Mr. Weber Loves Hoagies

Here's Mr. Weber savoring his 2010 hoagie. Mr. Weber loves hoagies, but he only eats one, any deli meat actually, once a year. Here's hoping this memory carries him to December 2011.


________

How Would You Keep Medicare Afloat, Or Would You?

Medicare covers about 46 million elderly and disabled Americans at a cost of about $500 billion. It's straining to pay that bill. Unfortunately, costs continue to rise along with number of beneficiaries (as baby boomers retire).

President Johnson signed Medicare into existence in 1965 as an amendment to the Social Security Act. It's a single-payer system covering about 80% of a patient's costs.

If you had to choose one method to keep Medicare afloat financially, which would it be?
________

Unsafe Levels Of Toxic Chromium Found In Drinking Water

The Environmental Working Group (EWG) tested tap water in 35 cities across the US; 31 had detectable levels of the carcinogenic metal called hexavalent chromium (chromium-6), 25 had levels thought to be unsafe. (Erin Brockovich famously and successfully petitioned for the cancer-stricken residents of Hinkley, California whose water was contaminated with chromium-6.)

California set the unsafe level in drinking water at 0.06 parts per billion (ppb). Here were the top 5 contaminated cities:

• Norman, Oklahoma: 12.9 ppb
  
• Honolulu, Hawaii: 2.00 ppb
  
• Riverside, California: 1.69 ppb
  
• Madison, Wisconsin: 1.58 ppb
  
• San Jose, California: 1.34 ppb

Here's how the other cities rated:


Click to enlarge.

Hexavalent chromium (Cr-6) is not the same as trivalent chromium (Cr-3), the latter employed as a dietary supplement to improve glucose metabolism and regulate body fat. Cr-6 is a strong oxidant linked to stomach and gastrointestinal cancers. Although the two can interconvert: Cr-3 becoming Cr-6 in the presence of chlorine, Cr-6 to Cr-3 in acid conditions.

What to do? We could regulate the industries that discharge Cr-6 into the environment. But that would cause a hardship for the industries. Maybe we could monitor discharge from big industries and exempt small ones, similar to the Tester Amendment on the food safety bill. After all, small industries care more about the public. They don't discharge toxins into the environment.

Maybe we should forego any regulation - just keep government out of people's business. Let water companies distribute any water they like.
________Bix is asking for coal in her stocking.

Full Lunar Eclipse

Last night:



At first, there was an enormous white ball low in the sky. It got smaller as it rose but was still full, illuminating almost like daytime. Slowly it became a sliver and everything darkened. I thought that was it. By the next hour there was a spectacular orange ball in the sky. Things on the ground glowed red. What a treat! (I tend not to sleep much.)
________

Hans Rosling: "We Have Become An Entirely New Converging World"

Dr. Hans Rosling tells the story of the world since 1810 in 4 minutes using an animated graph that plots life expectancy against wealth. Amazing:¹



Rosling co-founded the Gapminder Foundation which developed the Trendalyzer software used in the graph above. Google loved Trendalyzer so much it acquired it in 2007. They employ it in their new Public Data Explorer.

I love seeing the world advancing along the health-wealth trend line. But I can't help wondering if that will mean more meat consumption, which will mean more industrial livestock farms with their attendant pollution, resource depletion, and ethical dilemmas.

Is he right? Will "everyone be able to make it to the healthy wealthy corner?" I love his optimism.
________¹ The clip is from a BBC program, "The Joy of Stats."

Nights Before Christmas

The twelth day of Christmas, nightfall, my neighbor had just turned on his snowman.


________

Congresswoman DeLauro Is Bound And Determined To Get Her Single Food Safety Agency

Great news:

DeLauro Reintroduces Single Food Safety Agency Legislation, Food Quality News, Dec 17, 2010

She did this back in 1999 and periodically since.

Remember, the Food Safety Modernization Act currently going through Congress only addresses FDA's oversight. (But it's still needed.) There are up to 15 discrete agencies which in some way regulate food.

The current bill doesn't specifically address meat and poultry since those are under USDA's umbrella, as are egg products ... but not eggs:

"The FDA is responsible for egg safety when eggs are still in the shell, but the USDA takes over once they are broken. In addition, the FDA is in charge of chicken feed safety, while the USDA is responsible for the chickens."

________
Helena Bottemiller at Food Safety News has a choice quote from Senator Tom Coburn (R-Okla), who opposes the current food safety bill, but who has no qualms supporting one food safety agency:

"If you buy a cheese pizza, the Department of Agriculture is responsible for that. But if you buy a pepperoni pizza, it is the FDA. I may have them reversed. I do have them reversed. The FDA is responsible for cheese pizzas. How does that make sense?"

"It is a symptom of the disease in Washington," continued Coburn. "First of all, it is stupid. Second of all, it is inefficient. Third of all, it guarantees the two agencies are not going to be talking to each other."

"What do we have going on here? We have a mess."

________

The Pitfalls Of Testing

A wonderful blog post on the sensitivity and specificity of testing:
Why Medical Testing Is Never A Simple Decision
by Marya Zilberberg
________

The Human Body Cannot Make Glucose

Only plants can make glucose from scratch.* Humans must eat the plants, or eat animals that ate the plants, to obtain glucose. And humans absolutely need glucose to survive. This simple sugar is the sole source of energy for our red blood cells and the preferred source for other cells. We are utterly dependant on plants for our existence. (Not to mention that they release oxygen in the process of manufacturing glucose - oxygen that we also need to survive.)

* And some algae like seaweed, and some bacteria.

Glucose is a molecule with 6 carbon atoms bound together. Humans cannot harness the immense amount of energy needed to get 6 carbon atoms to bind together. Plants, however, can. It's quite a feat actually. They harness the energy from the sun to do this.

Plants take in carbon dioxide, string together 6 carbons to make glucose for their fuel (starch is just a chain of glucoses), and give off the excess oxygen.

Humans take in the oxygen given off from plants and use it to extract the energy from those bonds within the glucose molecule. (One pathway to extract that energy is called glycolysis. I'll return to glycolysis later.) The waste product, if you will, from our energy-extraction process is carbon dioxide. We exhale it. This is the same carbon dioxide that the plant takes in to make glucose - it needs those carbons. Humans and plants have a cyclical relationship.

