Archive for the ‘Health’ Category

Smokeless Smokes

April 13th, 2010

Have you ever seen one of these?

Electronic cigarette

I haven’t ever seen one in real life. But I’d love it if I did start seeing them in real life.

That is an electronic cigarette–a battery powered cartridge that atomizes a small amount of nicotine without producing smoke.

It’s a boon to public health, because unlike traditional cigarettes, electronic cigarettes (or e-cigarettes) do not produce smoke–and therefore eliminate the problem of second-hand smoke.

What’s more, e-cigarettes do not produce any of the carcinogens tobacco produces when it is burned–so they’re safer for the “smoker” as well. The only similarity between the output of e-cigarettes and traditional cigarettes is the presence of nicotine. Nicotine is a legal but controlled stimulant that is similar to caffeine. While nicotine has some slight risks, they are few compared to the enormous risks associated with smoking.

This suggests a great health boon to people who have tried to quit smoking multiple times–but without success. E-cigarettes approximate the look and feel of cigarettes, as well as delivering small doses of nicotine through the incredibly sensitive mucous lining of the mouth–but without the risks to self or others.

There are some who decry these little glowing sticks, convinced that nothing that looks like a cigarette could be positive.

Certainly, I’d never encourage someone to induce nicotine addiction in any form. I don’t want anybody to start smoking–or using smokeless nicotine.

But if switching from cigarettes to these smokeless smokes can protect both the smoker and those around him from cancer? I’m all for it.

How long does it take to bend a bone?

April 5th, 2010

Once a month, I give a nutrition presentation for our church’s children’s group “Rock Solid Kids.”

I’ve presented on the food groups–talking about variety and balance. I’ve presented on grains–and how half the grains should be whole. I’ve presented on fruits and vegetables–and how we should eat all the colors of the rainbow.

This Wednesday, I’ll talk about dairy.

Which means it’s time to talk bones.

For the sake of the kids (and certainly not for my own sake :-P), I purchased two fried chicken drumsticks from SuperSaver to eat for dinner tonight. I carefully ate every scrap of meat off the bones (such sacrifice!) and painstakingly removed all the excess cartilage from the joints.

I placed one bone on my stovetop to dry–and the other, I placed in a saucepan full of vinegar.

Bone in vinegar

Do you remember that experiment? Didn’t you do it when you were in elementary school? You soak a bone in vinegar until the calcium leaches out, leaving a soft, rubbery, bendable bone.

It’s been a long time since I did that experiment–and I can’t remember how long it takes to bend a bone. That’s why I’m heating the vinegar–I figured that’d make the reaction go more rapidly.

But still, I’m impatient. After three hours on the stove, surely my bone should be bendable, right?

But it’s not. Which leaves me with a dilemma. Do I leave the bone on the stove? Do I transfer it into a crockpot? Do I take it off the stove and leave it in a covered jar and trust that it’ll bend by Wednesday? I don’t know.

How long does it take to bend a bone?

Psychosomatic illness

March 18th, 2010

Bodily symptoms
Chest pains
Gasping for breath
as my chest squeezes tight
A dull ache
and occasional
sharp stab
My body acts out
the pain I feel
caused by mental
or emotional disturbances

Life is looking up

November 2nd, 2009

…a friend found my camera–the one I’ve been looking for for over a week. It has dozens of pictures from our ladies retreat on it–and I promised myself I wouldn’t buy another camera until I could afford a digital SLR. Now I won’t have to renege on my promise.
…I managed to get most of this morning’s lab reports graded and handed back today–with only a minimum of student complaints.
…I had a lovely conversation with a former classmate (under- and over-grad) who is now a lecturer in the department

Seasonal Affective Disorder still seems to be kicking my butt. I’m behind in nearly every class–not to mention laundry, cleaning, blogging, reading, bill paying, you name it. But every so often, I can see a glimmer of sunlight that promises that winter is not forever.

Thanks for praying–and please continue when you can. I need to find some time to talk to a medical practitioner about switching my meds–but right now just the thought of scheduling an appointment and discussing all this with a new doctor (since my teaching assistant insurance doesn’t pay for my regular PAs) is overwhelming.

