Growing Old Together Apart

New York Times' columnist Nicholas Kristof wrote an Op-Ed this weekend about his friend who chose to divorce her husband "not because of irreconcilable differences but because of irreconcilable medical bills."

Until Medical Bills Do Us Part

"She was married to a sweet, gentle man whom she loved, but who had become increasingly absent-minded. Finally, he was diagnosed with early-onset dementia.

The disease is degenerative, and he will become steadily less able to care for himself. At some point, as his medical needs multiply, he will probably need to be institutionalized.

The hospital arranged a conference call with a social worker, who outlined how the dementia and its financial toll on the family would progress, and then added, out of the blue: “Maybe you should divorce.”

“I was blown away,” M. told me. But, she said, the hospital staff members explained that they had seen it all before, many times. If M.’s husband required long-term care, the costs would be catastrophic even for a middle-class family with savings.

Eventually, after the expenses whittled away their combined assets, her husband could go on Medicaid — but by then their children’s nest egg would be gone, along with her 401(k) plan. She would face a bleak retirement with neither her husband nor her savings.

The hospital told M. not to waste time in dissolving the marriage. For five years after any divorce, her assets could be seized — precisely because the government knows that people sometimes divorce husbands or wives to escape their medical bills."

Social workers recommending dissolving a marriage because of medical bills. Something about that isn't right.
________Photo from a September, 2008 NYTs article about fixing how we finance long-term care in this country.

Dr. Weil On Greed And X-Rays

Dr. Andrew Weil has been increasing his internet exposure. In addition to his website, he now has a blog, a Twitter account, a Facebook page, and has been writing articles for the Huffington Post. What's his impetus? Likely promotion for his new book, "Why Our Health Matters." Whatever the reason, it's nice to hear his more integrated perspective on matters of health.

His latest Huffington blog post:
Fear, Greed and X-Rays

"It's vital to sever the link between ordering tests and making money."

I don't always agree with him. He promotes supplements too much for my taste. But that quote above? Dead on.
________Photo of Dr Weil with his biodiesel machine (not his imaging equipment), which converts vegetable oil into fuel for his car, from his Facebook page.

Texting While Driving

This PSA (Public Service Announcement) is currently airing in Britain. It's stirring controversy for its graphic nature.


________

USDA Argues For "Organic-Biotech"

Do you think that foods labeled "Organic" should be allowed to be made from genetically engineered ingredients? A report out of the USDA Foreign Agricultural Service is arguing that producers should be allowed to gain organic certification for biotech (genetically engineered) crops:

The Unexplored Potential of Organic-Biotech Production (pdf)
USDA Foreign Agricultural Service, Italy
May 26, 2009

According to the Organic Consumers Association, the report above, "is part of a well-funded campaign coordinated by Monsanto and their governmental, corporate, and non-profit partners to legitimize a dangerous and untested technology."

"Organic-Biotech." If ever there was an oxymoron.
________The photo is from one of Barry Estabrook's (of Gourmet Magazine) columns, "GM Birth Control?" He describes an experiment where mice were fed Monsanto's genetically engineered corn (pictured). The mice "had fewer litters, fewer offspring, and more instances of complete infertility than those receiving a conventional diet."

Less Than 1% Of American Cropland Is Organic

From:
America's Food Crisis and How to Fix It, Time, August 20, 2009

To be able to eat organic food is a privilege:

"According to the most recent data from the U.S. Department of Agriculture (USDA), less than 1% of American cropland is farmed organically. Sustainable food is also pricier than conventional food and harder to find."

To be able to eat organic food that is also locally grown, is to be part of an elite group indeed.

To be able to eat lots of fruits and vegetables is a privilege:

"Fruits and vegetables don't receive the same price supports as grains. A study in the American Journal of Clinical Nutrition found that a dollar could buy 1,200 calories of potato chips or 875 calories of soda but just 250 calories of vegetables or 170 calories of fresh fruit.

With the backing of the government, farmers are producing more calories — some 500 more per person per day since the 1970s — but too many are unhealthy calories. Given that, it's no surprise we're so fat; it simply costs too much to be thin."

This is one reason why obesity, diabetes, heart disease, and other chronic conditions are as much a result of social, political, and economic factors as they are a result of personal choice.
________

Eating Processed Food Makes It Easier To Gain Weight

Evidence for the harm caused by eating processed food - food made from overly processed grain (flour) with added fats and sweeteners - is mounting.

Can just changing the texture of food, processing it, contribute to weight gain?