At night, plants respire just like us. They use oxygen to extract energy from the glucose they made during the day, giving off carbon dioxide in the process.

One last point...

There is a process our bodies evolved to supply glucose in a pinch. It's called gluconeogenesis ... the new making of glucose. Since we can't make glucose from scratch, this process allows us to reassemble preformed 3-carbon and 4-carbon molecules to make the 6-carbon glucose. These precursor molecules' carbons were bound via photosynthesis, via plants' harnessing of energy from the sun. We still can't isolate ourselves from this fuel that plants make - that we eat.

Gluconeogenesis is essentially the glycolysis pathway (recall above) in reverse - not quite though. It uses different enzymes (enzymes make it go), and where glycolysis provides us energy by breaking down glucose, gluconeogenesis uses up energy. From where does the energy come to reassemble those precursors for gluconeogenesis? From plants!

Glucose From Fat?

If we eat too much glucose, we convert some of it to fat for storage. Since we can make fat from glucose, can we make glucose from fat? No.

When we disassemble the fat (fatty acid chain), we're left with a small 2-carbon molecule. Recall that gluconeogenesis requires at least a 3-carbon molecule.
________

Ethical Food Choices

Jury duty has taken me away. In the meantime, here's a quotation from a book I'm reading, The Way We Eat: Why Our Food Choices Matter:

"[This is], in both magnitude and severity, the single most severe, systematic example of man's inhumanity to another sentient animal."

Can you guess what "this" is?
________
Difference Between Ethics And Morals

WiseGeek describes the difference between ethics and morals, for which I was grateful:

"Morals define personal character, while ethics stress a social system in which those morals are applied.
...
So while a person’s moral code is usually unchanging, the ethics he or she practices can be other-dependent."

Examples:

"It may be helpful to consider a criminal defense lawyer. Though the lawyer’s personal moral code likely finds murder immoral and reprehensible, ethics demand the accused client be defended as vigorously as possible, even when the lawyer knows the party is guilty."
...
"Another area in which ethics and morals can clash is at the workplace where company ethics can play against personal morality."

________

Are Exemptions In The Food Safety Bill Justifiable?

I enjoy Jim Prevor's The Perishable Pundit. I don't always agree with him, but he makes some good points here about the Food Safety Bill which is inching its way through Congress right now:

Food Safety Bill Now Seems Likely To Pass With Exemption For Small Producers: FMI And NRA Refused To Join Ranks With The Produce Industry To Stop It. Final Bill Is An Attack On Wholesalers And Distributors
FMI: Food Marketing Institute
NRA: National Restaurant Association

The issue is whether the Tester Amendment which exempts small producers (less than $500,000 in sales during a 3 year period) creates a loophole that undermines the Bill's integrity. I think it does. Jim Prevor appears to think it does:

"... the size of the farm is not a relevant food safety characteristic. Same thing goes for the requirement that such small producers must sell more than half their production within the state they are located in or within 275 miles."

Note that almost half of a small producer's wares, which have been exempted via the Tester Amendment, may be sold non-locally (out of state and beyond 275 miles).

"... if you believe the bill is actually going to enhance food safety, then leaving small producers out of the loop poses enormous dangers to all producers — and the public."

Here he questions the link between food safety and selling directly to retailers, restaurants or consumers:

"In order to get the exemption from the food safety requirements, it is not sufficient to just be small or to sell locally; one also must sell directly to retailers, restaurants or consumers. ... The idea seems to be that if a buyer knows where the food is coming from, risk is reduced or eliminated.
...
But the restaurant or retailer 275 miles from the farm doesn’t necessarily know anything about his supplier. ... How many small retailers and restaurants [or consumers] have the knowledge to evaluate a farm or processor for food safety standards?"

Another good point he makes is that the Bill, with the Tester Amendment, discriminates against small family businesses that act as distributers.

If the Tester Amendment is not about protecting all small family businesses that sell perishables; if it's not about creating exemptions based on quantifiable food safety parameters; what is it for?

"... if one really believes these rules will enhance safety, they have to apply to everyone."

________

Mike Tyson: "I Became A Vegan"

Mike Tyson, on losing about 130 pounds:¹

"I became a vegan,” says Tyson. “Vegan is where no animal products. No livestock products. Nothing. I just did a lot of training and try to become more faithful in life. I wanted a different life. I felt like I was dying. I had an incident in life where I lost my 4 year old daughter in a tragic accident at home. I don’t know. I didn’t want to live anymore. So I said, that in order to go there, I had to change my life. I am going to change everything I dislike about myself. I changed everything that I was as a human being. I started that journey in October or November. … I don’t smoke anymore. I wanted to give up everything. I had to change my life. I didn’t have a problem with drugs or nothing. I had a problem with thinking. My thinking was broken. That was the solution of my broken thinking using drugs and living crazy. It was just the way I was thinking."

On the worst part about being 350 pounds:

"It was hard to wipe my butt… I was sweating like some kind of guy from a moon project or something. It was crazy… All the clothes you see me with now are clothes that I had 15, 20 years ago. (Host: Did you have the back fat and everything?) Oh man the back fat. The back fat is when it’s so bad, your ass looks like a board. It’s like boom. The back and ass is one. It’s not like the back goes down and the butt protrudes. No. It’s just straight down. And then girls were telling me I looked great. It has to be a money deal. It had to be."

Tyson this summer:
(Tyson was born June 30, 1966. He's 44 years old.)




Tyson last summer:


________¹ Mike Tyson On The Hangover: “I Was Doing That To Supply My Drug Habit”, Sports Radio Interviews, August, 2010.
Photo of Tyson at a soccer match in Peterborough, England in July 2010 (in tee shirt) from Lalate News.
Photo of Tyson in May 2010 (in dark suit) from TMZ.
Photo of Tyson in 2009 (in white shirt)from MuscleTalk.
Photos of Tyson in June 2009 (in grey shirt) from Lalate News.

