Santas, 1941

Below is a photograph of Santas from the Volunteers of America. The time is 12:45 pm, November 25, 1941. The place is Chicago.

Do you notice anything odd about this photograph?

Click to enlarge.________Photo: Scanned from Saveur Magazine, December 2007.

Cherry Pie

I had some frozen sour cherries (boy, were they sour!) left over from a visit to a farmers market this summer. Every time I opened the freezer, a voice inside me whispered "cherry pie." The voice became too loud to ignore last week.

This is the same pie you see baking in the oven in my previous post.

Ingredients:

Basic Pie Crust Recipe for a 9-inch pie

4 cups pitted sour cherries, unsweetened (fresh or frozen)
1 cup granulated sugar
2 tablespoons quick-cooking tapioca
1 tablespoon cornstarch
1/8 teaspoon salt
1 tablespoon fresh lemon juice
1/4 teaspoon almond extract
1 or 2 tablespoons unsalted butter, cut into small cubes or slices.
1 egg

________
1   Preheat oven to 425ºF.

2   Whisk 1 egg with 1 tablespoon water to make an egg glaze. Set aside.

3   Combine cherries, sugar, tapioca, cornstarch, salt, lemon juice, and almond extract in a large bowl. Stir well. Let stand 30 minutes.

Note: If using frozen cherries (I was), put them in the refrigerator the night before to partially thaw them.

4   Remove one pie crust square from refrigerator. Allow to warm for about 5 minutes to assist rolling. Place onto the middle of two overlapping sheets of plastic wrap, and cover with two overlapping sheets of plastic wrap. Roll through the plastic wrap into an approximately 13-inch round. Peel off top wrap, position dough over pie pan, and peel off bottom wrap. Press dough gently into pan. Leave overhanging dough in place.

Note: Peel the wrap off and replace it periodically as you roll (both top piece and bottom piece) to prevent stretching the dough instead of rolling it. Stretching will develop gluten and produce a tougher pastry.

You can omit the plastic wrap and roll pin-to-dough. I like using wrap because it prevents sticking and makes it easy to transfer the dough to the pie plate.

5   Brush bottom crust with egg glaze. This will lessen seepage of cherry juice into pastry.

6   Remove remaining dough from refrigerator and roll into a 13-inch round as described above. Doing this step before filling pie will reduce seepage.

7   Stir cherries a few more times then fill pie pan. Dot with cold butter slices.

8   Cover cherries with top crust. Fold top crust overhang under bottom crust overhang. (You may need to cut the bottom crust so it is about ½ inch shorter than the top crust.) Flute, pinch, fork, or otherwise seal the crust edge. Brush top with egg glaze. Make slits in top crust.

9   Place pie onto a cookie sheet or line bottom (or bottom rack) of oven with aluminum foil-covered pan to catch drippings. Bake at 425°F. for 30 minutes. Reduce oven temperature to 350°F. and bake for an additional 45 to 60 minutes or until top is golden and cherries are bubbling through slits.

10   Let cool at least 5 hours before slicing.

Note: Who can resist a warm cherry pie? We couldn't! I cut it before it was completely cooled and like a broken dam, cherry juice flooded the hole. The filling was more congealed the following day. The next cherry or blueberry pie I make, I'll bake it at least a day in advance :)

Enjoy!
________Photo: Homegrown

Giving Thanks 2007

Squeezing a minute while the pie is in the oven to toss a big thank you out to all my visitors! Thank you for all your kindnesses - for reading, commenting, teaching me, and helping to make this blog one of my favorite hobbies. Cheers!

________
Photo: Homegrown

USDA Inspects Open Sandwiches, FDA Inspects Closed Sandwiches

From the Government Accountability Office, February 2007:

"USDA inspects manufacturers of packaged open-face meat or poultry sandwiches (e.g., those with one slice of bread), but FDA inspects manufacturers of packaged closed-face meat or poultry sandwiches (e.g., those with two slices of bread)."
- Federal Oversight Of Food Safety: High-Risk Designation Can Bring Needed Attention To Fragmented System

A follow-up thought from my last post:

Why does the FDA, who inspects closed-face sandwiches, feel they can do a better job ensuring consumer safety with recall authority ... yet the USDA, who inspects open-face sandwiches, feel they can do a better job ensuring consumer safety without recall authority?