That was the question Kyoko Oka, et al. asked in:
Food Texture Differences Affect Energy Metabolism In Rats, 2003

Two groups of rats were fed either standard pellets or easily-chewed, soft pellets (made softer by increasing air content, as is done in breakfast cereals).

• Calorie intake was measured to be the same in both groups.
  
• Nutritional composition of diet was the same in both groups.
  
• Meal duration was the same in both groups.
  
• Calorie expenditure via locomotion was measured to be the same in both groups.

If energy intake, nutrient intake, and energy expenditure (activity) are similar, you would expect body weight and body fat to be similar. That wasn't the case.

Findings

• After 18 weeks and beyond, "body weight in the soft-fed group was significantly greater."
  
• After 22 weeks the rats were dissected. Weight of abdominal fat in the soft-fed group was significantly greater, enough to designate the rats as obese.
  
• The increased body weight in the soft-fed rats was due to increased body fat.

The authors concluded:

"In this study, 22 weeks was long enough to produce obesity in soft-fed rats." (They ate the same number of calories.)

Mechanism

The cost for digestion in the soft-fed rats was lower. This cost was measured in body temperature, which was significantly lower in the soft-fed group after a meal (up to 1 hour). Body temperature (thus, energy expenditure) was also significantly lower in the soft-fed group "during the dark period" or overnight.

If weight loss and reduction of body fat are the goal, merely reducing the number of calories consumed won't be as effective as also reducing the amount of processed food consumed, e.g. bread, crackers, breakfast cereals, and baked goods.
________Idea thanks to Richard Wrangham and his book Catching Fire. Great book.

Food Safety Attorney Bill Marler On Seattle Voices

Bill Marler was recently interviewed by Eric Liu, the host of Seattle Voices, a program that airs on Seattle Cable Channel 21.

For the video: click Bill's photo or the link below (28 minutes):
Seattle Voices With Bill Marler

This is one of the best treatments I've seen in the media of food safety issues. The interviewer is informed, smart, asks pertinent questions, then gives the wand to Marler for more than soundbite replies. Marler's responses are likewise informed, succinct, and compassionate.

Why are we experiencing more, and more deadly, foodborne illnesses in recent years? One reason - the increasing industrialization of food production, and the blink-of-an-eye, mass distribution of food that may originate, as with the case of Peanut Corporation of America, in one small contaminated plant.
________

Whole Foods CEO Alienates His Customers

Whole Foods' founder and CEO John Mackey wrote an opinion piece for the Wall Street Journal this week that put him in the hot seat with a nice segment of his store's clientele:
The Whole Foods Alternative to ObamaCare, Wall Street Journal, August 12

It left the folks at Whole Foods Market Headquarters scurrying:
Whole Foods Damage Control Begins (Now with Annotated Version), Daily Kos, August 14

By placing the onus for health squarely upon the individual, Mr. Mackey has shown he is either ignorant of, or rejects, the public health (PH) perspective. The UK Government Office for Science describes the PH perspective:

"Although personal responsibility plays a crucial part in weight gain, human biology is being overwhelmed by the effects of today’s ‘obesogenic’ environment. ... Some members of the population, including the most disadvantaged, are especially vulnerable to the conditions."

"The evidence is very clear that policies aimed solely at individuals will be inadequate and that simply increasing the number or type of small scale interventions will not be sufficient to reverse this trend."
- Tackling Obesities: Future Choices

Lots of other take-aways from his article, many embarrassing for the company. The most positive fall-out has probably been the publicity it's generated.
________Thanks to cw!

Alcohol Can Lower Fasting Blood Glucose

This topic has come up a few times recently so I thought I'd post about it.

Drinking alcoholic beverages can depress your fasting blood glucose levels. This can be beneficial, but it can also lead to a false sense of security about your glucose metabolism.

Mechanism

The ethanol in alcohol inhibits gluconeogenesis, which is the new (neo) making (genesis) of glucose (gluco). Gluconeogenesis occurs primarily in the liver and is one way your body supplies glucose to tissues during a fast, such as overnight.

So, if the only reading you're checking is fasting, or first thing in the morning, and it's below 100 mg/dl, and you think you're fine, double-check it with a few postprandials throughout the day. (A high HbA1c with low fastings could result from this effect.)

Here's one study:
Glycemic Effects Of Moderate Alcohol Intake Among Patients With Type 2 Diabetes: A Multicenter, Randomized, Clinical Intervention Trial, Diabetes Care, 2007

Participants (91 completed the study) had type 2 diabetes and received one of the following daily for 3 months (consumed at dinner):

• 150 ml wine (about 5 ounces or a little more than 1/2 cup) (either Merlot or Sauvignon Blanc)
  
• 150 ml nonalcoholic diet beer (control group)

Results:

• In the wine group, fasting glucose dropped from 139.6 to 118.0 mg/dl.
  