High BMI Predicts Early Death

Body Mass Index (BMI) has been getting a bad rap. That's somewhat deserving since, as a measurement that relies solely on height and weight, it lumps together as fat anyone whose weight is high relative to their height. So, if you have a lot of muscle it may say you are obese instead of finely chiseled. Conversely, if you have a "normal" weight relative to your height, it says you are "healthy." It doesn't get skinny fat.

Still, as a gross indicator of health BMI is useful (although its terminology is unfortunate, e.g. "morbidly obese"). This study draws out its use. When you're looking at 1.5 million people, the exceptions I noted above become blurred:

Body-Mass Index And Mortality Among 1.46 Million White Adults, New England Journal of Medicine, December 2, 2010.

The authors pooled data from 19 long-running studies - age range 19 to 84 years (median 58). A BMI of 22.5-24.9 was the reference category. Hazard ratios among women (men were similar) were:

• 1.47 for a BMI of 15.0 to 18.4
  
• 1.14 for a BMI of 18.5 to 19.9
  
• 1.00 for a BMI of 20.0 to 22.4
  
• 1.13 for a BMI of 25.0 to 29.9*
  
• 1.44 for a BMI of 30.0 to 34.9**
  
• 1.88 for a BMI of 35.0 to 39.9
  
• 2.51 for a BMI of 40.0 to 49.9

* For example, this is a 13% higher risk of death in overweight women.
** And this is a 44% higher risk of death in obese women, etc.

This study found the healthiest BMIs were between 20 and 25.

Note that those who were underweight also died earlier than expected. Any hazard ratio above 1.00 designates increased risk.

Seniors have more of a problem with underweight than other age groups. Since they also have more comorbidities it may have been their age and not their weight working against them. But the authors adjusted for age. Lead study author, Amy Berrington de Gonzalez:

"By combining data on nearly 1.5 million participants from 19 studies we were able to evaluate a wide range of BMI levels and other characteristics that may influence the relationship between excess weight and risk of death.

Smoking and pre-existing illness or disease are strongly associated with the risk of death and with obesity. A paramount aspect of the study was our ability to minimize the impact of these factors by excluding those participants from the analysis."

Here's the Institute of Health's BMI calculator. I can't embed it but clicking it will take you to it.



I'd guess the women in these photos represent BMIs of around 18 or less, underweight according to this scale. What do you think? Both women appear tall. (Left: Angelina Jolie. Right: Carla Bruni.)



Here's a photo of Shakira that looks like a BMI of around 22 or 23, normal weight. I think she's short? 5'1" or 5'2"?



Here's one of Ronald Mike Tyson that I think shows how BMI fails as a dependable anthropometric tool. What do you say his BMI is here?



________

Quitting Smoking Relieves Depression

A new study out of Brown University found that quitting smoking reduces symptoms of depression.¹ From Brown's press release:

"Researchers tracked the symptoms of depression in people who were trying to quit and found that they were never happier than when they were being successful, for however long that was.

The most illustrative — and somewhat tragic — subjects were the ones who only quit temporarily. Their moods were clearly brightest at the checkups when they were abstinent. After going back to smoking, their mood darkened, in some cases to higher levels of sadness than before.

Subjects who never quit remained the unhappiest of all throughout the study.

The ones who quit and stuck with abstinence were the happiest to begin with and remained at the same strong level of happiness throughout.

Looking at the data, [lead author Christopher Kahler] said, it is difficult to believe that smoking serves as an effective way to medicate negative feelings and depression, even if some people report using tobacco for that reason. In fact, he said, the opposite seems more likely — that quitting smoking eases depressive symptoms.

“If they quit smoking their depressive symptoms go down and if they relapse, their mood goes back to where they were,” he said. “An effective antidepressant should look like that.”

________ ¹ Time-Varying Smoking Abstinence Predicts Lower Depressive Symptoms Following Smoking Cessation Treatment, Nicotine & Tobacco Research, November 2010

Judge Orders GMO Beets Be Pulled From The Ground

Jody just sent this:

U.S. Judge Orders Destruction Of Monsanto GMO Sugar Beet Seed Plants, Globe and Mail, December 3 2010

A federal judge in California has ordered the removal from the ground of plants grown to produce seeds for genetically modified sugar beets.

In his decision, Judge White cited, “a significant risk of environmental harm.”

“The likely environmental harm ... is irreparable,” Judge White wrote.

The beet plants were genetically modified by Monsanto to resist their herbicide Roundup. Farmers may use Roundup liberally on Roundup-resistant plants.

Genetically modified seeds accounted for about 95% of sugar beet plantings this year.

Paul Atchitoff, of Earthjustice, an environmental law firm:

"The government's conduct is really outrageous. ... The court had just said in August the beets could not be grown and the government turned around and gave the industry the opportunity to grow them."

George Kimbrell, an attorney for the Centers for Food Safety:

"[Judge White's ruling is] a groundbreaking victory for farmers and the environment. ... This is the first time ever a federal court ordered an illegal biotech crop destroyed."

David Snively, general counsel for Monsanto:

"We believe the court's action overlooked the factual evidence presented that no harm would be caused by these plantings."

Click to enlarge.________Photo from USDA of geneticist Leonard Panella inspecting sugar beet plants.

New 2010 Dietary Reference Intakes For Calcium And Vitamin D

Finally, after more than a decade, we have new DRIs (Dietary Reference Intakes) for vitamin D and calcium - based on an "exhaustive review" of high-quality studies and on testimony from scientists and stakeholders. Cancer, cardiovascular disease, hypertension, diabetes, metabolic syndrome, falls, immune response, neuropsychological functioning, physical performance, preeclampsia, and reproduction were just some of the outcomes studied.

Interesting ... After writing about how high serum levels of vitamin D may be linked to pancreatic cancer last week, this report by the Institute of Medicine (IOM: responsible for setting recommended intake levels) is warning about over-supplementing with vitamin D, as well as calcium:

Dietary Reference Intakes For Calcium And Vitamin D, IOM, November 30, 2010

"Overall, the committee concludes that the majority of Americans and Canadians are receiving adequate amounts of both calcium and vitamin D. Further, there is emerging evidence that too much of these nutrients may be harmful."