Someone really needs to coordinate the activities of these agencies.
________

The USDA Doesn't Want Recall Authority

The USDA has jurisdiction over meat, poultry, and eggs. The FDA has jurisdiction over just about all other food products. The FDA does not currently have recall authority, but they are in the process of asking Congress for it.

In my previous post I said I did not know whether the USDA had recall authority. The article below suggests they do not have recall authority, nor do they want it:

"The U.S. Agriculture Department does not need additional authority to conduct meat recalls and would oppose any move to make the removal of such items from the market mandatory, the USDA's top meat safety official (Richard Raymond) told lawmakers on Wednesday."

And...

"Raymond (USDA Undersecretary) said there are several factors USDA is investigating that could be responsible for the uptick in E. coli discoveries. ... Among them include the pathogen becoming resistant to drugs and changes in weather or diet that can lead to stress in the animal. He assured lawmakers it was not because companies are being careless or inspectors sloppy in their work."
- USDA Says Has Enough Legal Authority To Do Recalls

Is the USDA being influenced by industry interests? Or do they truly believe that distancing themselves from meat commerce is the best way to assure the safety of our meat supply?

If the most effective way of assuring that recalled products have been removed from store shelves is to allow industry to police itself, then why did:

"State inspectors said Wednesday that they have found more boxes of potentially tainted meat on store shelves more than a month after a nationwide recall of Topps frozen hamburgers. ... Over the past few weeks¹, 141 boxes of Topps burgers have been found at 12 stores."
- Recalled Topps Meat Found In N.J. Stores

Someone made money from the sale of that recalled meat.
________¹ The recall was Sept 29, the date of this article was Nov 8.
Info thanks to Bill Marler, who had a little more to say about this here.

FDA Food Safety Teleconference For Bloggers

On Wednesday, November 14, 2007, the FDA engaged in a historic event: its first teleconference with bloggers. I felt honored to have been invited.

In attendance were FDA Commissioner, Andrew von Eschenbach (center in the photo), and FDA Assistant Commissioner for Food Protection, David Acheson (right in the photo). (HHS Deputy Secretary Tevi Troy is shown on the left.)

Dr. Eschenbach gave a nice overview of the FDA's new Food Protection Plan, nothing, however, that departed from their online document.

The plan was the FDA's contribution to a larger effort orchestrated by the Secretary of Health and Human Services (under which FDA falls), Mike Levitt. President Bush tasked Secretary Levitt with the job of reviewing our import practices.

In fact, HHS Secretary Levitt writes a blog - the only current administration official that I know who does.¹ In one of his recent posts, Import Safety Report, he outlines his thinking on why the US is experiencing an uptick in recalls:

"What are the underlying economic and social changes causing this sudden concern? Import safety concerns represent the natural maturing process of a global market. They represent an early warning that we need to adapt our systems and thinking to accommodate a new set of challenges. The old ways do not protect us adequately from the new risks."

He accepts comments on his blog :)

Back to the FDA's Teleconference

As a blogger, I enjoyed Commissioner Eschenbach's answer to a presumably pre-asked question, "Why are you doing this?" He was "doing this", that is, holding a conference call with bloggers - their first - because he was struck by bloggers' deft handling of the melamine story back in March. Blogging, a stimulus for change!

The call was short, about 30 minutes. It was primarily listen-only. Dare I say, it felt like a formality. I think there were 4 questions at the end. From memory, those were:²

Q1. Donna Byrne, from Food Law Prof Blog, asked what new FDA authorities, besides the proposed recall authority, the plan was requesting. (A1. Those are called out in the report.)

Q2. Marion Nestle, from What To Eat blog, asked the how-will-this-be-funded question, something I had also queued to ask. (A2. Congress has to allocate funds. Dr. Eschenbach replied that a request has been made via an appropriations bill for 2008, if not then, then 2009, if not then ... etc.)

