Healthcare And Individual Responsibility

BL sent this article from the New York Times yesterday. BL knows how to fire me up.

No Matter What, We Pay For Others’ Bad Habits

Who wrote this? Sandeep Jauhar? Major props!

The person in the article who said, "I’m tired of paying for everyone else’s stupidity," doesn't understand that we are already paying for other people's health problems in the form of higher health insurance premiums and higher medical costs.

About that "stupidity" part ... The person who said this also doesn't understand that you can't judge an individual apart from their environment. If what we see is stupidity, it is more a reflection of our country's stupidity, the stupidity of the choices of the population as a whole, than it is the conscious choices of a particular individual. This focus on the individual is simplistic, short-sighted, and deflects responsibility away from the person who thinks it.

Here are excerpts of the article that I whimpered joyfully when I read:

"When people advocate the need for personal accountability, they presuppose more control over health and sickness than really exists."

"Unhealthy habits are one factor in disease, but so are social status, income, family dynamics, education and genetics."

" "It’s the context of people’s lives that determines their health,” said a World Health Organization report on health disparities. “So blaming individuals for poor health or crediting them for good health is inappropriate.” "

"The context of people's lives." Whoever said this gets it. I'll admit, it took years of public health education and working for me to get it. I used to think ... "This person is overweight because they choose to eat too much." Of course I believe that an individual bears responsibility for their health. Of course I do. But I've come to understand that the wider context - a person's social, cultural, economic, religious, political, historical setting is more influential. You cannot ignore these effects.

My favorite analogy is ... if you pluck an overweight someone from a rich suburb in 21st century US and place him in 1960 rural China or in areas of Sudan and Chad right now, he will likely lose weight. Conversely if you move an underweight someone from war-torn Sudan and place him in a rich suburb here, he will likely gain weight. Changes in a person's health - both detrimental and advantageous - when they relocate to places unlike their origins have been documented.

Before you can blame an individual for their choices, you have to make sure they have the same choices as everyone else.

The conversation is ongoing at the NYTs Well blog: Paying For The Bad Habits Of Others
________Photo: Bix

One Worthy Diet

Since I'm mentioning Dr. McDougall's and Dr. Esselstyn's diets ...

I challenge anyone who wants to lower their cholesterol, lower their blood pressure, lower their blood glucose, lose weight, reduce inflammation, et al., to try their eating style.* For those who follow it exclusively, I've never seen it fail.¹

Here's Dr. Esselstyn's book. Lots of positive feedback in the comments.

From Esselstyn's website:

"The patients in Dr. Esselstyn’s initial study came to him with advanced coronary artery disease. ... The 17 patients in the study had 49 cardiac events in the years leading up to the study, and had undergone aggressive treatment procedures. Several had multiple bypass operations. After beginning the eating plan, there were no more cardiac events in the group within a 12-year period.

After 5 years on Dr. Esselstyn’s plant-based diet, the average total cholesterol levels of his research group dropped from 246 milligrams per deciliter to 137 mg/dL This is the most profound drop in cholesterol ever documented in the medical literature in a study of this type."

* Fat-free, plant-based (vegan) diet. Excludes all meat, fish, eggs, and dairy - cheese, yogurt, butter, etc. It's not a typical vegan diet since it excludes added fat/oil and there are no packaged/processed foods, e.g. foods made from flour (bread). It is essentially a diet of whole grains, beans, vegetables, and fruits.
________ ¹ I don't believe this is necessarily the best diet for all people, in all age groups and circumstances. Long-term vegan diets have shortcomings. But as a means to lower weight, lipids, BG, BP, and risk for chronic diseases, it's exceptional.

Bill Hale Was Diagnosed With Prostate Cancer

... So he changed his diet.

I like his straightforward speaking. Not embellished. Simple and believable. I'm also impressed, as I usually am, by people who make drastic dietary changes later in life, by choice.



Since I saw this at T. Colin Campbell's site, I suspect the diet Mr. Hale was following was similar to what Drs. McDougall and Esselstyn promote - a fat-free, plant-based (vegan) diet. It excludes all meat, fish, eggs, and dairy - cheese, yogurt, butter, etc. There is no added fat or oil. There are no packaged, processed foods. It is essentially a diet of whole grains, beans, vegetables, and fruits.