• The control group experienced no change, 136.7 to 138.6 mg/dl.
  
• Those with the highest HbA1c levels had the greatest reductions.
  
• Alcohol consumption had no effect on 2-hour postprandial glucose.

Of course, individuals vary. And not all studies show this effect, even though there's a biologically plausible mechanism.

Update: For those who are asking: A normal (conservative) postprandial blood glucose reading is below 140 mg/dl. You want to see your blood sugar getting below 140 at about 2 hours after you finish eating a meal.
________

African Chickens Added To List Of Animals That Reject GMOs

Remember my posts from 2008 where I recounted Jeffrey Smith's stories about cows, hogs, and geese that rejected genetically engineered corn and soy?

Let's add chickens to the list:

Smart Chickens Weren't Duped By Foul Play
Independent Online (South Africa), August 2, 2009

"Strilli Oppenheimer was recently approached by Dawid Klopper, the head gardener at the family estate, Brenthurst, informing her that her indigenous African chickens were refusing to eat the mealies in the chicken feed bought from a large supplier. Concerned that the birds may be ingesting genetically modified maize, she instructed Klopper to have the maize tested.

Oppenheimer stopped consuming the home-grown eggs and the maize was sent to the GMO testing facility at the University of the Free State for analysis.

The results confirmed Oppenheimer's initial suspicion - the maize had been genetically engineered to produce proteins that are toxic to certain insects and weeds.

"It contained BT1 which makes the maize insect resistant, as well as Roundup which makes it weed resistant. This is the first report we have had of chickens not eating GM feed," said a GM expert.

While small quantities of BT1 and Roundup weed killer were found in the seeds, the concern remained with the cumulative effect of GM feed, not only on the chickens, but also on the eggs they produced for the family."

________
The FDA does not require labels on foods that contain genetically engineered ingredients because they claim, "bioengineering does not make a food inherently different from conventionally produced food.":

"Consumer: Why doesn't FDA require companies to tell consumers on the label that a food is bioengineered?"

"FDA: We are not aware of any information that foods developed through genetic engineering differ as a class in quality, safety, or any other attribute from foods developed through conventional means. That's why there has been no requirement to add a special label saying that they are bioengineered."
- FDA Consumer, "Are Bioengineered Foods Safe?", January-February 2000.

(FDA seems to have removed this link, however, the entry in the Federal Register upon which this statement was based is still obtainable: Statement of Policy - Foods Derived from New Plant Varieties, FDA Federal Register, Volume 57 - 1992.)

About that photo of 2 rats: The smaller rat on the right was fed GM soy. The rat on the left was not. The rats are the same age. See: Disturbing Findings In Rats Fed Genetically Modified Soy.

Somebody needs to inform the cows, hogs, geese, chickens, and rats that there's no difference.
________
Photo of an African chicken, or guineafowl, from Wildlife Pictures Online. I love this photo not just for the unexpected brilliant colors of the bird, but for the close-up of its teeth. Wow. The caption: "Helmeted Guineafowl (Numida meleagris) close-up showing its brightly-colored head and neck, Kruger National Park, South Africa. © Scotch Macaskill"

I saw this story on Jeffrey Smith's Twitter feed: "Chickens avoid GMOs. Also cows, pigs, geese, buffalo, elk, deer, raccoons, mice, rats, squirrels. If only people."

Our Food Problems Solved

This video appeared at the bottom of Roger Ebert's recent article, "The Gathering Dark Age."



How in the world did this adult come to believe that "on the East Coast they have slaves and believe in slavery," and that "on the West Coast we don't believe in that."

If she thinks she is not consuming anything made in China, she needs to turn things over and read the stamp on the bottom.

How did she come to believe that food is free, and that the land it is grown on is free?

Roger Ebert took a stab at answering these questions:

"If I mention the cliché "the dumbing-down of America," it's only because there's no way around it. And this dumbing-down seems more pronounced among younger Americans. It has nothing to do with higher educational or income levels. It proceeds from a lack of curiosity and, in many cases, a criminally useless system of primary and secondary education."

I've been away from the school system for decades. Has it really deteriorated this much?
________Thanks again to BL!

Weak-Jawed Humans

Harvard Professor Richard Wrangham, in his book Catching Fire, explains how the shift from raw to cooked food was the key factor in human evolution, and that this shift is evident in our anatomy - we have smaller mouths, weaker jaws, and smaller teeth.

