Posts Tagged ‘Heart Disease’

Is the Public Not Confused Enough Yet?

March 22nd, 2014 at 7:45 am by timigustafson

It was the kind of report news outlets pounce on because it apparently offers one of those ‘gotcha’ moments their audience seems to crave so much. So you’ve probably already heard about the latest study on dietary fats and their limited impact on heart health.

If not, here are a few details. For their research, an international team of scientists undertook what is known as a ‘meta-analysis,’ meaning they reviewed a number of previous investigations (as opposed to doing their own) to determine the effects of diet changes with regards to fat intake. In the end they concluded that cutting back on saturated fat or adding polyunsaturated fatty acids, as recommended by many health experts, was not as beneficial as widely believed.

In layperson’s terms, the study results could be interpreted as saying that for heart health it doesn’t really matter all that much what kind of fat you eat – whether it comes from meat products (mostly saturated), oils (mono- and polyunsaturated), plant foods like vegetables, beans and grains (polyunsaturated), fish (omega-3), or nuts and seeds (omega-6 polyunsaturated).

This, of course, sharply contradicts existing nutritional guidelines – including those by the American Heart Association (AHA) – most of which urge limiting saturated fats and replacing them with the other varieties, especially for heart disease patients.

To be sure, studies like these (including studies of studies) are important and instrumental for the progress of science. They help us refine and, if need be, correct the knowledge we claim to have. On the other hand, if they are reported in the press and elsewhere in ways that misread or distort the facts and only add to the confusion of an already weary public, we may need to look for a more careful approach.

The findings of studies that solely focus on particular nutrients cannot readily be translated into nutritional guidelines, warns Dr. David L. Katz, the founding director of the Prevention Research Center at Yale University and the Integrative Medicine Center at Griffin Hospital in Derby, Connecticut, and author of several books on nutritional health, most recently, “Disease Proof – The Remarkable Truth About What Makes Us Well” (Penguin, 2013).

The point is that if you ask people to change just one thing in their diet, you are not necessarily improving their overall nutritional health. For example, it doesn’t suffice to recommend reducing consumption of meat (saturated fat) but say nothing about excessive intake of refined carbohydrates and sugar, which is equally common in the American diet, and has equally menacing health outcomes.

When people decide to eat less of certain foods, they usually compensate for the deficit by eating more of something else. The question is, what is that something else, says Dr. Katz.

To give meaningful dietary guidelines people can trust and follow in practical terms, scientists have to stop taking a “one-nutrient-at-a-time” approach and rather focus on the larger picture, he demands in an article he wrote in response to the study.

“Dietary guidance must be about the whole diet, and should be directed at foods rather than nutrients. If we get the foods right, the nutrients take care of themselves,” he argues.

So what should be the take-away from this study and others of its kind? To everyone who is interested in health-promoting eating habits, I suggest you continue with your regimen of a balanced diet as best as you can. The benefits are clear and so are the risks of deviating from what we know to be healthful. There is nothing to be confused about.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Education, the Best Protection Against Obesity and Related Diseases

March 12th, 2014 at 12:43 pm by timigustafson

With growing wealth in many developing countries around the world, diet and lifestyle changes are showing dramatic increases in obesity and related diseases like diabetes, heart disease and cancer. From Central and South America to the Middle East to Asia, weight problems are now among the leading causes of morbidity and mortality. But more than rising standards of living, lack of education seems to contribute to these dismal trends.

In China, India and Brazil, where economic growth has been especially dramatic but has also created vast inequalities in their populations, diet and lifestyle changes have had a particularly profound impact on the risk of obesity, according to one study that investigated the effects of rising incomes on people’s health.

In Mexico, which is considered a middle-income country, prevalence of obesity proved to be the highest among those who were better off financially but had little education. Similar findings were made in Egypt, a low-income country, where obesity has become a fast growing problem, especially among women. Here too, increasing wealth is a predictor – but even more so, lack of schooling.

“For the first time, we have studied the interaction between wealth and education and found they have fundamentally different effects on obesity,” said Dr. Amina Aitsi-Selmi, the lead author of the Egypt study.