Note that he said he ate a lot of cheese. In previous posts I noted that a 2001 Harvard review of the body of evidence at that time on dairy intake and prostate cancer found:

"[Consumption of dairy products] is one of the most consistent dietary predictors for prostate cancer in the published literature."

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Eating Organic Isn't The Answer

How to avoid eating food grown in sewage sludge? Eating organic is not an option for most people. Simply, there isn't enough to go around.

The USDA says organic farmland makes up less than 1% of total farmland and grazeland in the US.^1,2

Telling people to eat organic is like telling 100 people at the bottom of a well that they can all get out safely if they grab onto the rope ... except there's only one rope and it can only hold one person.

It's not true that everyone can be saved if they would just eat organic food, as much as it comforts people to say that. Ropes, and organic food, are only for a privileged few.

The more realistic choice is to stop spreading sludge on cropland - to clean up the land that produces the food most of us eat. Even Michelle Obama's supposed organic garden is contaminated by high levels of lead owing to the spreading of sewage sludge (euphemistically packaged as organic fertilizer, such as Orgro®) from a nearby wastewater treatment plant.

The Netherlands and Switzerland ban the use of sludge on farmland. Food companies Heinz and Del Monte won't accept produce grown on sludge-treated land. Banning sludge on farmland is the right thing to do.
________¹ USDA: Farms And Land In Farms (932 million acres)
² USDA: New USDA Data Offers In-Depth Look At Organic Farming (4 million acres)

ComPRO® and Orgro® are made from sewage sludge.

Sewage Sludge Is Not Soil

This sludge story is something else.

Sludge is the muddy material left over from treating everything that goes down a sewer. It consists of human excrement mixed with prescription drugs, solvents, cosmetics, heavy metals, pesticides, plastics, and thousands of industrial chemicals.

Prior to the 1970s, the EPA considered sewage sludge "hazardous waste." Prior to the 1970s, most of our food wasn't grown in it.

But in the 1970s, when the EPA acknowledged that treatment plants "would be generating 10 million tons of sludge per year, a thought that 'gives us all a massive environmental headache,' " they OK'd its use as a "soil conditioner."

"As budget concerns mounted in the late 1970s, the EPA began to pressure sewage plants to adopt the cheapest method available [for disposal]--spreading sludge on farm fields."
- SourceWatch

Here's an excellent documentary on waste and the consequences of spreading sludge on farmland by the National Film Board of Canada. (It's available on DVD, but I've embedded the entire 52 minute film below for free. Double-click along the time bar to skip through it.)

That alternative in the end, the composting toilets, I don't know about that. Do you think it would take off?

Crapshoot: The Gamble with Our Wastes
Jeff McKay, 2003


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China's Pollution Is Our Pollution

A friend of mine sent this link:
Amazing Pictures, Pollution In China

Another friend said of it:

"We’ve just moved our polluting ways to another country. We let other countries manufacture products cheaply and buy them up.

In the past we were just as bad. The Cuyahoga River in Ohio caught fire a number of times. It was known as the river that "oozes rather than flows" and in which a person "does not drown but decays." Do you think the US would consider sanctions against China to clean up? Not bloody likely."

He makes a good point.

The photos in this link are chilling. What further impressed me was how recent they were. Many are from just last year.

Here's a photo of our Cuyahoga River on fire, from the EPA's site. This photo was taken on November 3, 1952. When asked why there were no photos of the famous 1969 Cuyahoga fire, the EPA said:

"Rivers catching fire was not that rare an occurrence in the United States in the 20th century. (Chicago River, IL (1899), Passaic River, NY (1918), Buffalo River, NY (1968))."

Sewage, industrial and agricultural waste, water and air pollution ... these are becoming an increasing problem as more people populate the planet, and as more nations become developed.

I'm reading "The Post-American World" by Fareed Zakaria. He discusses the explosive growth in developing countries such as India and China, ofttimes at the expense of the environment. Here's an excerpt:

"Demand for electricity is projected to rise over 4% a year for decades. And that electricity will come mostly from the dirtiest fuel available -- coal. Coal is cheap and plentiful, so the world relies on it to produce most of its electricity.

To understand the impact on global warming, consider this fact. Between 2006 and 2012, China and India will build 800 new coal-fired power plants -- with combined CO₂ emissions five times the total savings of the Kyoto accords."