So they decided not to raise vitamin D intake levels after all, well, not too much, just a few hundred IUs.


Click to enlarge.

Vitamin D deficiency may be overstated:

"Before a few years ago, tests for vitamin D were conducted infrequently. In recent years, these tests have become more widely used, and confusion has grown among the public about how much vitamin D is necessary. Further, the measurements, or cut-points, of sufficiency and deficiency used by laboratories to report results have not been set based on rigorous scientific studies, and no central authority has determined which cut-points to use. A single individual might be deemed deficient or sufficient, depending on the laboratory where the blood is tested. The number of people with vitamin D deficiency in North America may be overestimated because many laboratories appear to be using cut-points that are much higher than the committee suggests is appropriate."
...
"The committee concludes that once intakes of vitamin D surpass 4,000 IUs per day, the risk for harm begins to increase. Once intakes surpass 2,000 milligrams per day for calcium, the risk for harm also increases."
...
"Kidney stones have been associated with taking too much calcium from dietary supplements. Very high levels of vitamin D (above 10,000 IUs per day) are known to cause kidney and tissue damage."

In the end, according to the IOM, most adults require about 800 mg of calcium and 400 IUs of vitamin D a day (assuming "minimal sun exposure"). I really thought they'd go higher on the vitamin D.
________

Eating Potatoes Lowers Weight, Cholesterol, Blood Glucose

Chris Voigt ended his 20-potatoes-a-day, 60-day experiment last night at midnight:

"I'm the Executive Director of the Washington State Potato Commission. In an effort to remind the public about the nutritional value of potatoes, I am going on a diet consisting of ONLY POTATOES, nothing else. No toppings, no chili, no sour cream, no cheese, no gravy, just potatoes and maybe some seasonings or herbs and a little oil for some of the cooking. I will be on this "potato only" diet for 60 days straight, starting October 1st and ending November 29th. I want to show the world that the potato is so healthy, that you could live off them alone for an extended period of time, without any negative impact to your health. And who knows, maybe it will make me healthier by lowering my blood pressure and cholesterol?"

Lower his cholesterol it did:

Weight:
Pre: 197 lbs
Post: 176 lbs

Cholesterol:
Pre:214 mg/dl
Mid: 162 mg/dl
Post: 147 mg/dl

Fasting Glucose:
Pre: 104 mg/dl
Post: 94 mg/dl

Here's Chris last week celebrating Thanksgiving:


________

Whoosh!

When out on the lawn there arose such a clatter,
We sprang from the couch to see what was the matter.
Away to the window we flew like a flash,
Tore open the shutters, and threw up the sash.



We thought it was going to hit the trees. It finally gained some height. That was right as the sun was setting last night.


________Photo: Bix

Fat Cats ... And Dogs And Monkeys And Mice And...

The human population is growing, in number but humans are getting bigger too. Obesity is epidemic. Is it simply that we eat too much? Or move too little? If the cause is something external - say, artificial light at night, or pollutants in air/water/food, or viruses and bacteria, or epigenetic factors (factors that affect genes without any change in DNA) - then perhaps other animals are experiencing a similar plumping.

This study found they are:

Canaries In The Coal Mine: A Cross-Species Analysis Of The Plurality Of Obesity Epidemics, Proceedings of the Royal Society, November 2010

Klimentidis et al. examined data on 20,000 mammals from 24 populations (12 each male and female) from 8 species. They included cats, dogs, mice, rats, monkeys, chimpanzees - all living with or around humans in the developed world:

"Surprisingly, we find that over the past several decades, average mid-life body weights have risen among primates and rodents living in research colonies, as well as among feral rodents and domestic dogs and cats.

The consistency of these findings among animals living in varying environments, suggests the intriguing possibility that the aetiology of increasing body weight may involve several as-of-yet unidentified and/or poorly understood factors."

All 24 populations they studied experienced weight gain. The researchers calculated that the probability of that occurring by chance was 1 in 12 million.


Click to enlarge.

Here's an unusual finding ... Lab animals gained weight over the last few decades even though they were fed the same amount of food:

"But these factors [he was talking about selective predation of wild rats, and rats eating our highly-caloric refuse] cannot account for the findings in the laboratory animals that are on highly controlled diets, which have varied minimally over the last several decades. These animals are typically fed ad libitum, so if weight increases are attributable to increases in food consumption (which is possible), it is difficult to understand why animals in controlled environments on diets of constant composition are consuming more food today than in past decades."

What's going on?

• He points to endocrine disruptors, chemicals in pesticides, plastics (e.g. bisphenol-A), and fuel, which are widely present in the environment and which have been shown to contribute to obesity. (The Endocrine Society went on record in 2009 saying endocrine disruptors are "a significant concern to public health.")
  
  
• He points to infection with a virus, specifically adenovirus-36 which "leads to obesity in multiple experimental models, and antibodies to AD36 are correlated with obesity in humans."
  
  
• From my reading I know that colonic bacteria populations differ between lean and obese people, the lean have more Bacteroidetes, obese more Firmicutes. Other gut flora could play a role.

Food marketing? You'd be hard pressed to apply that argument to a feral rat. Domesticated dogs on the other hand... And there's this:

"It is also noteworthy that the obesity epidemic has also occurred among children of six months of age and under, an age group for which explanations involving food marketing, less physical education is schools, and more labour-saving devices seem questionable."

What do you think? ________Photo of Powder, a.k.a. Prince Chunk, the cat who was abandoned on the streets of southern New Jersey in 2008 when his owner's home went into foreclosure. Staffers at the Camden County Animal Shelter say he ate normally despite his wide girth. Prince Chunk died yesterday of congestive heart failure. He was 10 years old.
(The cat's new owners set up the Prince Chunk Foundation to help pet owners keep their animals.)

Vitamin D Linked to Pancreatic Cancer

Stopped me in my boots, this one:

Circulating 25-Hydroxyvitamin D and Risk of Pancreatic Cancer, American Journal of Epidemiology, 2010

It found:

"A high 25(OH)D concentration (≥100 nmol/L) was associated with a statistically significant 2-fold increase in pancreatic cancer risk."