B3,RD: How safe are artificial sweeteners?

October 29th, 2009

I know some of you have been wigging out waiting for this–so I’ll put you out of your misery.

Artificial sweeteners? Safe or the devil’s spawn? It’s a great question that’s racing through the minds of nutrition conscious people everywhere. Dietitians are divided in their thoughts. There’s the “I can’t live without my Diet Pepsi” crowd (many of my nutrition professors in our “Pepsi” school fit into this group), and there’s the “artificial sweeteners are going to be the end of Western civilization as we know it” crowd (although this crowd tends to not mind the end of Western civilization in other contexts).

Because this issue is such a divisive one–and one with so many different opinions–I’m going to give you the facts and my general recommendations, and then let you decide for yourself.

FDA Regulation of Food Additives

First of all, it’s important to be aware of how additives to our food supply (such as artificial sweeteners) are regulated. According to the rules of the 1958 amendment to the Food, Drugs, and Cosmetics Act of 1938, no chemical additive can be used in food if it has been “found to induce cancer in man…or in animals.” This means that, at least as far as cancer is concerned, we’re home free. If additives have been found to cause cancer in humans or in lab animals AT ANY LEVELS of exposure, they may not be used in the American food supply.

Once the additive has been determined to not cause cancer or other genetic changes, experiments are done to determine what levels of the additive are safe. Researchers find the highest “dose” that causes no observable health effects and then decrease that 100 times to determine the “Allowable Daily Intake” or “ADI”.

See the below table nabbed from the Mayo Clinic for more information on the ADIs.

Artificial sweetener ADI* Estimated ADI equivalent** OK for cooking?
Aspartame (NutraSweet, Equal) 50 milligrams (mg) per kilogram (kg) 18 to 19 cans of diet cola No
Saccharin (Sweet’N Low, SugarTwin) 5 mg per kg 9 to 12 packets of sweetener Yes
Acesulfame K (Sunett, Sweet One) 15 mg per kg 30 to 32 cans of diet lemon-lime soda*** Yes
Sucralose (Splenda) 5 mg per kg 6 cans of diet cola*** Yes

*FDA-established acceptable daily intake (ADI) limit per kilogram (2.2 pounds) of body weight.
**Product-consumption equivalent for a person weighing 150 pounds (68 kilograms).
***These products usually contain more than one type of sweetener.

You can see that the ADI limit for a 150 lb individual ranges from 6 to 30 cans of diet soda per day (for the rest of your life). Since ADIs are established at 100x LESS than the highest exposure at which no observable health effects can be noted–the actual “danger level” is somewhere around 600 to 3000 cans worth of diet soda per day. I think it’s safe to say that none of us consume that much artificial sweetener.

So, based on FDA regulations, artificial sweeteners are safe for use at the levels in which they are present in the food system.

The National Cancer Institute on Artificial Sweeteners

According to the National Cancer Institute’s fact sheet on artificial sweeteners, “there is no clear evidence that the artificial sweeteners available commercially in the United States are associated with cancer risk in humans.”

A few studies suggest correlations between artificial sweeteners and cancer risk, but these studies are generally poorly designed. It is unclear whether the vague results of these studies have any applicability. For example, a study suggested that national brain cancer rates rose as a result of the introduction of aspartame. However, the trend in rising rates began 8 years prior to the introduction of aspartame and occurred in a population unlikely to consume aspartame.

The American Dietetic Association (ADA) on Artificial Sweeteners

According to the ADA Evidence Analysis Library (which compiles and evaluates all of the best research on nutritional topics), “Limited research in humans, from peer reviewed journals, supports the safety of non-nutritive sweeteners for the general population. Considering the lack of high quality studies, continuing post-market surveillance of the safety of non-nutritive sweeteners is prudent.”

The phraseology is a bit bulky (that’s what happens when committees write a recommendation), but the gist is as such: “We don’t have a lot of good research in humans, but what we do have says that non-nutritive sweeteners are safe for the general population. However, since there isn’t a lot of good research available, we should continue watching for evidence one way or the other.”

How’s that for equivocation?