As developing nations grow more powerful and globally influential, it becomes challenging to find agreement on global issues such as how to cope with Iran's nuclear ambitions and how to protect the environment. This was evident at the global warming talks in Copenhagen a few months ago, where Chinese officials resisted even meeting with Obama and Sectretary of State Clinton.

But agreement we will have to find because the world is no longer a collection of local, isolated societies. (e.g. The FDA's 2007 Food Protection Plan stated that 60% of our fresh fruits and vegetables were imported. Only 1% were inspected.)
________Caption accompanying top photograph: "A Large amount of the chemical wastewater discharged into Yangtze River from Zhenjiang Titanium mill every day. Less than 1,000 meters away downstream is where the water department of Danyang City gets its water from. June 10, 2009"

The Impala And The Spider

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Kucinich Vs. Nader On Healthcare

I was surprised to see Dennis Kucinich vote for the healthcare bill. Here's his rationale:

And from Democracy Now:
Dennis Kucinich and Ralph Nader: A Discussion on Healthcare, Politics and Reform


Kucinich:

"I want to see this as a step. It’s not the step that I wanted to take, but a step so that after it passes, we can continue the discussion about comprehensive healthcare reform."

"But this [bill] is about a for-profit system, something I don’t endorse."

Nader:

"What we’re seeing here is a legislation that doesn’t even kick in until 2014. ... That means that there will be 180,000 Americans who will die between now and 2014 before any coverage expands, and hundreds of thousands of injuries and illnesses untreated."

"This bill does not provide universal, comprehensive or affordable care to the American people. It shovels hundreds and billions of dollars of taxpayer money into the worst corporations who’ve created this problem: the Aetnas, the CIGNAs, the health insurance companies. And it doesn’t require many contractual accountabilities for people who are denied healthcare in this continuing pay-or-die system that is the disgrace of the Western world."

"For the drug companies, it’s a bonanza."

Kucinich:

"Now, Ralph Nader, who is someone who I respect greatly, is right when he says that we need to continue to move forward with a single-payer movement. That’s what I want. That’s been what I’ve worked my politic—almost my entire political life towards."

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"This Is What Change Looks Like" - Obama

Some things I'm happy to see in the Health Care Bill that passed in the House last night:

• The eventual closing of the gap, known as the donut hole, in the Medicare Prescription Drug Plan benefit. (The Plan was signed into law by President Bush in 2003.) This was heartless.
  
• No more lifetime limits on coverage.
  
• No cutting off coverage for people who get sick.
  
• Increased payments to providers from Medicaid.
  
• Less discrimination for pre-existing conditions. I don't really understand this one, though. It looks like insurance companies can still refuse to cover someone, causing that someone to have to buy special coverage through a high-risk program. Murky.

I hope these changes become law.

Obama speaking after the vote:

"So this isn’t radical reform. But it is major reform. This legislation will not fix everything that ails our health care system. But it moves us decisively in the right direction. This is what change looks like."

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No Bent Trees

Nicholas Kristof's recent column describes the experience of his former neighbor, Jan, whose health insurance company dropped her when she was diagnosed with stomach cancer. They stopped paying her bills because she developed a "chronic condition," which they defined as:

"Chronic means a medical condition which has at least one of the following characteristics: has no known cure; is likely to recur; requires palliative treatment; needs prolonged monitoring/treatment; is permanent; requires specialist training/rehabilitation; is caused by changes to the body that cannot be reversed."

"Changes to the body that cannot be reversed." Every day I have changes to my body that cannot be reversed. I don't get it ... they'll insure me if I stop growing?
________Photo: Bix

Sharing To Survive

Below is an excerpt from "An Edible History of Humanity" by Tom Standage. He was quoting Elizabeth Marshall Thomas from her book, "The Harmless People." The harmless people were the !Kung Bushmen from Africa's Kalahari Desert. Mrs. Thomas was writing from her experiences during several expeditions to the Kalahari in the early 1950s.

"A Bushman will go to any lengths to avoid making other Bushmen jealous of him, and for this reason the few possessions that Bushmen have are constantly circling among the members of their groups. No one cares to keep a particularly good knife too long, even though he may want it desperately, because he will become the object of envy; as he sits by himself polishing a fine edge on the blade he will hear the soft voices of the other men in his band saying: "Look at him there, admiring his knife while we have nothing." Soon somebody will ask him for his knife, for everybody would like to have it, and he will give it away.