Cancer risk was higher in Caucasians and those living at latitudes above 35ºN. Interestingly, "few participants residing at low latitudes had 25(OH)D concentrations greater than 100 nmol/L."

That form of vitamin D, 25(OH)D, is an indicator of vitamin D status in the body. It comes from a blood test. It's not the vitamin D we eat, it's not the vitamin D we make in our skin, and it's not the active form of the vitamin. It's an intermediate that we measure to test for deficiency.

While 100 nmol/L is high, it's not that high:

"The range of 25(OH)D3 levels associated with risk in this study was below that considered to reflect hypervitaminosis D (400-1,250 nmol/L)."

This particular study pooled results of several studies, 8 to be exact. The advantage of this ... it covered more geographical regions, had a larger number of cancer cases, and a wider range of vitamin D concentrations than the individual studies alone. You get a better feel for viable associations.

In one separate study of male Finnish smokers, "prediagnostic serum concentrations greater than 65.5 nmol/L were associated with nearly a 3-fold increased risk of pancreatic cancer."¹ However, you can't generalize those results to women, to men younger than 50, or to populations outside Finland. Although these results are pretty ominous for men over 50 who smoke and who live at higher latitudes.

Mechanism

"The active form of vitamin D might influence growth factors (ref. given) which promote tumor growth (ref. given)."

Active vitamin D is a steroid hormone. It affects a number of other regulators and hormones. Much of its influence has been discovered in only the last few decades. The manner of that influence is still in many cases a mystery.

Why The Pancreas?

The islet cells in the pancreas (if you have diabetes you may know that beta cells, part of the islet cell group, make insulin) make the particular enzyme that turns 25(OH)D3 into its active form 1,25(OH)D3. Not many cells make this enzyme. I know the kidney makes it. I'll have to be on the lookout for studies linking vitamin D to renal cancer.

Conclusion

"Given the present study's pooled results and research gaps in the understanding of vitamin D's role in carcinogenesis, recommendations to increase vitamin D concentrations in healthy persons for cancer prevention seem premature."

________¹ A Prospective Nested Case-Control Study of Vitamin D Status and Pancreatic Cancer Risk in Male Smokers, Cancer Research, 2006

Protection Of Public Health Is A First Responsibility Of Government

Since Sarah Palin is keen on landing the job of supreme public servant, it would do her well to bone up on public health, as it is a primary responsibility of government.

On Wednesday, in an interview with Laura Ingraham, Palin said (referring to Michelle Obama's "Let's Move!" initiative to combat childhood obesity):¹

"Take her anti-obesity thing that she is on. She is on this kick, right. What she is telling us is she cannot trust parents to make decisions for their own children, for their own families in what we should eat.

And I know I'm going to be again criticized for bringing this up, but instead of a government thinking that they need to take over and make decisions for us according to some politician or politician's wife priorities, just leave us alone, get off our back, and allow us as individuals to exercise our own God-given rights to make our own decisions and then our country gets back on the right track."

Let me contrast Palin's assertion - that individual choice is the antidote to the obesity epidemic - with assertions in three recent in-depth publications.

First:

"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, UK Government Office for Science, October, 2007

Second:

"At any population level, ‘business as usual’ will not control or reduce overweight and obesity. This is a public health issue. All public health challenges and opportunities require public support, public money, and public resources, from the public authorities. This means that formally the lead must come from government, and in the case of a global crisis at all levels, from global to international to national to state and province, to municipalities and communities.
...
Protection of public health is a first responsibility of governments at all levels, especially including heads of state and prime ministers. This implies renewed political will. It also implies a new understanding of public health as the first public good, needing adequate and therefore increased human, financial, and other material resources’
...
How can the change come? As with tobacco and alcohol, and indeed other big public health issues, all the evidence shows that the lead has to come from governments.
...
Properly seen, nutrition as practiced is a branch of public health. The health of populations is crucial to the social, economic and other aspects of the welfare of nations. The current pandemic of obesity is a great warning sign that something has gone very wrong with the systems of governance now being operated in the world."

- The Big Issue Is Ultra-Processing, Journal of the World Public Health Nutrition Association, November 2010

Third:

"Governments can increase choice by making new healthy options available, or by making existing ones more accessible and affordable.
...
A survey of national policies in 2007-08 covering all OECD and EU countries shows that governments acknowledge that individuals are often exposed to large amounts of potentially confusing information on health and lifestyles from a variety of sources, and assert that it is primarily their responsibility to act as a balanced and authoritative source of information, thus providing clear guidance to individuals who struggle to cope with increasingly powerful environmental influences.
...
Individual interventions have a relatively limited impact; therefore, comprehensive strategies involving multiple interventions to address a range of determinants are required to reach a “critical mass” – one that can have a meaningful impact on the obesity epidemic by generating fundamental changes in social norms."

- Obesity and the Economics of Prevention: Fit not Fat, 265-page OECD (Organization For Economic Co-Operation And Development) document, September 2010

This last reference noted that a "multi-stakeholder" approach would have the most success. That would involve individuals, government, industry, and citizen groups acting together. Not easy, but not impossible.

If Palin read just these three documents, she would be far-and-away more educated on the topic than her comments reveal she is. You can't tell someone dying of thirst in a desert to just drink more.
________¹ Palin Slams Michelle Obama Again, This Time For Anti-Obesity Campaign, Huffington Post, November 24, 2010

Feeling Thankful

A big thank you to everyone ... for your wisdom, your tolerance, your devotion, your curiosity, your fellowship. Who could ask for more?

Here are some images from this year's National Geographic Photography Contest, compliments of the Boston Globe. You can see all 47 at Boston.com's The Big Picture, or you can see a whole lot more, as well as rate them, at the National Geographic source.

Now that's camouflage. (Click photos to read captions.)


Have you been there?


I want to try thistle pith.


Putting it into perspective.

________Thank you, BL.

Local Food Doesn't Mean Safe Food

Nice opinion piece by Caroline Scott-Thomas this morning:
Local Food Doesn't Mean Safe Food, FoodQualityNews, November 23, 2010

In speaking about the Food Safety Modernization Act S.510, she says:

"The amendment, put forward by Senator Jon Tester (D-MO) would exempt businesses that bring in less than $500,000 a year."

