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Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

Long Commutes Are Hazardous to Drivers’ Health, Study Finds

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

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

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

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

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

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

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

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

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

High Taxes on Sodas Could Reduce Obesity Rates, Experts Say

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

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

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

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

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

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

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

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

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

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

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

World Health Organization Sets New Targets for Reducing Chronic Diseases

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

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

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

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

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

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

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

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

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

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

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


Diabetes Dramatically on the Rise Among Teenagers

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

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

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

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

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

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

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

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

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

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

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

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

The True Cost of Healthy Eating

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

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

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

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

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

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

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

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

Stigmatization Makes It Harder to Overcome Obesity

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

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

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

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

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

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

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

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

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

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

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

More Americans Suffer from Asthma

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Nearly Half of All Americans Will Be Obese Within Two Decades, Study Projects

May 9th, 2012 at 6:24 am by timigustafson
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A study by the Centers for Disease Control and Prevention (CDC) predicts that obesity rates in the United States will reach up to 42 percent of the population by the year 2030. More than 10 percent will be classified as “morbidly obese,” which is 100 pounds plus over a healthy weight range. If these predictions come true, health care costs in the U.S. will increase by well over half a trillion dollars.

The study report was presented at a conference sponsored by the CDC, titled “Weight of the Nation” (May 7 to 8, 2012) in Washington D.C. and simultaneously published in the American Journal for Preventive Medicine.

While it is difficult to make these kinds of forecasts, it is clear that obesity trends that started in the 1980s and 1990s continue on their paths. Currently, over 60 percent of Americans have weight problems and over 30 percent are diagnosed as obese. Even more worrisome are the growing rates among young people. Over 20 percent of children and adolescents are obese today.

Obesity can cause a host of chronic health problems such as cardiovascular disease, diabetes and also certain forms of cancer. Many people who develop weight-related illnesses during childhood are likely to face at least some of the consequences throughout their adult-lives.

“The prospect of such increasing rates, particularly those of severely obese Americans, is alarming, especially since efforts aimed at helping people to lose weight have so far proven relatively ineffective,” said Dr. Eric Finkelstein, one of the authors of the CDC report.

For a long time, the causes of obesity have been in dispute. One popular explanation is that people just eat too much and exercise too little. Some health experts say it’s not that simple. In a separate report on America’s obesity epidemic that was also released at the “Weight of the Nation” conference, the Institute of Medicine (IOM) concluded that the crisis is deeply rooted in the environment we live in, which is, as the report called it, “obesogenic.” According to the IOM, it is not so much people’s behavior that has changed over the past few decades but rather a number of factors that are beyond any individual’s control, including agricultural policies and food manufacturing.

“When you see the increase in obesity, you ask, what changed? The answer is, the environment,” said Dr. Shiriki Kumanyika, a professor at the University of Pennsylvania of Medicine and IOM committee member in an interview with Reuters. “The average person cannot maintain a healthy weight in this obesity-promoting environment.”

Instead of appealing to “personal responsibility,” the report suggests for policy makers to pursue structural changes like shifting subsidies from corn and wheat farms to fruit and vegetable growers, creating more pedestrian-friendly infrastructure, and limiting the number of fast food outlets near schools and residential areas and so on. The hot-button-issue of imposing surtaxes on sodas to curb consumption was also mentioned.

The Center for Consumer Freedom, an advocacy group for the food manufacturing and restaurant industry, rejected the IOM report and argued that Americans should be free in making their own food choices but should act responsibly. It accused the IOM of joining forces with the nation’s “food nannies,” according to a Reuters report (5/8/2012).

By contrast, the IOM panel said that blaming obesity on a failure of personal responsibility and individual willpower has long been used by the industry as the basis for resisting legislative and regulatory efforts to address the problem.

The costs for treating obesity and obesity-related diseases are responsible for about 20 percent of all spending on healthcare today, about $190 billion annually, not counting rising insurance premiums, lost productivity and missed work days due to illness. The IOM urges employers and insurance companies to participate more aggressively in the fight against obesity, if for no other reason than their own bottom line.

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.” (, and at You can follow Timi on Twitter and on Facebook.

The Other Biological Clock

May 2nd, 2012 at 6:58 am by timigustafson
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This year, I have a significant birthday coming up, nothing too dramatic by today’s standards of longevity, but still a good time to take stock. I’ve been reading lately a few books on the difference between chronological and biological age and have even taken some tests online, just out of curiosity (yeah, right).

Of course, I’m supposed to be as old as I feel, but what does that really mean? Am I in some ways younger on days I feel refreshed and energetic after a good night’s sleep. Does time catch up with me when I’m a bit under the weather?

One of the tests I’ve been taking was designed by Dr. Michael F. Roizen. In his book, “RealAge – Are You as Young as You Can Be,” he suggests that shaving off as much as a quarter of a century from your numerical age is a real possibility (so don’t take the test while you’re still in your twenties), provided you have good genes and stick to healthy diet and lifestyle choices. But seriously, taking the “RealAge” (sic) test was an eye-opener for me.

As Dr. Roizen points out, for the longest time aging was considered as a linear process. For example, all sixty-five plus year olds are categorized as seniors and as such, presumably, in a state of decline. This view may be helpful for census bureau statisticians, but it is not an accurate representation of today’s reality. “Not everyone ages equally,” says Dr. Roizen. Some of us continue to live active and fulfilling lives and pursue their goals with the same zest and energy they always had. Others are riddled with debilitating diseases, barely managing to get through the day. In other words, your ‘real age’ is not identical with the number of years you’ve lived according to your birth certificate.

Many people, including doctors, still believe that aging is mostly a matter of genetics. For this reason, everyone’s aging process, and ultimately life expectancy, is supposedly predetermined by his or her genetic makeup. Indeed, there is good scientific evidence that supports this assumption.