Their culture insists that they share with each other, and it has never happened that a Bushman failed to share objects, food, or water with the other members of his band, for without very rigid cooperation Bushmen could not survive the famines and droughts that the Kalahari offers them."

________Photo of !Kung Bushman by John Marshall, Mrs. Thomas' brother. Marshall began his successful filmmaking career photographing the inhabitants of the Kalahari Desert over 50 years ago.

"The Entire Nation Regularly Consumes Foods Grown On Fields Fertilized With Sludge" - Jill Richardson

As Barry Estabrook wrote about here:
Sludge Fest: Center For Food Safety Vs. San Francisco. It’s A Battle That May Be Coming Soon To A City Near You, Politics of the Plate, November 2009

And Jill Richardson wrote about here:
Outrage in San Francisco: City Gives Residents 'Organic' Compost Containing Toxic Sewage Sludge, AlterNet, March 2010

Sludge, the end product of the treatment process for human waste, hospital waste, industrial waste and stormwater, is being spread on agricultural land as fertilizer to the possible detriment of our health. In this case, and in others, it is being sold as "organic." But, as Richardson writes:

"SFPUC [San Francisco Public Utilities Commission, who is giving the sludge away free to homeowners, community and school gardens] also defended its usage of the word "organic," claiming its use of the term "referred to the scientific definition of organic matter as in containing significant amounts of organic carbon" and never meant that the compost was certified organic by the United States Department of Agriculture (USDA). Use of the word "organic" was particularly misleading because the USDA's organic standards strictly forbid the application of any sewage sludge on land used to grow organic crops."

Whether you call it "sludge" or "organic biosolids compost", "hazardous waste" (which Richardson says the EPA called sludge prior to 1992) or "fertilizer", it still, according to the Center for Food Safety, contains "toxic chemicals and hazardous materials." Says Estabrook:

"According to a report released this year by the Environmental Protection Agency (EPA), sludge has been found to contain heavy metals, pharmaceuticals, PCBs, flame retardants, and endocrine disruptors -- pretty much anything that humans living and working in a large metropolitan area flush down their toilets or pour down their drains."

And those toxins are finding their way into our food (as we saw with E. coli in my previous post). Writes Richardson:

"Thallium, a rat poison toxic to humans even in small doses, went from the sludge, to the crops, to the cows, all the way to milk on grocery store shelves. ... In the EPA's recent tests, 80 out of 84 samples of sewage sludge tested positive for thallium."

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It's time to find another use for sewage sludge. Or at least label our food as being grown in sludge:

H.R. 185: Sewage Sludge in Food Production Consumer Notification Act, 111th Congress

"To amend the Food, Drug, and Cosmetic Act and the egg, meat, and poultry inspection laws to ensure that consumers receive notification regarding food products produced from crops, livestock, or poultry raised on land on which sewage sludge was applied."

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When E. coli On Produce Cannot Be Washed Off

No matter how much care food processors take to prevent bacterial contamination of produce, if the water and soil in which the plant is grown is contaminated, the plant may be too ... inside.

Here are two studies that demonstrate:

1. Association Of Escherichia coli O157:H7 With Preharvest Leaf Lettuce Upon Exposure To Contaminated Irrigation Water, Journal of Food Protection, January, 2002

Researchers added E. coli to the growing medium (soil or hydroponics) of lettuce. The bacteria adhered to the plants' roots allowing internalization through roots, stomata, cuts, or bruises.

"These data suggest that preharvest crop contamination via contaminated irrigation water can occur through plant roots."

2. Interaction Of Escherichia coli With Growing Salad Spinach Plants, Journal of Food Protection, October, 2003

Researchers inoculated spinach seeds with E. coli, grew them in soil, and found E. coli on the leaf surfaces and roots 42 days later:

"E. coli was recovered from the external surfaces of spinach roots and leaves as well as from surfacesterilized roots."

Researchers also grew 20-day old plants hydroponically in an E. coli-infused medium. They found E. coli associated with the roots after harvest, even after surface sterilization, "indicating that it had been internalized."

A positive finding...

