get around. Still, a rickshaw for the living room seems awfully forced.

In the movie, “The Bucket List,” which has become some sort of a cult movie among baby boomers, two cancer-ward roommates, one an insanely rich entrepreneur, the other a blue color worker (played respectively by Jack Nicholson and Morgan Freeman), decide to go off on a last around-the-world adventure before – well, before they kick the bucket. Even the billionaire realizes that money is all he has left and it won’t buy him what he wants the most – time. All he can do is fill his remaining days with as many meaningful experiences as possible. And he goes for it. Together with his unlikely companion he discovers what life has to offer beyond material wealth. And what a difference it makes.

I myself have long realized that my experiences and memories are the only things that have lasted in my life. Most of my possessions have come and gone. Even the homes I owned only exist now in my mind as places where we built our lives as a family, where my children grew up, where we entertained friends, where my dogs were raised and buried, where the seasons came and went, marking the rhythm of time. What’s completely absent from the picture are the knickknacks accumulated and then discarded.

So, here is what’s on my wish list now and hopefully for the rest of my life:

1. I want to love and be loved
2. I want to preserve my physical health for as long as possible
3. I want to stay mentally fit
4. I want to keep my curiosity and playfulness
5. I want to continue to be financially secure
6. I want to see my family happy, healthy and prosperous
7. I want to have at least one good belly laugh a day
8. I want to be free of negative emotions like fear, anger or bitterness
9. I want to be grateful, kind, forgiving and patient
10. I want to be useful and helpful for others
11. I want my work to make a difference for the better
12. I want to take a few more rickshaw rides in far-flung places

And I want to wish you, my dear readers, happy holidays and all the best for the coming year.

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.

Your Drinks Count, Too

December 18th, 2011 at 5:40 pm by timigustafson
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Most people are well aware that they will probably gain some weight over the holidays from all the festive dinners and extra treats. They are less conscious of the fact that drinks, both alcoholic and non-alcoholic, can contribute just as much if not more to the expansion of their waistline. It’s hard to keep track of the extra calories from liquids because the brain doesn’t receive a “full” signal from the stomach the way it happens with solid food.

Especially drinking alcoholic beverages can significantly increase calorie intake with just a few shots or sips. Many liquors are as caloric as sugary sodas. Alcohol itself is high in calories – 7 calories per gram, more than carbohydrates or protein (4 calories per gram) and almost as much as fat (9 calories per gram). This applies just to straight drinks, like beer, wine and spirits. Cocktails with added ingredients can quickly multiply the calorie content.

“If you drink, even moderately, first you do need to acknowledge the calories. They count,” said Lona Sandon, a nutritionist at the University of Texas Southwestern School of Health Professions and spokesperson for the American Dietetic Association (ADA).

Keep in mind that calories from alcohol are “empty” calories, meaning they don’t contain any nutrients. The liver processes alcohol first to get rid of toxins, while other nutrients are put on hold. While alcohol is being metabolized, fat burning is suspended. Moreover, an increased alcohol level in your blood stream can make you feel hungry because it lowers your blood sugar. All of these factors combined are the perfect set-up for weight gain.

Another well-known fact is that alcohol diminishes one’s inhibition and self-control. That’s why the holidays are often a time when caution gets thrown to the wind with regrets to follow later.

Of course, not everyone who enjoys a drink or two develops weight problems. Scientists have not been able to consistently tie alcohol consumption to weight gain. Also, a person’s individual genetic make-up can greatly affect his or her body’s ability to process alcohol.

Gender can play a role as well. Researchers found that when men drink, they also tend to eat more food, thereby increasing their overall calorie intake through both. Women, on the other hand, are more likely to compensate for their drinking by eating less.

Naturally, it matters what kind of food or snacks you’re having with your drinks. Beer with pretzels or peanuts, or wine with cheese and crackers are popular combinations, but they can be deadly in terms of weight control.

Coffee drinks and seasonal spirits are not harmless either. Many are loaded with sugar and cream and a few gulps can quickly add up to a calorie count of a full meal. Eggnog, a traditional favorite, is a real heavy weight. A one-cup serving has about 400 calories – and who can just have one?