Q2. Marion also asked how this new plan compares to the current HACCP Program. HACCP (Hazard Analysis and Critical Control Point) is an existing food safety program. This was a good point. Why reinvent, and pay for, another food safety program? (A2. This plan is different is that it will highlight areas of risk, and concentrate resources.) (Resources which I think everyone has agreed are currently inadequate.)

Q3. Bix, from Fanatic Cook blog, asked which foods the newly requested FDA recall authority did not cover. I assumed it did not cover ground beef, pork products, poultry, and eggs, since those are governed by the USDA, not the FDA, but this was not made clear in the presentation. (A3. It does not cover meat, poultry, and egg products. It does cover most other products including dairy, produce, and seafood.)

Curiously, the FDA appears to show an item of poultry in their presentation display (see photo above). And they discuss the FDA's testing for salmonella in shell eggs (a USDA, not FDA responsibility) in their report. I was airing the fact that different agencies were responsible for different foods, and this is leading to confusion ... confusion made all the more tangible by these apparent inconsistencies, or perhaps redundancies.

I don't know if the USDA today has recall authority. (Update: They don't.) But if they don't, our tax dollars may in the future be spent on a redundant report asking for that authority, and for additional funding.

Q4. Susan Schneider, from Agricultural Law Blog, raised a related point about the grey area between the FDA and the USDA. (A4. Dr. Acheson defended that the FDA and the USDA, for example, worked well together during the melamine crisis.)
________
The call was wrapped up hurriedly after those last two questions - which began to scratch the surface of the problem of having different agencies in charge of different, and sometimes the same (e.g. pepperoni pizza), food items.

I came away impressed by Dr. Acheson's grasp of facts. He knew, by count, every initiative called out in the document that would require legislative action. Where Dr. Eschenbach was palsy and story-telling, Dr. Acheson was detail-oriented. The pair seemed to work well together, in a Laurel-and-Hardy kind of way. (Acheson's British accent lent even more flavor to that analogy.) Not to say they might not be funny in person.

Your Comments

The subject of a one-stop, food safety website didn't come up, although it is called out for in their report. (Section 3.2: "Build a consumer Web site to communicate relevant food protection information.")

So that your comments did not go unheard, I summarized them in my reply email:

Comments and suggestions gleaned from my readers' comments, as regards the proposed consumer web site called out in Sec 3.2 (or for the current FDA-managed FoodSafety.gov):

• Consider a blog format for the site. Daily updating is a plus!
  
• Incorporate an RSS feed (or other feed) for consumers to keep track of updates.
  
• Incorporate a search box where consumers can find specific information quickly, and that would not require browsing various agencies' sites.
  
• Choose a site that prioritizes timely and complete content over links.
  
• Allow for consumer feedback (comments, media uploads, e.g. audio/visual). This could assist the adverse event detection need called out in Sec 2.3
  
• Include results of recent studies that address food contamination issues.
  
• Manage links, i.e. clean up, or notify owners of dead links, e.g. http://www.epa.gov/oppfead1/cb/csb_page/
  
• Introduce yourself! And describe the purpose of the site.

I hope there will be more tele- and web-conferences in the future. And I hope the list of invitees expands.³
________¹ Listen to Secretary Levitt talk about his blogging experience on NPR: Human Services Secretary Takes Blogging Seriously.
"I write them myself and I find it allows me to think out loud a little bit. ... It allows me to discover a new public policy domain which I think blogs have the potential to become."

² Big thanks to Donna Byrne, from Food Law Prof Blog, for filling in the blanks on my questioner info.

³ And if you're reading this, Bill Marler, I think your presence was missed!

Burgenland, Austria

Famed for its wine. Wikipedia has Burgenland inhabited since the Stone Age. How many years ago that was, I can't tell. I wonder if Burgenlanders enjoyed wine back then.

Below is Willi Wetschka (right) and his friend in the barn of Wetschka's winery, 2007.