Greater exposure of emerging economies to global food markets and rising buying power of consumers lead to these consequences. The best way to prevent this from happening would be to invest in education, especially in women who are in charge of food shopping, cooking, and taking care of the health needs of their families, she said.

“Our study suggests that investing in women’s education protects against this effect by empowering individuals to look after their health,” she said to Science Daily.

As ‘gatekeepers’ in their households, women have the most influence on the nutritional wellbeing of children, which is our best hope for breaking the vicious circle that begins with childhood obesity and subsequent, often chronic, health issues during adulthood.

Scientific evidence leaves no doubt that the environment we live in is largely responsible for the obesity epidemic, Dr. Aitsi-Selmi said. We can only change the environment by changing the behavior of individuals. And that is best accomplished through education.

Obviously, providing even a basic amount of health education in different socio-economic and cultural settings is no easy task in one country, let alone on a global scale. But, as this study and others have shown, increase in literacy and greater opportunities for learning have many benefits and can provide the groundwork for attitude and behavior modifications, including improving eating habits.

It also means that greater affordability of food does not automatically lead to better health outcomes – sometimes to the contrary. Only when people understand how their diet and lifestyle choices affect them, they can make appropriate changes and take control of their wellbeing.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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A Responsibility Not to Get Sick

February 26th, 2014 at 11:39 am by timigustafson

According to the World Health Organization (WHO), no other current health threats spread as fast as so-called ‘non-communicable diseases’ (NCDs) like obesity, diabetes, heart disease and cancer. What distinguishes these from infectious illnesses is that humans bring them mostly upon themselves through poor diet and lifestyle choices. Nevertheless, the impact is very real and there is no letting up in sight.

How can that be? How can we self-inflict debilitating and potentially life-threatening diseases on a pandemic scale? How can this happen when we have a pretty good understanding of the causes and how they could be averted? And why is it that the countless messages about diet and lifestyle changes produce such meager results?

Unsurprisingly, there is great uncertainty among the experts about how to address these issues. For example, only last year, the American Medical Association (AMA) decided to classify obesity as a “disease,” with the goal to bring greater attention to the urgency of the matter. Yet some have expressed skepticism about the helpfulness of such a move.

In a recent op-ed article in the New York Times, psychology professors Dr. Crystal L. Hoyt and Dr. Jeni L. Burnette, both of the University of Richmond, Virginia, suggested that the classification may in fact be counterproductive because it potentially diminishes incentives to deal effectively with weight problems.

“Calling obesity a disease provides a clear warning of the significant health risks associated with excessive weight,” they wrote. “We wondered, however, if there also might be psychological ramifications inherent in that message. Would it reduce or add to the burden of body-image concerns and shame? Would it empower people to fight back, or lead to a fatalistic acceptance of being overweight?”

They both agreed that stigmatization and discrimination of any kind have no place in how we view obesity and other related health issues. On the other hand, we ought not simply relieve people of all responsibility for their own well-being.

Suggesting that someone’s weight is his or her unfortunate fate, a “fixed state like a long-term disease,” can make efforts of weight loss and dietary improvements seem futile and may indeed undermine them, the professors warned.

As a dietitian and health counselor, I have no problem with declaring obesity a disease, especially considering the complexity of potential causes, some of which are indeed beyond an individual’s control. Having said that, I also believe that the only appropriate response to illness is to make every effort to overcome it as quickly possible. An even better approach would be prevention, so that damages don’t occur in the first place. For this, I believe, we all have a duty, a personal responsibility not to get sick as a consequence of our own actions.

Yes, there is much confusion around diet and lifestyle issues. Many people have given up and are tired of listening to oftentimes inconsistent, if not contradictory, messages. But there is also some certainty. Eating healthily by adding more fresh fruits and vegetables and cutting back on processed foods is part of that. So is observing portion sizes. Regular exercise is a must without question. Reducing stress and getting enough sleep matter as much. All these we know to be true. If we acted upon just this bit of knowledge each and every day, things could improve real fast.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Salt and Sugar Contribute to Rise in Heart Disease, Studies Find

February 12th, 2014 at 11:26 am by timigustafson

Several new studies focusing on heart health confirm that following certain dietary guidelines is crucial for preventing heart disease, one of the leading causes of death worldwide. Many, if not most, of these deaths could be avoided with appropriate diet and lifestyle changes.