So, what can you do to avoid these calorie traps without spoiling your holiday spirit? Quite a bit, actually. For starters, don’t get caught off guard when alcoholic beverages are being served. If you like wine or beer, stick with it. Don’t mix with other drinks. If hard liquor is your poison, have it straight up, on the rocks or with club soda but without a lot of other stuff added. Be particularly careful with super-caloric cocktails. They are desserts in disguise. If you have eggnog or fruit punch, I recommend taking them “naked,” meaning no extra toppings like chocolate or whipped cream.

As with everything, moderation is key. If you have been reading my columns regularly, you know one of my favorite mottos: “Nothing is forbidden, but everything counts.” Observing this little piece of wisdom is even more important during the holiday season. Cheers!

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.

Reducing Risk Factors for Alzheimer’s Disease

December 14th, 2011 at 3:47 pm by timigustafson
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At an international conference, sponsored by the Alzheimer’s Association last July in Paris, researchers discussed the growing global risk of Alzheimer’s disease. It is estimated that 36 million people currently suffer from the disease worldwide. Predictions are that those numbers will triple by the mid-century.

Although the causes of Alzheimer’s disease are not yet fully understood, it is becoming increasingly evident that diet and lifestyle choices play a more significant role than previously thought. Altogether seven lifestyle-related risk factors were identified based on a new mathematical model that was developed by a research team from the University of California, San Francisco (UCSF).

They are: Physical inactivity (21 percent), depression (15 percent), smoking (11 percent), hypertension (8 percent), obesity (7 percent), low education (7 percent) and diabetes (3 percent). These risk factors combined are believed to contribute to about five and a half million cases of Alzheimer’s in the United States alone.

Based on findings such as these, the Alzheimer’s Association has pledged to fund more studies to explore the importance of mental and physical health for risk reduction and ultimately prevention of the disease.

One area on which researchers have been able to shed some light is the connection between Alzheimer’s and cardiovascular disease. Autopsy studies have shown that 80 percent of Alzheimer’s patients suffered from cardiovascular disease or related conditions like high blood pressure, heart disease, high cholesterol and stroke.

“Taking care of your heart protects your brain,” said Dr. Jack C. de la Torre, a leading researcher in the field. He believes that reducing cardiovascular risk factors as early as possible is key in the prevention of memory loss and dementia in later years. There is general agreement among the experts that a healthy, balanced diet and regular exercise are the most effective measures people can take to protect their mental health.

A study report from Rush Medical College in Chicago concluded that a Mediterranean-style diet, which is predominantly vegetarian and low in fat, may have positive effects on the brain as well. For this project, 3,790 men and women ages 65 and older were periodically tested over an average of 15 years for memory and thinking skills. The participants who adhered most strictly to the Mediterranean diet scored significantly higher in the tests and were diagnosed as two years younger in “brain age” in comparison to their counterparts who didn’t follow a particular diet regimen. The findings still held after adjustments were made for other risk factors like age, sex, race, education, etc.

The report, which was published in the American Journal of Clinical Nutrition, concluded that, although the research “could not account for all the many factors that may contribute to cognitive decline in old age, […] a Mediterranean diet helps cut down on inflammatory substances in the body.” Inflammation has long been tied to heart disease and now possibly to Alzheimer’s disease as well.

Key ingredients of the Mediterranean diet, which derives its name from the typical food choices in countries around the Mediterranean Sea, include an abundance of fresh fruits, vegetables, whole grains, nuts, legumes, olive oil and fish but only limited amounts of dairy products and meats.

The other equally important component of an anti-Alzheimer’s disease lifestyle is regular exercise. A study on the benefits of physical activity for mental health, published in the Archives of Internal Medicine, found that “regular exercise may be good for staying mentally sharp into old age.”

Particularly resistance training (weight lifting) was singled out as a highly effective form of exercise in a study from Vancouver, Canada. Participating seniors who engaged at least twice a week in weight lifting scored on average higher on mental acuity tests than those who did only aerobics.