One of the symptoms of aging is the slowing of cell division. Cells in the body must continuously divide in order to reproduce and replace damaged tissue. How often cells are able to divide depends on the genetic information (DNA) embedded in them.

Each time a cell divides, its DNA strand, called chromosome, uncoils and genetic information gets copied into the new cell. When the copying process is complete, the strand coils up again and gets capped by a piece at the end called telomere (Greek for “end bodies”). This procedure can be repeated thousands of times over a lifespan, however, every time a DNA strand is replicated, a small portion of telomere gets cut off. Eventually, the telomere become too short (a.k.a. the Hayflick limit) for further DNA replications and cells stop dividing. They enter a period of so-called “cell senescence,” the cellular equivalent of aging, before they finally die. This also means that by measuring the lengths of telomere, we have effectively a way of estimating how far someone’s aging process has advanced. Or so scientists thought for a while.

In 1985, two researchers discovered an enzyme called telomerase. Dr. Elizabeth Blackburn and Dr. Carol Greider found that through telomerase the length of telomere can actually increase. In other words, its shortening is not an irreversible process.

While it is not yet fully understood how exactly telomerase helps telomeres, and in turn the health of cells, there is evidence that lifestyle and diet are important contributing factors. Besides aging, telomeres also seem to be affected by chronic stress, lack of exercise, sleep deprivation, obesity, low intake of essential nutrients and so on – in a nutshell, all the usual suspects that make people sick and wear them out.

On the other hand, if it turns out that positive lifestyle changes can in fact enhance telomerase activity, it may indeed be possible to slow down the aging process on a cellular level, if not reverse it.

Does that mean we can make ourselves biologically younger by eating right, exercising, getting more sleep and managing stress? Perhaps not. But there is ample evidence that diet and lifestyle choices do impact the way people age. I’m not just talking about the dramatic differences between the life expectancy of some villagers in remote places in Japan or the Mediterranean region and the rest of us. Extending longevity for its own sake is not necessarily progress. Maintaining good health and thereby one’s quality of life for as long as possible is the real goal.

So instead of counting my years and comparing myself to other members of my generation, I make sure I give my body what it needs to be well, knowing that when the time comes to let go, I have done my best. I can’t ask for more.

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

Protecting Children from Developing Weight Problems

April 29th, 2012 at 7:30 am by timigustafson
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You have probably heard by now of Marshall Reid, the sixth grader from Sanford, North Carolina, who managed to change his and his family’s poor eating habits and wrote a book about the experience, titled “Portion Size Me,” which was obviously inspired by the well-known documentary film, “Super Size Me,” by Morgan Spurlock about the negative health effects of fast food.

Like many overweight children, Marshall was bullied and made fun of by his peers. After being called “fat” one too many times, he decided to take action and asked his mother to help him lose weight and eat more healthily. He also took up exercising with his father. Eventually, the family made a video about their lifestyle changes and put it up on YouTube. The book that followed is filled with healthy recipes, easy to understand nutrition facts and a journal describing Marshall’s journey to a new life. “We realized that the amount of weight you drop isn’t the endgame. It’s about how good you feel about yourself, about making healthier choices,” said Alexandra Reid, Marshall’s mother in an interview with the New York Times (4/24/2012).

Marshall is by no means alone in his struggle with weight problems at a young age. According to the Centers for Disease Control and Prevention (CDC), almost 20 percent of American kids ages 6 to 11 are now obese. Childhood obesity is one of the greatest health threats we’re facing today, not just here but around the world. What makes this story so remarkable, however, is that one child’s determination to take control of his life and turn his situation around can make this much difference.

Understanding your child’s nutritional needs
Parents are often confused not only about the kind of foods but also how much their young ones need at different stages of their lives. Children always want more of the foods they like, and often these are not the most nutritious choices.

Moreover, appropriate portion sizes can be difficult to determine. Deciphering serving sizes on Nutrition Facts labels is hard to do for adults. There is virtually no information that can help parents with apportionments for smaller stomachs.

The right amount of food to put on your child’s plate varies with age. Toddlers should eat about a quarter of an adult’s serving in one meal, according to the American Academy of Pediatrics (AAP). Preschoolers and younger school-age kids have greater calorie needs, especially during growth spurts. Between the age of four and eight, appropriate portion sizes are around one third of those of an adult. Older children and teens will eat almost as much as their parents, but this is the time when overeating becomes particularly tempting.

Addressing the issues
For families like the Reids, weight problems can be a sensitive subject to discuss. Parents don’t want to embarrass their children even more than they already are and yet the issue must be addressed before things get further out of control.

“While it may be uncomfortable to discuss weight concerns, the sooner you bring it up and help your child take action, the easier it will be to help him or her achieve a healthy weight. Ignoring it won’t make it go away, and in fact, waiting until your child is older to deal with weight issues may make it harder in the long run,” wrote Constance Matthiessen a freelance writer for WebMD.

She strongly recommends tackling weight problems when a child is still young and more open to lifestyle changes. Parents, she says, must act as their child’s ally, not their critic. When it comes to making better food choices, children should be involved in the decision-making process. It gives them ownership and teaches them to take responsibility for their actions. Most importantly, parents have to be good role models. “If parents go to fast-food restaurants and expose their child to junk food around the house, that child will develop the same habits – and those habits are extremely hard to break.”

That’s also Alexandra Reid’s, Marshall’s mom’s experience. It’s a challenge to keep up the hard-won eating and exercise regimens for the whole family. “We are a work in progress,” she said. Aren’t we all?

If you are interested in learning how to determine healthy portion sizes for children, go to “Food and Health with Timi Gustafson R.D./Kids’ Health.

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.” (, and at 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

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