I thought it was less than $500,000 in three years. Still, I agree with her that half a million dollars of revenue seems to be getting away from a cottage industry.

This point she raises about "local" is worth a comment:

"And after some protest that a 400-mile radius was too broad, the definition of ‘local’ in the Tester Amendment was narrowed to 275 miles. Since when was Washington, D.C. (comfortably) local to New York City? Even if it is, where’s the evidence that local, family businesses make safer food?"

What mileage constitutes "local?" Is food miraculously unsullied if it is grown or raised under 250 miles, but suspect over 250? Where does that number come from?

And what if the person buying the "local" product turns around and sells it to someone further away? Is it still "safe?" If not, is it now exempted from being exempted? When does oversight kick in, if at all? This Tester Amendment has added a layer of complexity that doesn't have to be there.

Via Bill Marler:

"It was selling spinach wholesale from a small, organic farm that caused the 2006 spinach outbreak. Twenty-five acres of an organic spinach farm sold to a wholesaler, who sold to a manufacturer. The fecal contamination with E. coli O157:H7 was introduced at the spinach farm and amplified at manufacturer."

Would the supplier of that spinach have qualified for an exemption? (See update.) I don't know ... maybe not. But I can imagine farms springing up designed explicitly to fall within exemption criteria - whose food ends up being consumed beyond that inviolate 250 miles.

Update: My original post incorrectly named Earthbound Organic Farm as the spinach supplier.
________Photo: Life.

42,389,619 Americans Received Food Stamps In August

From:
In US, 14% Rely on Food Stamps, Wall Street Journal, November 4, 2010

"Some 42,389,619 Americans received food stamps in August, a 17% rise from the same time a year ago, according to the U.S. Department of Agriculture, which tracks the data. That number is up 58.5% from August 2007, before the recession began."

On top of that, unemployment benefits expire in 8 days:
Jobless Benefits Bill Fails In House Of Representatives, Politico, November 19, 2010

"The House failed to pass a three-month extension of jobless benefits Thursday. ... Approximately 4 million people could lose benefits."

Who is eating all this organic, artisan food?
________Photo from: Food Stamp Use Soars, and Stigma Fades, New York Times, 2009.
"Stockpiles of food for the needy in the Lebanon Food Pantry in Lebanon, Ohio, where residents can also sign up for food stamps."

Poll: Should Ms. Estrella Be Prevented From Selling Her Cheese?

From:

Small Cheesemaker Defies FDA Over Recall, New York Times, November 18, 2010

The FDA found listeria in some of Ms. Estrella's cheese. They found listeria throughout the building where she makes it. Ms. Estrella "did a vigorous cleaning and renovation." FDA found listeria in her cheese and facility after the cleaning.

Listeria can be deadly for those with compromised immune systems, the very young and the elderly. Pregnant women are about 20 times more likely to become infected with listeria than are other healthy adults. Infection during pregnancy can lead to miscarriage or permanent disability in the newborn.

The FDA asked Ms. Estrella to recall her cheese. She declined. (The FDA does not have the authority to recall.)

What do you think? Should Ms. Estrella continue to sell her cheese? Should society prevent Ms. Estrella from selling her cheese? Should Ms. Estrella's farm and food product be inspected for pathogens at all?

Should Ms. Estrella be prevented from selling her cheese?


________Photo of a cow being milked at Ms. Estrella's farm from NYTs.

Produce Industry Opposes Tester Amendment To Food Safety Bill

The Senate is close to a vote on the Food Safety Modernization Act S. 510. There is debate over an amendment to the bill advanced by Jon Tester of Montana (Tester Amendment). The amendment exempts small businesses from many of the food safety requirements in the bill.

Late yesterday the produce industry came out in opposition to the Tester Amendment:

"Dear Senators:

As the Senate begins final deliberations on S. 510, the FDA Food Safety Modernization Act, we are writing to express our opposition to latest “compromise” on Senator Tester’s amendment to exempt small farms and business operations from basic federal food safety requirements. As organizations representing the vast majority of fresh produce grown and consumed in this country – from small, medium and large-sized farms – the Tester amendment utterly fails to protect consumers by including blanket exemptions from the rest of the bill’s strong safety net, without regard to risk.

We applaud the leadership of the Senate HELP Committee and Senator Durbin who worked hard to construct a bill that embraces a risk based approach to food safety. Providing a framework for developing preventive control standards from farm to table was a fundamental principle of a new food safety structure at FDA and had broad support amongst fresh produce companies across the country. Unfortunately, by incorporating the Tester amendment in the bill, consumers will be left vulnerable to the gaping holes and uneven application of the law created by these exemptions. In addition, it sets an unfortunate precedent for future action on food safety policy by Congress that science and risk based standards can be ignored. And most importantly, this amendment rejects the fundamental purpose of S. 510 that requires FDA to develop standards and set requirements that are based on science and risk.

Comments from Senator Tester and supporters are now making it abundantly clear that their cause is not to argue that small farms pose less risk, but to wage an ideological war against the vast majority of American farmers that seeks to feed 300 million Americans. We are appalled at statements by Senator Tester reported today in the Capital Press that “Small producers are not raising a commodity, but are raising food. Industrial agriculture, he said, takes the people out of the equation."

The consequences of inadequate food safety precautions have no boundaries as to size of operation, geography, nor commodity. The consumer has a right to know that all food that they purchase has been produced, transported and offered for sale under the same food safety requirements. The undersigned produce organizations strongly oppose inclusion of the Tester amendment in S. 510. If this language is included in the bill, we will be forced to oppose final passage of the bill.

Sincerely,

United Fresh Produce Association
American Mushroom Institute
Fresh Produce Association of the Americas
National Potato Council
National Watermelon Association
Produce Marketing Association
U.S. Apple Association
Western Growers
California Citrus Mutual
California Strawberry Commission
California Grape and Tree Fruit League
Florida Fruit and Vegetable Association
Florida Tomato Exchange
Georgia Fruit and Vegetable Growers Association
Idaho Grower-Shipper Associations
Idaho Potato Commission
New York Apple Association
Northwest Horticultural Council
Texas Produce Association
Washington State Potato Commission"

"Small producers are not raising a commodity, but are raising food."
- Tester
(Ouch.)
________
Thanks to Obama Foodorama.