Wrangham says:

"Our small, weak jaw muscles are not adapted for chewing tough raw food, but they work well for soft, cooked food.

In nonhuman apes these muscles often reach all the way from the jaw to the top of the skull where they sometimes attach to a ridge of bone called the sagittal crest, whose only function is to accommodate the jaw muscles. In humans, by contrast, our jaw muscles normally reach barely halfway up the side of our heads.

If you clench and unclench your teeth and feel the side of your head, you have a good chance of being able to prove to yourself that you are not a gorilla: your temporalis muscle likely stops near the top of your ear."

Here you can see the anatomical difference in jaws and teeth between us and ancient members of our Family. (The author of this video states, "This is not meant to be an accurate representation of our own lineage."):


________

How Americans Spend Their Day

BL just sent this graphic from the New York Times. It addresses the question in my previous post, How Many Minutes A Day Do You Spend Eating (Chewing)?

It shows that Americans spend an average of 67 minutes, or a little over an hour each day eating and drinking (great apes spend 6 hours/day eating their raw food diet). Those aged 65 and older, and those with advanced degrees spend a little more time, about an hour and 20 minutes.

How Different Groups Spend Their Day, New York Times, July 2009
"The American Time Use Survey asks thousands of American residents to recall every minute of a day. Here is how people over age 15 spent their time in 2008."

Their graphic is interactive. Click the map above and it will take you to their site where you can isolate categories.
________Thanks, BL!

How Many Minutes A Day Do You Spend Eating (Chewing)?

I've put a poll for this question on the sidebar. This is just the time you spend moving food around your mouth, not the time you spend preparing food.

Some perspective, via Wrangham's Catching Fire:

• "In the US, children from 9 to 12 years of age spend a mere 10% of their time eating, or just over an hour per 12-hour day." (72 minutes)
  
• In 12 subsistence societies around the world, children aged 6 to 15 chewed about 7-8% of the day, adults about 5%. (Children: 54 minutes, Adults: 36 minutes)
  
• By contrast, Tanzanian chimpanzees spend more than 50% of their waking hours chewing, roughly 6 hours to consume about 1800 calories. (360 minutes)
  
• Wrangham asked, "How long would humans be obliged to spend chewing if we lived on the same kind of raw food that great apes do? ... Conservatively it would be 42% of the day, or just over 5 hours of chewing in a 12-hour day." (302 minutes)

That last point is one reason, argues Wrangham, that humans did not evolve to eat a raw food diet. We didn't have the time to eat plus do all the other things we were doing - hunting, setting up food economies. It's also a reason why humans are not carnivores:

"When eating muscle, chimpanzees are forced to chew it slowly ("their teeth cannot cut meat easily, their mouths are relatively small, their stomachs do not process hunks of raw meat efficiently"), taking as much as an hour to chew one-third of a kilogram (three-quarters of a pound)"

This puts the raw food, vegan Evo Diet into better perspective. It may be effective for weight loss, but it's probably not the diet humans evolved to eat.
________
Results of chewing poll:

How many minutes a day do you spend eating (chewing)?


________Source for quotations: Catching Fire: How Cooking Made Us Human, Richard Wrangham, 2009.

A Teachable Moment

If obesity and overweight are primarily a result of an individual's choices, why has Dr. Benjamin, an intelligent woman, someone who knows the health costs associated with obesity, someone who has a family history of obesity-related illnesses in her family (high blood pressure and diabetes), and is on record as calling them "preventable diseases," now someone who has been selected as the nation's premier advocate for public health, made the choice to be overweight?

Update: I should say where I stand.

I may be in a minority, but I don't believe obesity stems primarily from an individual's choices.

I may not be in the minority in the UK, however, where personal choice's role in obesity is considered just one factor among others, including class, location, and time (time in history, as in "the Britian of today"):

"Although personal responsibility plays a crucial part in weight gain, human biology is being overwhelmed by the effects of today’s ‘obesogenic’ environment, with its abundance of energy dense food, motorised transport and sedentary lifestyles. As a result, the people of the UK are inexorably becoming heavier simply by living in the Britain of today. This process has been coined ‘passive obesity’. Some members of the population, including the most disadvantaged, are especially vulnerable to the conditions."

"The evidence is very clear that policies aimed solely at individuals will be inadequate and that simply increasing the number or type of small scale interventions will not be sufficient to reverse this trend."
- Tackling Obesities: Future Choices - Summary of Key Messages, Government Office for Science

Not to say individual responsibility doesn't count, but there are strong social and political forces acting against personal choice.________