Seedlings grown in soil inoculated with E. coli (opposed to hydroponically) resisted uptake of the bacteria. Authors speculated:

"Competitive microflora in soil may have restricted root colonization by E. coli."

So - organic or locally grown, thoroughly washed after harvest - these should not instill peace of mind if the water, soil, and fertilizers (e.g. manure) used to grow produce are themselves contaminated. And in the case of E. coli O157:H7, you only need about 10 bacterium to infect and cause illness. (See 100,000 Fit On A Pin Head; Only 10 Needed To Kill.)

________Photo of a local farm in Maryland by Dylan Slagle of the Carroll County Times. Caption:

"Organic liquid fertilizer recovered from poultry production is applied by injection to a grainfield on the Snader farm in Marstan July 15 [2009]."

The backstory on this particular farm is contentious and shines a light on the problem of what to do with the rising tide of excrement originating from the rising tide of livestock farms that supply the rising tide of humans their rising demand for meat.

It Says So On The Label

Sodium:

• Campbell's Tomato Soup labeled "25% Less Sodium" has 480 mg sodium per serving.
  
• Campbell's regular Tomato Soup has 480 mg sodium per serving.

"So they both have the same amount of sodium even though this one has 25% less." - Shopper

Fat:

• Campbell's Healthy Request Tomato Soup labeled "Low in fat" has 1.5 grams fat per serving.
  
• Campbell's regular Tomato Soup not labeled "Low in fat" has 0 grams fat per serving.

(15 second ad in the beginning.)
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Intestinal Contractions

I've been hearing more lately about problems with defecation ... either sluggish bowels/constipation or overactive/irritable bowels.

If you're experiencing a problem, here's a simple experiment you can try. I learned this in school years ago. It's based on the gastrocolic reflex. This reflex causes us to feel the urge to go.

An underactive reflex leads to constipation. An overactive reflex leads to spastic colon or any the symptoms of irritable bowel syndrome (bloating, gas, cramping, diarrhea).

• If you're experiencing sluggish bowel, add some fat to your diet.
  
• If you're experiencing overactive bowel, remove fat from your diet.

Fat in the diet stimulates the gastrocolic reflex. Any fat does this - butter, avocadoes, French fries, olive oil, chicken skin, nuts, fish oil, whipped cream, and that tried-and-true constipation remedy ... mineral oil.
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Salmonella Found In Common Food Ingredient

That ingredient is hydrolyzed vegetable protein (HVP). It's everywhere - soups, stews, sauces, gravies, dressings, frozen dinners, cheese, hotdogs, dips, seasoned snacks, dressings. This recall could get big.

As we know, the FDA does not have recall authority. Manufacturers recall voluntarily.

• Large-Scale Recall Looms Due To Salmonella-Tainted Flavor Enhancer, FoodQualityNews.com
  
• Salmonella Found In Food Additive Sparks Recall, Los Angeles Times
  
• FDA List of recalled foods
  
• Canada's Food Inspection Agency's List of recalled foods

I don't know if food manufacturers carry insurance against recalls, but given the changes in quantity food production and sourcing in the last decade (and the globalization of the food market), I wouldn't go into a food business without it.

________Photo from bk_minhas' Flickr Photostream. Trader Joe's Organic Creamy Ranch Dressing and Dip is part of the recall.

Bites

High levels of PCBs found in popular fish oil pills. Manufacturers sued for not disclosing. TwinLab, Nature Made, Now Foods, Solgar, GNC? Oh, boy. San Jose Mercury News, Lawsuit FAQ (Due to PCB's toxicity and ability to persist in the environment, Congress banned its production in 1979. One reason it persists is because it's fat-soluble. That's a reason it persists in our bodies too.)

Cheap cousin of aspirin, salsalate, lowers blood sugar in diabetes. It's not (so much) the fat, it's the inflammation. Chicago Sun-Times (I write about this for work. Nice to see it in the news.)

"If there were a medication you could take that would reduce stress, lower your blood pressure, reduce anxiety, increase your ability to focus, prevent disease and improve your quality of life would you take it? Well, there is no such drug, but research shows that meditation can help all of those things." - Mayo Clinic (I don't think you need an iPhone app. Did it really require 4 years of research to come up with it? Vivien Williams ... that voice! Still, meditation is a highly effective, under-appreciated, under-prescribed, cheap tool in the healthcare arsenal. Do you meditate?)

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