Still, as other studies from the U.S. and Europe have shown, older men and women who follow a moderate to intense exercise regimen of any kind score regularly higher on cognitive tests than their sedentary contemporaries.

Alzheimer’s is a complex phenomenon. Understanding it enough to hope for better prevention, let alone a cure, requires much further studying, especially with regards to its genetic components. However, since lifestyle factors almost certainly play a major role, we all can start taking steps to do our part in preventing this terrible disease.

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.

Quality of Life Is Part of Health Care

December 11th, 2011 at 5:38 pm by timigustafson
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Even people who decry European social policies as socialism or welfarism admit that countries like Sweden, France or Germany provide their citizens with benefits not commonly available in the United States in terms of access to health care, job security, unemployment aid, maternity leave, child day care, paid vacations and more.

While it is true that the U.S. spends more than most countries on health care, the average life expectancy is lower and infant mortality is higher here than in many other industrialized nations. Why the discrepancy?

Based on a study that compared the various health care policies of the 30 most developed countries in the world, researchers found that spending on health care combined with spending on social services made the most significant difference. The study report, which was published in the journal BMJ Quality and Safety, concluded that spending on social services can extend and improve people’s lives in ways that health care alone cannot achieve.

“We studied 10 years’ worth of data and found that if you counted the combined investment in health care and social services, the United States no longer spent the most money – far from it,” wrote Elizabeth H. Bradley, a professor for public health at Yale University, and Lauren Taylor, a program manager at Yale’s Global Health Leadership Institute, in a co-authored op-ed article in the New York Times (12/9/2011).

“America is one of only three industrialized countries to spend the majority of its health and social service budget on health care itself. For every dollar we spend on health care, we spend an additional 90 cents on social services. In our peer countries [mostly in Europe], for every dollar spent on health care, an additional $2 is spent on social services. So not only are we spending less, we’re allocating our resources disproportionately on health care,” they added.

Health experts agree that unmet social needs often lead to an increase in acute health problems. Like actual diseases, lack of health insurance, job insecurity and poverty contribute heavily to the worsening of our public health. For millions of Americans, the hospital emergency room is the only option left in an otherwise broken system, a last resort that is not really sustainable.

“It’s time to think more broadly about where to find leverage for achieving a healthier society,” wrote Bradley and Taylor. The simplest way would be to invest more in social services, like the Europeans do. But this would mean an extended role of government and probably higher taxes, both of which are considered non-starters in the current political climate.

Still, the authors insist that introducing variations of the European model may be possible at some point in the future. As an example where this is already happening they cite a program called “Stand Downs” by the Department of Veterans Affairs, which addresses a number of social needs of retired service members as part of their health care plan.

So, what can be done in the meantime for the rest of us? For once, we need a better understanding of the importance of pro-active instead of strictly re-active health care. While it is common knowledge that “an ounce of prevention is worth a pound of cure,” we have yet to turn these insights into action. Health education and counseling should be considered as important as drug prescriptions and surgery – and appropriately funded. The fact that many of today’s common diseases are caused by poor lifestyle choices, bad eating habits, stress and sleep disorders should make us rethink our health care priorities.

Furthermore, studies have shown how access to basic health care can give people peace of mind and improve their overall well-being and quality of life (as I have reported earlier in an article titled “Health Insurance Shown to Make a Big Difference in Quality of Life”). It is part of a safety net nobody should have to be without. Seeing so many people in our midst deprived of some of the most elementary social services is intolerable. We can and must do better.

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

Growing Old Is Not for Sissies

December 8th, 2011 at 10:07 am by timigustafson
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According the Census Bureau’s latest report, there were 40.3 million people age 65 and older living in America in 2010, an increase of about 15 percent from a decade ago. By contrast, the entire U.S. population grew by only 9.7 percent during the same time period. For the first time in history, the elderly are now the fastest growing demographic group in the country.

In 1900, Americans could expect to live for about 49 years. In 2000, the average life expectancy had expanded to almost 77 years. Over the 20th century, people’s average lifespan lengthened between 1.5 and 2.7 years – per decade.