Today Is The 35th Annual Great American Smokeout

Smoking is the leading cause of premature death in the United States.^{1, 2}

Smoking causes heart disease (increases risk up to 4 times).
Smoking causes lung diseases (bronchitis, emphysema).
Smoking causes lung cancer (increases risk 23 times in men, 13 times in women!).
Smoking causes cancer of:

• Blood or bone marrow (leukemia)
  
• Bladder
  
• Cervix
  
• Esophagus
  
• Kidney
  
• Larynx
  
• Oral cavity (mouth)
  
• Pharynx (throat)
  
• Stomach
  
• Uterus

"Causes," not just "is correlated with."

For a causal relationship, "there must be enough scientific evidence that smoking either increases the overall number of cases of the disease or makes the disease occur earlier than it otherwise would."³

The US Surgeon General uses these criteria as a foundation for a causal relationship:

• Do multiple high-quality studies show a consistent association between smoking and disease?
  
• Are the measured effects large enough and statistically strong?
  
• Does the evidence show that smoking occurs before the disease occurs?
  
• Is the relationship between smoking and disease coherent or plausible in terms of known scientific principles, biologic mechanisms, and observed patterns of disease?
  
• Is there a dose-response relationship between smoking and disease?
  
• Is the risk of disease reduced after quitting smoking?

For all my talk of food ... Smoking (and second-hand smoke) is hands-down the most potent modifiable risk factor for disease, disability, and death that we know.
________ ¹ Actual Causes of Death in the United States, 2000, Journal of the American Medical Association, 2004
² CDC, Smoking and Tobacco Use, Health Effects of Cigarette Smoking
³ CDC, Smoking and Tobacco Use, How Do We Conclude That Smoking Is a Cause of Disease?

The Once-In-A-While Diet

I had a client once. He said, "But I only eat a donut once a week!" "I only eat pizza on Friday night!" "I only have a few cookies with the kids after school!" "We go out for fast food just a couple times a month!" Even after I showed him that his "once-in-a-while" eating equated to a diet high in unhealthy fat and refined products, he still couldn't see it. For him, once in a while for everything was okay.


________

Obama Supports Senate Food Safety Modernization Act

From the Administration's OMB yesterday:


________Thanks to Bill Marler.

Food Safety Modernization Act (S 510) Should Become Law

"The FDA Food Safety Modernization Act, S. 510, will be brought to the floor of the U.S. Senate Wednesday for a procedural vote."
- Food Safety News (FSN), Could Food Safety Bill Clear Senate By Weekend?

I hope it passes. Dan Flynn at FSN recaps the bill:

• Increases inspection of both foreign and domestic food processors
  
• Grants FDA mandatory recall authority
  
• Requires joint planning by FDA and USDA (e.g. who is responsible for egg safety? FDA or USDA?)

Unfortunately, opposition to this legislation is coming from members of the food activist community who are claiming that it will force small organic farmers and specialty producers into bankruptcy.

Small farmers won't go out of business. This is a scare tactic. They will manage costs, as they do already, by passing them on to their customers.

People can have any food they want - local, organic, non-GMO, artisan - any food. They just have to pay for it.

It is deplorable that with 1 in 5 Americans receiving food assistance in this country (and those, according to the USDA¹, are only the ones who receive it, not everyone who is eligible), assistance that restricts purchase of organic/artisan/specialty food, we have a contingent that wants to exempt a tiny group of high-end profiteers from sensible food safety legislation.

If trying to get the healthiest food into the hands of more Americans was the intent behind blocking this legislation, I believe a more effective method, one that would boost production and sales of organic and specialty food is to allow food assistance monies (currently around $61 billion/year!) to be used for their purchase. This would increase the market overnight. Why not fight for that instead? I don't see this happening.

It saddens me to think that some food activists care more about their own privileged plate than the plates of millions of less fortunate Americans.

Here's a recent video by food safety activist and attorney Bill Marler discussing infection by E. coli 0157:H7, bacteria whose prevalence in our food supply is growing, owing to modern livestock production practices. This is one reason why food safety legislation is so needed right now, to counter the recent and growing threat from shiga-toxin producing bacteria (which I discussed in 4 parts, starting here), among other food safety threats.


________ ¹ USDA: The Food Assistance Landscape, 2008 Annual Report

Fridge Watcher

shaun sent this:
FridgeWatcher.com

I can't stop looking. I'm such a voyeur. This one is like a lot of little refrigerators in one big one. I wonder if Tupperware has BPA in it:

"This Fridge is from Guang Zhou, China
Hello. My name is Li Jia Yu. I come from Guangzhou, China. I would like to show you my “new fridge” here. It doesn’t mean I bought it recently. It means my fridge is organized well and fresh smell after I got the special service from Tupperware Household Consultant. You can see the totally different effect from before and after pictures. Now I am very satisfied my pretty fridge and kitchen life."

________

Where Your Federal Tax Dollars Go

BL sent this:
Tracking Your Federal Tax Dollars, Wall Street Journal, November 6, 2010

Enlightening. I was surprised at how high, relatively, interest on the national debt was.

Where's the FDA? Oh ... next to last, right below National Parks. So much for food safety.

I thought Food Stamps was high too, relatively, for one discrete program. Which got me thinking. It's really a subsidy, isn't it. It supports the agriculture sector, boosts our economy via (at least) consumer spending, as well as provides food assistance.

It's kind of like ... Say I have $10 of lemonade to sell. My father gives my sister vouchers to buy lemonade, but only my lemonade, which she does gladly. I am happy to be richer because I sold all my stock, my sister is happy to drink my lemonade, my father is happy to see his daughters happy. I can go out and buy more lemons which makes lemon growers happy. They can hire more workers to grow more lemons which reduces unemployment.

Probably lots of programs are like this ... defense spending, health care spending, even international food aid (boosts our agriculture sector, sets up future markets). Government spending is more like an engine for economic growth, than just a hand-out.