Click to enlarge.________
Photo: Scanned from Gourmet Magazine, November 2007. A few more photos here. You have to love the gent in the third slide, at The Gasthaus!

Meat And Cancer, Part 2

Here was Part 1.

I'm surprised by what I'm discovering about the possible carcinogenic effects of meat. I'm also surprised that these points weren't raised in any of the literature I read so far surrounding low-carb diets, which almost universally promote meat consumption. I've been experimenting with low-carb diets as a way to manage my blood sugar. But with the recent diagnoses of cancer in my family, I'm revisiting their safety.

It's difficult to find material that isn't biased. Where are the people who approach this without having made up their mind? Where are all the scientists? It's not as if there is overwhelming evidence that meat, especially red meat, is or is not carcinogenic.

Speaking of Evidence

As I stated in my previous post, most thinking on the link between meat and cancer in humans comes from epidemiological studies. These studies look at large groups of people, tens of thousands, and note the incidence of cancer pursuant to a certain lifestyle choice, in this case, meat consumption. Unfortunately, it's not easy to sift out other influences. Maybe people who ate the most meat also smoked the most or exercised the least - and maybe it was the smoking or inactivity that caused the cancer, not the meat. Good epidemiological studies adjust for these factors, known as confounders. But they can never account for all of them.

A more telling study is a clinical trial, where a substance hypothesized to cause cancer is introduced and cancer formation or progression is noted afterwards. Not since the Tuskegee Study, which ended in this country in 1972, have such harm-inducing trials been intentionally conducted on humans. Well, not without participants' informed consent.

We do, however, continue to conduct harm-inducing trials on animals.

Below are a few studies I found that implicate meat in the formation of colon cancer in the rat or mouse.

(Photo of laboratory rat from the National Institutes of Health, Human Genome Research Institute.)

________
1.   Beef Meat And Blood Sausage Promote The Formation Of Azoxymethane-Induced Mucin-Depleted Foci And Aberrant Crypt Foci In Rat Colons (2004)

Findings:

"This study is the first to show that meat can specifically promote colon carcinogenesis."

Dietary meat significantly increased colon carcinogenesis compared to a meat-free diet, and was directly proportional to the amount of heme in the meat (see study #2 for a definition of heme). All meats in the study: chicken (low-heme), beef (medium-heme), and black pudding (blood sausage, high-heme), promoted carcinogenesis.
________
2.  Meat And Cancer: Haemoglobin And Haemin In A Low-Calcium Diet Promote Colorectal Carcinogenesis At The Aberrant Crypt Stage In Rats (2003)

Findings:

Dietary heme* significantly and dose-dependently increased colorectal carcinogenesis in rats.

Some good news: Carcinogenesis was inhibited by dietary calcium (equivalent to ~5347 mg/day in humans, 427 mg/day or less was not protective), dietary antioxidants, and dietary olive oil (which contains antioxidants). These act to decrease the oxidation of fat or lipids in the colon.

* Heme is the iron-containing unit of hemoglobin in red blood cells, and myoglobin in dark meat such as beef and pork muscle. There is some hemoglobin in white meat. Heme is what is presented to the colon after digestion of dietary hemoglobin and myoglobin.
________
3.  Heme Is A Potent Inducer Of Inflammation In Mice And Is Counteracted By Heme Oxygenase (2001)

Findings:

Heme induced gut inflammation in mice. It does so by up-regulation of adhesion molecules, an increase in vascular permeability, and granulocyte infiltration. Chronic gut inflammation may contribute to the progression of precancerous growths.

An aside: Heme induces systemic arterial inflammation by the same processes. And arterial inflammation is a factor in the development of atherosclerotic plaque. Not only is heme implicated in cancer, it's also implicated in heart disease.
________
4.  Green Vegetables, Red Meat And Colon Cancer: Chlorophyll Prevents The Cytotoxic And Hyperproliferative Effects Of Haem In Rat Colon (2005)

Findings:

Either spinach or an equivalent concentration of chlorophyll prevented the detrimental cytotoxic and hyperproliferative effects of dietary heme in the colon.