High amounts of sodium (salt) and added sugars in processed and packaged foods are believed to be among the main culprits for the dramatic rise of the disease over the past few decades.

High sodium levels in the blood stream are a cause for high blood pressure, which, in turn, is a risk factor for heart disease and stroke. Decreasing sodium intake could prevent thousands of deaths annually, according to the Centers for Disease Control and Prevention (CDC).

Consuming sugary foods and beverages also apparently adds to the risk of heart disease. A recent study on the health effects of added sugars in sodas, cakes, candy, and other sweetened foods found that participants were more likely to develop heart disease as their percentage of total calorie intake from sugars went up. In fact, those whose diet included more than 25 percent from added sugars almost tripled their risk.

According to the CDC, most of us consume way too much of both ingredients.

On average, Americans have a daily sodium intake of about 3,400 mg, significantly above the recommended limit of 2,300 mg, and more than twice the amount considered adequate, which is about 1,500 mg.

An estimated 16 to 20 percent of total daily calories in the typical American diet come from added sugars, according to the CDC. Curbing consumption could reduce calorie intake from nutritionally deficient sources and help prevent diseases associated with overweight and obesity, including heart disease.

Unfortunately, trying to make such reductions may prove difficult for consumers because the sources of sodium and sugars are not always easily identifiable. Even items that don’t taste especially salty or sweet may still have high sodium and/or sugar contents.

Nutrition experts recommend to carefully read food labels. If the sodium amount per serving is 5 percent daily value or less, it is a low-sodium product. Everything over 20 percent daily value is considered high.

Because sugars are not required nutrients, there are no official limits or guidelines available. The Institute of Medicine (IOM) recommends that consumption should not exceed 25 percent of daily calories, an amount some experts still consider excessively high.

The best way to lower the risk of heart disease may be making gradual improvements to your meal plans by adding more fruits, vegetables and other fresh ingredients, while limiting or eliminating processed items as much as possible.

Another recent study on the subject revealed that a so-called “whole diet approach” that focuses on increased consumption of healthful foods can be more effective than, for example, being too concerned with fat content. Diet plans like DASH (Dietary Approaches to Stop Hypertension) or the Mediterranean-style diet seem especially helpful in this regard.

Like with most other diet and lifestyle-related health problems, it is unlikely that we will alter the current trends anytime soon. But better education and willingness to overcome ingrained preferences could eventually move us in the right direction.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Lifestyle-Related Ills Tend to Multiply with Age, Study Finds

April 24th, 2013 at 7:13 am by timigustafson

Seniors who suffer from chronic health conditions like high blood pressure or heart disease often develop a host of other, seemingly unrelated health problems, including cognitive impairment like memory loss and dementia, according to a new study based on data collected by the National Center for Health Statistics.

For the study, the researchers analyzed the medical records of hundreds of thousands of seniors residing in assisted-living facilities and found that most had at least one chronic health condition. What was more alarming, however, was that many had overlapping ailments. While high blood pressure and heart disease were most common, nearly half of the assisted-living residents showed signs of dementia.

“These findings suggest a vulnerable population with a high burden of functional and cognitive impairment,” the authors of the study report wrote.

Many studies have suggested a link between vascular disease and dementia, particularly Alzheimer’s, said Dr. P. Murali Doraiswamy, a professor for psychiatry and behavioral sciences at Duke University’s Institute for Brain Sciences (DIBS). Therefore it may not be possible to treat dementia without treating vascular problems, he added.

But that may be easier said than done. “We don’t universally do a great job of how we treat conditions that overlap, for example Alzheimer’s and high blood pressure,” said Dr. Cythia M. Boyd, an associate professor of geriatric medicine at the John Hopkins University Center on Aging and Health, to the New York Times. “Much of the way we practice medicine is looking at disease by disease. We aren’t doing enough thinking about how to add them together and really integrate care.”

What makes things more complicated is that most doctors are not sufficiently trained in preventing or reducing lifestyle-related illnesses – not in the general public and certainly not in older patients – other than through medicating. For instance, the importance of nutrition as a part of preventive care is rarely ever mentioned in medical schools. The approximate time devoted to nutrition science over the first two years of medical education is six hours, which is clearly inadequate, according to the National Academy of Sciences. The same goes for other health-promoting measures such as exercise, especially for the aging population.