Okay, crude, but I'm not an economist. I'm sure there's a lot more to understand.
________

The Stomach As Bioreactor, Fat Oxidation Takes Off In A Chain Reaction

Mike, in the comments in my previous post Rethinking Eggs, talked about cholesterol oxidation which reminded me ... about diets high in fat and cholesterol, and about the oxidation of that dietary fat.

Heating food causes oxidation of the food's fat. But so does the environment of the gut, which is warm and acidic and full of oxidizing chemicals. In fact, lipid peroxidation takes off in a chain reaction there. A number of compounds are formed which have been shown to damage gastrointestinal cells. Some are absorbed and can be detected in plasma where they contribute to artery damage, atherosclerosis, diabetes, arthritis, and certain cancers. These oxidized compounds are especially elevated in blood following a fatty meal.

Some redeeming news ... eating foods that contain polyphenolic compounds, especially at the same time, can decrease products of fat oxidation. Red wine is known to do this, as are vegetables and fruits.*

Here are two studies addressing the wine angle:

The Stomach as a “Bioreactor”: When Red Meat Meets Red Wine, Journal of Agricultural and Food Chemistry, June 2008

A Novel Function Of Red Wine Polyphenols In Humans: Prevention Of Absorption Of Cytotoxic Lipid Peroxidation Products, FASEB Journal, 2008

* Alcohol in wine substantially increases the risk for breast cancer.
________

Rethinking Eggs

I was taken in by the Incredible, Edible Egg.

"There's no reason you can't enjoy them for breakfast every day."
- American Egg Board

Indoctrinated with the risks of egg consumption in my academic years, I resurfaced with the notion that dietary cholesterol in general, and egg consumption in particular, wasn't that bad - its impact on serum cholesterol was minor, its contribution to atherosclerosis and heart disease inconsequential. How did I come to believe that?

This recent commentary in the Canadian Journal of Cardiology tells me I was hoodwinked by the Egg Board's propaganda:
Dietary Cholesterol And Egg Yolks: Not For Patients At Risk Of Vascular Disease, The Canadian Journal of Cardiology, November 2010

Spence et al. says that eggs are not harmless for people at risk for cardiovascular disease (CVD). They say that messages the Egg Board is propagating are based on effects in healthy people - people who would need to be followed for longer periods of time before ill effects became apparent.

However, those very same Egg-Board-quoted studies did find increased CVD risk in people with diabetes:

A Prospective Study Of Egg Consumption And Risk Of Cardiovascular Disease In Men And Women, Journal of the American Medical Association, 1999
"The apparent increased risk of CHD associated with higher egg consumption among diabetic participants warrants further research."

Regular Egg Consumption Does Not Increase The Risk Of Stroke And Cardiovascular Diseases, Medical Science Monitor, 2007
"The increased risk of coronary artery disease associated with higher egg consumption among diabetics warrants further investigations."

Both of the studies above showed a doubling of CVD risk in a non-healthy population (diabetes). The first one also showed that regular egg consumption actually increased the risk for diabetes, as do these two:

Food Intake Patterns Associated With Incident Type 2 Diabetes: The Insulin Resistance Atherosclerosis Study, Diabetes Care, 2009
Finding: Consumption of eggs increased risk for type 2 diabetes.

Egg Consumption And Risk Of Type 2 Diabetes In Men And Women, Diabetes Care, 2009
Finding: Consumption of eggs increased risk for type 2 diabetes.

Here's one that found regular egg consumption doubled mortality:

Egg Consumption In Relation To Cardiovascular Disease And Mortality: The Physicians' Health Study, American Journal of Clinical Nutrition, 2008
"Egg consumption was positively related to mortality, more strongly so in diabetic subjects."
________
The Problem Is...

The problem with eggs, Spence et al. says, is three-fold. Dietary cholesterol:

1. Increases the susceptibility of LDL to oxidation "by 37% in one study and by 39% in another." (Oxidized LDL contributes to the formation of plaque.)
   
2. Increases postprandial lipemia. (Increased triglycerides and other lipid particles.)
   
3. Potentiates the adverse effects of dietary saturated fat. (This is called the "bacon and egg effect" or the "egg and cheese effect." At high cholesterol intake, a high saturated fat diet leads to higher LDL than if you paired the same saturated fat diet to a lower cholesterol intake.)

There's another point Spencer raises, a point that has become apparent in my work with diabetes. Postprandial (after meal) measurements may be more telling than fasting measurements. (In diabetes, you may have a fasting glucose below 100 mg/dl, but your glucose during the day, unbeknownst to you, may rise and stay elevated long enough to cause damage.) Although fasting measurements are still important:

"In people consuming a low cholesterol diet, egg-yolk intake increased fasting serum cholesterol level by 40 mg/dl."

We measure fasting levels because they are less affected by meals; standards can be developed. But what happens after meals is equally important:

"In human subjects, endothelial function is impaired for approximately 4 hours after consumption of a high-fat/high-cholesterol meal."

Function deteriorates in the presence of oxidative stress and inflammation. This is one reason why antioxidants in foods and supplements are beneficial. They can partially mitigate the damage to arteries after a high-fat meal.* That's why it's valuable to study dietary patterns in addition to single nutrients.

Eat a fatty, cholesterol-laden meal every 3 or 4 hours during the day and you may significantly and chronically compromise the function of your arteries.

So, if you're going to keep your cholesterol intake to below 200 mg a day, as recommended by the National Cholesterol Education Program (NCEP) and the American Heart Association (AHA), you'll be hard-pressed to fit eggs into your diet at all ... as one large egg can contain between 215 to 275 mg cholesterol.

For relativity sake:

"The yolk of a large egg provides more than the 210 mg. of cholesterol in a Hardee's Monster Thickburger, which contains two-thirds of a pound of beef, three slices of cheese and four strips of bacon."

* Related post: The Stomach As Bioreactor, Fat Oxidation Takes Off In A Chain Reaction. "Heating food causes oxidation of the food's fat. But so does the environment of the gut, which is warm and acidic and full of oxidizing chemicals."________