Scaling this effect: A human would have to consume about a pound of spinach daily to take in enough chlorophyll to see this protective effect.
________
In sum:

• Heme, an iron-containing component of red and darker-colored meats, has been shown repeatedly in rat studies to promote cancer of the colon. The mechanism for that promotion is thought to be oxidation of fat in the colon, direct cell destruction, or increase in colonic pH.
  
• Some dietary components appear to lessen the carcinogenic effect of heme:
  • Calcium
    
  • Antioxidants
    
  • Olive oil
    
  • Chlorophyll, via leafy greens

For the time being, I've been limiting my focus to just meat and cancer, particularly colon cancer. But I can't help noticing in my research that while calcium has been shown to inhibit colon carcinogenesis (see above), the protein in milk, casein, has been shown to promote colon carcinogenesis. I'll probably look at that link next.
________

Safety of Imported Food

I was reading through the FDA's new Food Protection Plan and came across a few facts I didn't know. See if you can guess first. Then select the hidden text above the line with your mouse. It should reveal the answer.

• Approximately 60 percent of fresh fruits and vegetables consumed in the US are imported.
  
  
• Today, 80 percent of seafood in the country is imported; less than 2 percent is inspected.*
  
  
• In 1999, the CDC estimated that there were around 76 million cases per year of illness from foodborne agents. (In 1999, according to the Census Bureau, the population of the US was 273 million.)

* This statistic came from the 2-minute CNN clip below. The FDA's report concurs. The video is somewhat partisan; Dobbs takes a personal stand near the end.

________

Counting Calories?

Do visit a Calorie Counter.

It also counts protein, fat, carbohydrate, fiber, and lots of other nutrients the USDA has tucked away in their data base. Uncluttered, fast, informative - government agencies in charge of food could learn from a site like this. :)

The owner of the site also has a blog. His last entry on November 6th points to a spectacular table he just created that compares basic nutrition facts for some popular foods from over 20 fast food restaurants:

Fast Food Restaurants & Nutrition Facts Compared

Clicking the table will take you to his complete list.
It amazes me what individuals can accomplish between meals.
________Thanks to Sans Fromage for the tip!

Request!

I'd like to ask a favor of anyone who sees this post in the next few days.

Would you visit this site: FoodSafety.gov ...

... and tell me if you think it easily answers any questions you, as a consumer, may have about food safety -- things like consumer alerts, current recalls, current food-related outbreaks, consumer guidance for same, etc. No big deal, just a quick scan.

As I understand it, the site, Foodsafety.gov, is being promoted by the government as a "primary mechanism for providing food safety information to the public."

• It is meant to serve as one-stop shopping for food safety news, that is, it's meant to incorporate information from the 12 or so agencies that have some responsibility for the safety of our food.
  
• It is designed to "provide and respond to the public's need for up-to-date, scientifically based, food safety information."

Do you think it succeeded?
(The site is currently managed by the FDA.)

Why I'm Asking For Your Input

The FDA is holding a conference call for bloggers next Wednesday, November 14th, on their new Food Protection Plan. I've been invited to listen in and ask questions. But I thought ... why are my questions important? Why aren't everyone's questions important?

So, if you leave your food safety questions and comments (that would apply to the Food Protection Plan) in the comment section, I'll read through them in the next few days and try to incorporate them into my RSVP. I can't imagine that any question or comment is too simple. After all, this is a teleconference for bloggers ... not scientists, journalists, academics, or industry insiders.

I had planned to at least comment about the FoodSafety.gov site mentioned above. I think it's difficult to navigate and requires that a consumer know which agency is responsible for a particular food (produce, meat, poultry, dairy food, pet food, livestock food, seafood, packaged food, imported food) before they can access news about it. Your comments don't necessarily have to address this point.

Social Influences On Diet

A few more thoughts on why I believe social influences play a role in health and disease:

I have a friend who has serious weight and health problems. If he was born in Abkhasia or Okinawa, would he have turned out similarly? My feeling is he wouldn't.

By the same token, if a person from Okinawa, a place that experiences extraordinary health and longevity, were to migrate to the West, would they die earlier and experience our diseases?