Yet many studies have provided compelling evidence that diet and exercise play a significant role for physical and mental health at any time in life but increasingly so as we age.

For example, a more recent study from Britain concluded that the so-called “Western diet,” which typically includes fried, sweet and processed foods, red meat, refined grains and high-fat dairy products, increases the risk of chronic diseases, which in turn can adversely affect both physical and mental health in later years. Eating a Western diet makes it less likely to have an ideal aging process, says Dr. Tasnime Akbaraly, a researcher at the University College of London and lead author of the study report. Conversely, making dietary improvements can yield multiple benefits in this regard.

There is also further evidence that exercise can give a boost to the aging brain. Scientists at the University of British Columbia found that older women who suffered from mild cognitive impairment could improve their memory through weight training and brisk walking.

The connections between physical and mental decline may not yet be completely understood, but it seems clear that chronic diseases play a major role in the process. While these are widespread, the encouraging news is that many, if not all, are preventable by healthier lifestyle choices.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Searching for the Cause(s) of Obesity

March 13th, 2013 at 12:08 pm by timigustafson

Two thirds of Americans are overweight. One third is obese. Obesity and a host of illnesses related to weight problems kill more people than any other disease. Experts are scrambling to find answers for what causes the epidemic and seem to come up with new explanations every day, only to be contradicted by the next study. Unsurprisingly, consumers are confused and stop paying attention.

How is it that we are eating ourselves to death, not just here but increasingly around the world? Does the so-called “Western diet,” consisting of cheap, highly processed, highly caloric foods, make us fat? Or is it sugary sodas? Are portion sizes too big? Does the food industry turn us into addicts? Do we just not exercise enough?

So far, none of the countless studies on these subjects have had much impact in practical terms. Lobbying efforts and political gridlock are oftentimes blamed for the maddeningly slow progress. But that may not be the only reason. Some experts warn that despite of all the research, finding definite answers may prove elusive for some time to come.

“If we can find the causes of obesity, we can try to eliminate or counter them,” wrote Christopher Chabris, a professor of psychology at Union College, together with his colleague Daniel Simons of the University of Illinois in an op-ed piece in the New York Times. “Unfortunately, finding causes is easier said than done, and causes we think we see can turn out to be illusions.”

Hoping for a smoking gun that lets us clearly identify causation may not be in the cards, ever. As an example, the authors cite a study that analyzed potential connections between food advertising on billboards and prevalence of obesity in certain parts of Los Angeles and New Orleans. The study results showed that areas with more outdoor food advertisements had a higher proportion of obese people than those with fewer ads. So, there seems to be a direct link.

Not so fast, say the professors. Studies like these have a significant problem: They can show association between separate phenomena but not causation. In this particular scenario, interpretations of the findings could go in totally different directions. Even if you accept the existence of a correlation between food advertisements and obesity, you still have to consider a wide field of possible explanations. One could be that food vendors tend to invest more of their advertising budget in places where they believe food consumption is especially high. Obesity then may be an indicator that this is a good market for them. Which comes first, the chicken or the egg?

So does this mean there is no proof that food advertising influences people’s eating habits, and not necessarily in a good way? Studies like these can at best provide some indication that there may be a link, but they don’t provide evidence for causation, the professors conclude. Only the gold standard of scientific research, which is the randomized controlled trial, could prove such connections, they say. And these standards are often not achievable in the real world.

The question is what does that mean in terms of taking anti-obesity measures. Do we have to remain indolent in the face of this alarming health crisis just because we can’t pinpoint its causes with the highest standards of certainty? Food manufacturers and restaurant operators support that view. But if no compelling evidence can be had that advertising works, why would they keep spending billions of dollars every year on doing just that?

With all due respect for scientific standards, I can’t help but think that calling for more and more studies on the causes of obesity only delays critical action that ought to be taken now. We may not know whether food ads influence everyone’s eating habits, but we still can ban them from children’s programs on TV. We may never be sure whether drinking sugary sodas or consuming sweet snacks cause diabetes, but we still can stop offering them on school campuses. It may be unclear whether posting calorie counts in restaurants will make patrons order smaller portions, but we should at least give them the option, so their choices can be better informed. How many more studies and trials do we really have to conduct before we take at least a few steps in the right direction?