We are not alone in this trend. Aging populations are a global phenomenon. “The world is changing as a result of mankind’s greatest gift to itself, the engineering of longer lives,” writes Ted C. Fishman, author of “Shock of Grey.” In fact, if one adds up all the extra years of today’s average human life expectancy and multiplies it by the current world population, the magnitude of this development becomes even more apparent. The seven billion people now living on earth will enjoy more than 250 billion extra years compared to our ancestors of just one hundred years ago.

Obviously, it is debatable whether this dramatic rise in human life expectancy should be considered a success story or cause for concern. While the world population continues to grow, space and resources diminish. Increases in birth rates and longevity burn the candle at both ends. As Fishman puts it, “Billions of extra human-years would seem to virtually require a second planet.”

Not everyone predicts a doomsday scenario, however. Some see the graying of America as an opportunity to rethink our youth-obsessed culture and come up with workable alternatives. “As baby boomers move into the next stage of life, [they] now have the opportunity to experience a mold-shattering period of reinvention and personal growth, career, liberation, nourishing relationships and financial freedom,” writes Ken Dychtwald, bestselling author of “The Power Years – A User’s Guide to the Rest of Your Life.”

Instead of drifting off into the twilight, Dychtwald encourages his readers to use their golden years for having fun and being creative. Like any other part of our lives, he suggests, we can reinvent retirement and turn it into yet another adventure.

There is also lots of spiritual advice how to cope with the many challenges of aging. Self-help guru Deepak Chopra, MD recommends a new perception of old age by applying “techniques for harnessing the power of awareness […] to experience timelessness. By intervening at the level where belief becomes biology, we can achieve our unbounded potential,” he writes in his bestselling book, “Ageless Body, Timeless Mind – The Quantum Alternative to Growing Old.”

Views like these are particularly popular among baby boomers who are physically fit and financially secure, but they don’t necessarily apply to the majority of today’s seniors, according to Susan Jacoby, author of “Never Say Die – The Myth and Marketing of the New Old Age.” “The idea that there is a new kind of old age, experiences in a radically different way from old age throughout history, is integral to the marketing of longevity. The idea that we can control the future by aggressively focusing on and taking care of ourselves is an article of faith for baby boomers,” she writes.

Whether it turns out to be another adventure or pure fantasy, increasing longevity challenges the baby boomers in different ways than any other generation before them. They must come up with visions and concepts of what their added years will mean to them. Taking up the proverbial “rocking chair” is neither an attractive nor, in most cases, a realistic option.

What is now called “active retirement” can entail many things, such as a career change, part-time work, hobbies, travel, a new relationship or even marriage. But most of all, it means staying physically and mentally as healthy as possible for as long as possible. Striving for optimal health is a task of a lifetime, but it becomes absolutely crucial as we grow older, according to Andrew Weil, MD, author of “Healthy Aging – A Lifelong Guide to Your Physical and Spiritual Well-being.” He writes, “Although aging is an irreversible process, there are myriad things we can do to keep our minds and bodies in good working order through all phases of life.”

In other words, the way we age comes down to the efforts we make on behalf of our well-being. All the experts quoted above agree on one thing: Healthy aging takes work, hard work.

“Growing Old Is Not for Sissies,” is the title of a book by Etta Clark, a photographer, in which she presents portraits of senior athletes. Some are astonishing overachievers, regardless of their age; others just keep doing what they have always enjoyed with no particular goal other than remaining active. They all are an inspiration, in their deeds as well as their wisdom. It was the author’s own mother who first gave her the idea for her book. She quotes her saying: “Age – who cares? The years belong to someone else. I’m interested in living.”

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.

Subsidized School Lunches Save More Children from Malnutrition and Hunger

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

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

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

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

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

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

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

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

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

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

Vision Loss at Old Age Becomes a Growing Concern

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

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

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

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

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

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

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

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

A Civic Duty to Be Healthy

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

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

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

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

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

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

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

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

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

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

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

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

Rethinking the Meaning of Thanksgiving

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

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

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

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

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

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

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

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

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

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

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

Poor Nutrition in Schools Will Continue

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

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

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

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

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

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

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

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

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

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

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

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

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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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