One study found they would:

Impact Of Diet On The Cardiovascular Risk Profile Of Japanese Immigrants Living In Brazil

Study Basics

• Cross-sectional study
  
• Participants: 234 Okinawans living in Okinawa (OO) and 160 Okinawan immigrants living in Brazil (OB) (aged 45–59 years)

Findings

• "Japanese immigrants from Okinawa living in Brazil have a higher mortality from cardiovascular diseases and have their mean life expectancy shortened compared with their counterparts living in Japan."
  
• OO had 37% less obesity than OB.
  
• OO had 50% less hypertension than OB. The OB subjects used threefold more antihypertensive medication than OO.
  
• Meat intake was 34% higher in OB than OO.
  
• Fish intake was sevenfold higher in OO than OB. Urinary taurine (an index of seafood intake) was 43% higher in OO than OB.
  
• Serum potassium levels were 10% higher in OO than OB.
  
• Urinary isoflavones (an index of the intake of soy products) were significantly lower in OB than in OO.
• Omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were two- and threefold higher in OO than OB.
  
• The rate of ischemic ECG changes in OO subjects was only 50% of that of OB subjects.
  
• There were no differences in the smoking rate between OO and OB subjects.
  
• "The results of the present study suggest that coronary risk factors and cardiovascular health are not only regulated by genetic factors, but that the impact of lifestyle (mainly diet) can be large enough to modulate the expression of genes."

________
Addendum: Since I'm talking about the Okinawans, and since my mind has been on cancer the last few weeks, I thought I'd post this excerpt from a book I'm reading, "Healthy At 100":

"When it comes to cancer, the medical data for these fortunate people are nothing short of amazing. Despite living to such extremely old ages compared to North Americans, their cancer rates are orders of magnitude better than those found in the West. Compared to someone in the United States, an Okinawan elder is:

• 85% less likely to die from breast cancer.
  
• 88% less likely to die from prostate cancer.*
  
• 70% less likely to die from ovarian cancer.
  
• 70% less likely to die from colon cancer."

* While prostate cancer is the most common cancer in males in North America and Europe, and the second leading cause of death from cancer among males in the modern industrialized world, it is extremely rare in Okinawa. When researchers in the Department of Urology at Ryukyus University conducted a study on prostate cancer in Okinawa, they found so few cases that they never bothered to publish the results. Most Okinawan men have never even heard of the disease.

And this:

"The extremely low rate of cancer among the elders in Okinawa cannot be explained by lack of chemicals or pollution, nor by shortened life spans. Three of Okinawa's rivers now rank among the five most polluted rivers in Japan."

________Photo of 89-year-old Zen-ei Nakamura from Okinawa, via National Geographic.

Who Is Profiting From The Rise In Obesity And Diabetes?

This was unbelievable. To see this kind of frankness in a public report just made my jaw drop. Virtually all of the diabetes- and health-related material I've laid my hands on over the years has skirted these issues. Most of those publications, however, were either produced by drug companies directly, or indirectly influenced by them. My non-profit is.

The following is an excerpt from the report I posted yesterday. It was produced by the City University of New York, Campaign Against Diabetes and the Public Health Association of New York City:

Reversing The Diabetes And Obesity Epidemics In New York City: A Call To Action To Confront A Public Health, Economic And Moral Threat To New York City’s Future

________
Pharmaceutical and Medical Supply Companies

For pharmaceutical companies diabetes is big business. Avandia is one of a number of medications available to treat diabetes. It has been prescribed nearly 60 million times and generates $3 billion a year for its producer, GlaxoSmithKline. Recently published evidence that Avandia increases the risk of heart attack has spurred debate over the drug’s safety and the regulation of pharmaceutical drugs. Similarly, Pfizer’s diabetes drug Rezulin was pulled off the market because it was found to cause liver damage. Drug industry opposition to legislation that would reduce the cost of prescription drugs has meant that many people with diabetes have been unable to afford their medications. Similarly, medical supply companies profit by selling their products to the growing ranks of people with diabetes. “Controlling my condition isn’t that hard,’’ an 82 year old man with diabetes told The New York Times. “The hard parts are the things outside my control, like getting the test strips and the medicines’’.