If you liked this article, you may also enjoy reading “How Serious Is the Food Industry About Helping in the Fight Against Obesity?” and “Obesity Must Be Addressed on Multiple Levels.”

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

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Less salt in our food supply could save at least half a million Americans from dying prematurely over the next ten years, according to separate studies conducted at three universities, two American and one Canadian. If the average daily salt intake were to drop to 1,500 milligrams, as recommended by the Dietary Guidelines for Americans, the number of lives saved could more than double. All study results were published in the medical journal Hypertension, a publication of the American Heart Association (AHA).

Americans currently consume on average 3,600 milligrams of salt daily, mostly in form of sodium, widely used as an ingredient in processed foods. Sodium is considered a significant contributor to high blood pressure, which can lead to heart disease, heart attack and stroke, all leading causes of death in the U.S. today.

About a third of American adults, or 68 million, suffer from high blood pressure, a.k.a. hypertension, according to the Centers for Disease Control and Prevention (CDC). The condition was identified as a primary or contributing cause of nearly 350,000 deaths in the U.S. in 2008, the last time the CDC has updated its research on the subject.

Despite of these alarming statistics, there are currently no signs of improvement. Even better treatment has only shown mixed results. Less than half (46 percent) of high blood pressure patients have their condition under control, according to the CDC.

Because the salt content in processed food is already added before it reaches the consumer, there is little opportunity to make changes on an individual basis other than limiting one’s choices to fresh items like produce. This would also exclude many options in restaurants.

“Individuals can’t make this choice easily,” said Dr. Kirstin Bibbins-Domingo, professor of medicine and epidemiology at the University of California, San Francisco (UCSF), to ABC News. “So maybe we should find ways to work with the food industry,” she suggested.

The National Salt Reduction Initiative, a partnership started by the New York City Health Department that has expanded to nearly 100 city and state health organizations across the country, has been trying to get food manufacturers and restaurant operators to cut salt by 25 percent or more since 2008, the year of the organization’s inception. The current goal is to achieve a reduction of 20 percent by 2014.

Critics say that such measures are impractical and would make little difference. Public health advocates have been focusing on hypertension as if no other health threats existed, said Morton Satin, Vice President of science and research at the Salt Institute, a trade association for the salt industry, in response to the recent studies to ABC News. The association warns that low salt intake could produce its own set of health problems, especially for the elderly.

While most experts would agree that multiple factors can be responsible for the development of high blood pressure, including genetic predisposition, gender, age and other non-modifiable components, poor diet and lifestyle choices, which are modifiable and therefore preventable risk factors, usually play a much greater role. In a milestone conference on the connections between sodium intake and blood pressure, sponsored by the National Heart, Lung and Blood Institute (NHLBI), the participating scientists concluded that “an abundance of scientific evidence indicates that higher sodium consumption is associated with higher levels of blood pressure, [as demonstrated in] animal studies, observational epidemiologic studies, and clinical studies and trials.” They were also hopeful that more effective strategies could be developed to improve diet and lifestyles patterns that benefit the larger population.

If you liked this article, you may also enjoy reading: “Too Much Salt in Our Food Creates Serious Health Hazards.”

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

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Life in America More Precarious Than in Other Developed Countries

January 12th, 2013 at 3:49 pm by timigustafson

It shouldn’t come as a big surprise. On average, Americans are in poorer health and have shorter lifespans than the citizens of other affluent countries, including most Western European nations, Australia, Canada and Japan. Considering that close to 50 million people, almost 20 percent of the population, are without health insurance and many more with only limited access to medical services, a decline in public health would seem inevitable. Still, the findings of a recent study by the U.S. government are quite shocking.

According to the Institute of Medicine (IOM), America currently ranks at or near the bottom among the 17 richest nations in the world in terms of life expectancy and chronic diseases like heart disease, lung disease, obesity and diabetes as well as injuries and death from violence and sexually transmitted diseases.

What’s even more disturbing is that these statistics not only apply to the poor and the elderly, as experts long expected, but across all demographics, including young adults and those who can afford health care coverage.

“We are struck by the gravity of these findings,” said Dr. Steven Woolf, professor of medicine at Virginia Commonwealth University and chairman of an expert panel that was tasked with the study. “What concerns [us] is why, for decades, we have been slipping behind.”

Even first generation immigrants coming to the U.S. show negative health effects within a relatively short time due to diet and lifestyle changes. According to the National Institute of Health (NIH), obesity rates among immigrants roughly equal those of U.S.-born adults within 10 to 15 years after taking up residence here. One study found that migrants from comparatively poor countries like Mexico or Guatemala are especially prone to develop diseases like obesity, diabetes and heart problems because of dietary changes.

“If you go with the flow in America today, you will end up overweight or obese, as two-thirds of all adults do,” said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC) in an interview with USA TODAY. “Obesity is one of the few things that has gotten worse quickly. It really is a very serious health problem,” he added.

The obesity epidemic is also one of the main reasons why it is so hard to get health care costs under control in this country. It costs $1,400 more per year to treat an obese patient compared to someone who is normal-weight and $6,600 more to treat a diabetic, said Dr. Frieden.

What changed in the U.S. more profoundly than in other countries – although similar trends are now emerging worldwide – is a dramatic shift in our eating habits. We eat more conveniently prepared but highly processed foods and enjoy fewer healthy meals made from scratch. Our portion sizes have gone through the roof. We also have become more sedentary due to progressive automation in the workplace, longer commutes and lack of safe outlets for physical activity.

“What has happened is that the structure of our society has changed in ways that make it difficult to maintain a healthy weight,” said Dr. Frieden. It’s a fertile ground for the diseases we now see on an epidemic scale.

Obviously, there is not one solution that could undo all of these regrettable developments. Multiple measures will have to be put in place and made to work together. Personal responsibility is certainly part of the equation, but so are numerous other components such as better health and nutrition education for the public, further improvements to school lunch programs, reintroduction of mandatory physical education (PE), more effective safety and disclosure regulations of agricultural and food manufacturing industries, to name just a few.

The current deterioration of our public health is not irreversible. On the contrary. Most of our ailments are self-inflicted and therefore in our control if we only muster the will to address them in meaningful ways.

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger 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 amazon.com. You can follow Timi on Twitter and on Facebook.

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The Egg Controversy Revisited

August 19th, 2012 at 2:22 pm by timigustafson

Eating eggs can almost be as bad for your health as smoking, according to Canadian researchers whose findings reignited a long-standing controversy over the nutritional benefits and detriments of eggs, or more specifically, egg yolks.

For the study, which was published in the journal Atherosclerosis, a team of scientists from the University of Western Ontario’s medical school interviewed over 1,200 participants about their egg consumption as well as smoking habits, and then used ultrasound technology to measure the plaque build-up in their arteries.

Why the combination of egg eating and smoking? To give a better perspective on the magnitude of the effects of high cholesterol intake from egg yolk, a comparison to smoking appeared to be an appropriate marker, the researchers wrote in their report.

Egg yolk is well known for its high dietary cholesterol content – about 185 to 210 milligrams, depending on size. (The recommended limit is 300 milligrams per day.)

Over time, high cholesterol levels can cause plaque buildup in the arteries – as smoking does. In fact, the potential damage from egg yolk is about two-thirds as bad as that from tobacco use, said Dr. David Spence, the lead author of the study report, in a press release.

In response to the study, some critics have rejected its findings, calling the research “flawed.” As an example, Dr. Steven Nissen, chair of the Department of Cardiovascular Medicine at the Cleveland Clinic Foundation, expressed misgivings about the “very poor quality” of the study “that should not influence patients’ dietary choices.” According to Dr. Nissen, the research depended too heavily on participant’s self-reporting, which is notoriously unreliable, and other dietary and lifestyle factors were not or only insufficiently included.

Similar concerns were raised by Dr. David Frid, a cardiologist at the Cleveland Clinic. He didn’t think egg consumption should be equated to smoking, even though both can contribute to ill heart health. Smoking, he said in an interview with ABCNews.com, causes arteries to become inflamed, which can result in the build-up of plaque, however, in a different way than from cholesterol. Moreover, he said, people who like eggs, often have a preference for other fatty foods. That possibility must be taken into account as well, he added.