Insurance Companies

A 2006 investigation by the New York Times points out that most insurance companies refuse to pay small fees for preventive care but do pay for major medical procedures. For example, seeing a podiatrist costs $150 and could prevent a $30,000 amputation. By limiting the diabetes related services they cover, insurance companies do their best not to attract patients with this and other chronic illnesses. By not paying for prevention, these companies are betting that patients with diabetes will have changed insurers by the time the costly complications kick in. Withholding preventive care saves the companies money and forces their competitors and taxpayers to pay for the long-term consequence of this practice.

Hospitals

Hospitals make money by providing expensive procedures that address diabetes complications but not from less expensive preventive services. By charging tens of thousand of dollars for amputations, dialysis, and coronary bypass surgery, hospitals generate income. According to the New York Times investigation of diabetes care in New York City, some local hospitals have opened and subsequently closed diabetes centers because they were so effective at reducing complications they also reduced hospital income.

Food and Beverage Companies

These businesses profit from selling the inexpensive, calorie dense and nutrient poor foods that contribute to growing rates of obesity and diabetes. By saturating our neighborhoods, schools, and workplaces with their products and advertisements, they promote and profit from the over consumption of their products. In addition, our national agricultural policies subsidize the production of key ingredients for their products such as high fructose corn syrup. This helps make their products the cheapest and sweetest calories on the market.

________
The following was the preface to the above list of social influences:

"If diabetes were mainly the result of individual decisions, some might argue that the inequitable burdens it imposes are unfortunate but “just desserts” for over eating, exercising too little and failing to seek appropriate health care. In our view, however, the current diabetes and obesity epidemics can best be explained by changes in the environment, not individual decisions. In fact, as shown in Figure 6, many in our society have profited by participating in the circumstances that contribute to diabetes. We call attention to those who have gained from the rise in diabetes not to point fingers but rather to fairly apportion responsibility for reversing the epidemic.

To expect individuals to take the main responsibility for stopping diabetes is both ineffective – it doesn’t get at the roots of the problem – and unfair because it blames the victims."

You can read the rest of the report at:

Reversing The Diabetes And Obesity Epidemics In New York City: A Call To Action To Confront A Public Health, Economic And Moral Threat To New York City’s Future________

Obesity And Diabetes Are Not An Individual's Problem

Oh. A trend!

A few weeks ago I posted a report by the UK's Government Office for Science which said:

"The obesity epidemic cannot be prevented by individual action alone and demands a societal approach."
...
"The people of the UK are inexorably becoming heavier simply by living in the Britain of today. This process has been coined 'passive obesity'."

I lamented that government agencies in the US still frame America's weight problem as the creature of an individual's nefarious choices. "Eat less refined corn and soy products!" they say, as if our weight problem is our fault.

It's incomprehensible to me that those same agencies, backed by Congress, turn around and fund the production of those very corn and soy products they tell us not to eat - making them cheaper, more accessible, and, well, downright popular.

It's as if the USDA is saying, "Don't eat corn! Wait ... Eat corn! Wait ... Don't eat corn! Wait ... Eat corn!"¹

Oh, look. Adam Drewnowski, director of the nutritional sciences program at the University of Washington also thinks it's incomprehensible:

"Drewnowski finds it ironic that the Agriculture Department encourages people to eat vegetables like lettuce or carrots that are not subsidized, and therefore more expensive, while giving people an economic incentive through subsidies to buy foods it says they should eat sparingly."
- Fat? Blame Congress, At Least Partly

Maybe it's not incomprehensible. If the government blames obesity on us, they don't have to change their policies.

King Corn

Since I'm talking about corn, I may as well interject this 2-minute trailer for King Corn, "a documentary about two friends, one acre of corn, and the subsidized crop that drives our fast-food nation." (Was that Michael Pollan?)