In defense of the egg’s reputation, the Egg Nutrition Center and American Egg Board have released a statement, emphasizing the wide range of health benefits from essential vitamins, minerals, protein and antioxidants richly provided by eggs, combined with a relatively low calorie count of 70 calories on average. Even the 2010 Dietary Guidelines for Americans recognizes eggs as “a nutrient-dense food that can be part of a healthful diet,” it says in the statement. Canada’s Food Guide also changed its recommendations to allow for higher egg consumption after the Canadian Egg Marketing Agency voiced objections to the originally proposed guidelines.

Unfortunately, this recent controversy still leaves consumers uncertain about the safety of their egg dishes. In the face of all the pros and cons, it would appear that – as it is so often the case when it comes to food – moderation is the best way to go. Discarding the yolk and eating egg whites only is one possibility. Adding healthy items like spinach, mushrooms, peppers and the likes to your omelet can help balance potential downsides. Ultimately, until the experts come to a consensus, using our best judgment is pretty much all we have.

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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Fast Food Consumption Around the World Linked to Health Risks

July 8th, 2012 at 1:23 pm by timigustafson

A growing preference for Western-style fast food in Asian and Southeast Asian countries shows already an impact on their populations’ health, and not in a good way, according a newly released study by the University of Michigan (UM).

Researchers of the university’s School of Public Health found that Chinese residents in Singapore were at a higher risk of developing diabetes and heart disease since fast food restaurant chains like McDonald’s, Burger King and KFC started setting up shop in the 1980s. Prior to that time, American-style fast food was practically unknown there and diseases like these were comparatively rare.

“What we found was a dramatic public health impact by fast food, a product that is primarily a Western import into a completely new market,” Odegaard said in an interview with the Duluth News Tribune (7/5/2012), a local Minnesota newspaper.

According to the study report, which was published online in the journal Circulation by the American Heart Association (AHA), people who consumed fast food even as little as once a week, increased their risk of developing coronary heart disease by 20 percent compared to those who never touched it. The rate jumped to 50 percent for those who indulged two to three times per week, and to 80 percent for those who went beyond that. Regular consumption of fast food also seemed to lead to a substantially higher risk of type 2 diabetes, according to the study.

Until now, there has been surprisingly little research on potential links between fast food and health risks and that was mainly focused on the United States. Andrew Odegaard, a post-doctoral researcher at UM and study leader said he wanted to look at a Southeast Asian population because of the relatively small time frame since fast food was introduced there and also because the population there is quickly becoming a hotbed for diet and lifestyle diseases similar to the U.S.

In cooperation with the National University of Singapore, the UM team analyzed medical records and questionnaires about diet and lifestyle habits of over 50,000 Chinese Singapore residents. During the study’s 16-year follow-up period, 2,252 participants developed diabetes and 1,397 died of heart attacks or heart-related diseases.

Although focused on a relatively small group, the study results could be relevant for future research in public health on a global scale. “The consumption of Western-style fast food is really growing in Asia and South and Southeast Asia, in countries where there are a lot of developing economies,” said Odegaard in the interview. [For the major fast-food chains], “this is their primary engine of growth. What the companies have going on in North America is steady, the market is saturated, but there is real growth in the growing economies.”

Critics of the report have called the results inconclusive because many of the applied data were largely based on self-reporting by participants, which is often considered imprecise and unreliable. Also, critics say that unhealthy eating habits tend to go hand in hand with other poor lifestyle choices, such as smoking, drinking and sedentary behavior. Poverty and lack of access to healthcare may also play a role. Singling out fast food as the one culprit would therefore be unreasonable.

Still, it is undeniable that the growing popularity of Western eating styles is coinciding with a dramatic increase in obesity and related illnesses in many parts of the world. Even in places like Brazil, where the government has made serious efforts to limit access to fast food in schools and residential areas to protect the public’s health, especially of children, the rates of diabetes and heart disease are going up. Apparently even some of the most stringent existing regulations don’t suffice.

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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