________
Back To My Trend

Two groups in New York City (the City University of New York, Campaign Against Diabetes and the Public Health Association of New York City) have come out proclaiming that obesity and diabetes are not an individual's problem. Bless their souls.

Here's the report they published in September, 2007 (warning, it's a 12mb pdf file):

Reversing The Diabetes And Obesity Epidemics In New York City: A Call To Action To Confront A Public Health, Economic And Moral Threat To New York City’s Future

They state:

"For the most part, our society has viewed diabetes as an individual problem, requiring people at risk to eat less, move more, and follow their doctors advice more consistently. In our view, this simplistic perspective ignores the major role that our social and physical environments play in shaping the choices individuals make."

Made my day.
________¹ Someone needs to do away with the USDA's conflict of interest. I feel for them.
Thanks to Food Law Prof Blog for the link to the article in the Danville Register & Bee.

Thoughts On Meat And Cancer

Some diagnoses of cancer have hit my family in the last few months. It's been a trying time. I've been especially keen to understand why, so I've been pouring over research. One dietary item keeps popping up ... meat. I don't know what it is about meat ... heme-iron, hormones, a type of fat, environmental toxins that are dissolved in animal fat, carcinogens produced via cooking, etc. But the association is common in my reading.

We can't ethically feed meat to someone until they get cancer. So there aren't clinical trials, just epidemiological studies, and those can always be devalued. Even I question some of their conclusions. Still, over and over, cancer is seen in populations that eat the most meat. And the mechanisms of action hypothesized for this link make sense to me.

In the absence of a clear, indisputable guideline, and in the presence of this association, how is someone with cancer to eat?

Fitting Low-Carb Into The Picture

I believe in the health benefits derived from eating a low-carb diet. That's not to say I believe in eating a low-carb diet. As I've said before, I don't believe carbohydrates are the problem. The problem is blood glucose and hormones (e.g. insulin). Since carbohydrates have such an impact on them, I can understand where the idea of limiting carbs came from. However, we still don't know the long-term effect of this dietary choice.

While science elucidates further the meat:cancer link, I think it would be prudent to reduce my meat intake, an intake that has risen to at least once-a-day since discovering my impaired glucose tolerance. Once-a-day meat intake has been linked to some of the highest rates of cancer. I respect that some find this link tenuous bordering on meaningless. I'm not willing yet to discard its implication.

How can I derive the benefits of eating low-carb, but still eat carbohydrates -- a situation I'm faced with when I cut back on meat?

The problem to me is not carbohydrates per se. The problem is:

• The type of carbohydrate.
  • Stay away from refined products such as flour and sweeteners (e.g. HFCS) which are digested quickly. Choose vegetables and seeds (that would include grains which are seeds) in their whole form and containing starch-types that are more slowly digested, e.g. amylose instead of amylopectin, resistant starch, etc. These qualities are reflected in a food's glycemic index.
• The amount of carbohydrate eaten at one time.
  
• The speed of digestion and absorption, the slower the better.
  • Digestion is slowed by the presence of fiber and fat in a meal.
    
  • Digestion is slowed by the temperature of a meal, e.g. cold foods pass through quickly, hot foods slowly.
    
  • Digestion is slowed by the fluidity of a meal, e.g. liquids pass through quickly, dry foods slowly.
• The frequency of carbohydrate-containing meals.
  • Not every 2 hours! Or as Michael, one of our commenters said, "Wait until there is some space in the tank before refilling."
• Activity after a carb-containing meal.
  • Exercise has been shown to accelerate post-meal glucose clearance.

The worst scenario, that is, the worst of all of the above combined, can be found in the consumption of a cold, liquid, high-fructose-corn-syrup sweetened beverage consumed every few hours. You may as well have an IV of sugar hooked up to your arm.

In my mind, eating a "low-carb" diet -- one that virtually eliminates foods that contain carbohydrates, and one that is rich in foods like meat, fish, dairy, and eggs -- is a patch, a symptom-alleviator, not necessarily or unquestionably the best way to eat.

Update: See Meat and Cancer, Part 2 for more on the meat/cancer link.
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