My opinion on the safety of artificial sweeteners

My opinion falls somewhere between the FDA’s “of course they’re safe”, the National Cancer Institute’s “all the studies that say they aren’t are flawed,” and ADA’s “we can’t really tell.”

I think that it is safe to believe that artificial sweeteners are unlikely to cause cancer. Because of the restrictions of the 1958 Delaney Clause, the FDA is required to conduct a great deal of research on the carcinogenic properties of potential food additives prior to approving them. The National Cancer Institute concurs that the artificial sweeteners that have been approved by FDA are unlikely to cause cancer.

However, only a limited body of research exists in other non-cancer areas of health. There are big blank holes in the research.

We do know, based on other chemicals, that most substances have dose-dependent responses. Even the best of things, when consumed in excess, can be toxic. Much of the nation was startled to learn of water intoxication in 2002 when Cassandra Killpack died after being force-fed excess quantities of water by her adoptive parents. Even water, the chemical most essential for life, is toxic in large quantities. On the other hand, in low doses, many potential toxic chemicals have little effect.

It makes sense that we should control the DOSES of artificial sweeteners that we consume. If you are close to or above the FDA ADIs, you might consider backing off on the artificial sweeteners.

Also, since children have lower body weights, they are more susceptible to overdosing on anything–so it makes sense to watch children’s intake more carefully. Pregnant and lactating mothers may want to watch their intake more carefully as well, as we do not know what effect any artificial sweeteners might have on rapidly growing babies.

So, my general recommendation, is that artificial sweeteners are likely to be safe when consumed in moderation. As a quick rule of thumb, I would say that if you are consuming more than three servings of foods made with artificial sweeteners (half the ADI for Splenda for a 150 lb individual), you might want to back off. But if you’re consuming less than three servings of artificial sweeteners in a day, the benefit of consuming fewer calories is probably greater than the risk of some unknown health issue.

Your B3,RD challenge for today (although today is nearing its end–sorry folks, this one took longer than I expected) is to calculate up approximately how much artificial sweetener you consume in an average day. Do you top my recommendations? How about the FDA’s?

B3,RD: On Alternative Sweeteners

October 27th, 2009

You see them everywhere in dizzying arrays. Little pink or blue or yellow pouches. The grocery store shelf containing alternative sweeteners is growing larger every year. And diet products are forever announcing that they’re “now made with [insert name of alternative sweetener here]!”

It’s hard for anyone to keep track of all the many sweeteners that are available–which is why I’m going to focus today’s B3,RD post on simply understanding what’s available.

Alternative sweeteners are non-sugar substances that can be used in place of sugar to provide sweetness with fewer calories. They do this one of two ways. Some alternative sweeteners are indigestible or only partly digestible and are passed through the digestive system with only minimal calorie absorption; while others contain the same number of calories per gram as sugar, but are so much sweeter than sugar that much less of them can be used (thereby allowing them to contribute fewer calories to the food item).

The main characters in the first group (that are only partly digestible) are sugar alcohols. These contain somewhere between 1.5 and 3 calories per gram; less than sugar’s 4 calories per gram. Sugar alcohols are often used in hard candy or chewing gum because they do not promote cavities like regular sugar does. In fact, they do the exact opposite and inhibit cavity development. Sugar alcohols include sorbitol, xylitol, isomalt, mannitol, maltilol, and lactilol. Because these products are only partially digested, they can create unpleasant gastrointestinal effects (such as diarrhea and gas) if consumed in large quantities.

In the second group (those alternative sweeteners that are much sweeter than sugar), we have a whole smattering of artificial and “natural” sweeteners. Below is a quick chart with pertinent information about these “non-nutritive sweeteners”.

Common name
(Brand Names)
Times sweeter than sugar Heat stable? Approved by FDA
Acesulfame-K
(Sunnette, Sweet One, Swiss Sweet)
200x Yes 1988
Aspartame
(Nutrasweet, Equal, Natrataste)
160-200x No 1996
Neotame 800-13000x No 2002
Saccharin
(Sweet’n'Low, Sugar Twin)
200-700x Yes 2000
Stevia
(Truvia, PureVia)
300x Yes 2008
Sucralose
(Splenda)
600x Yes 1999

Some of these non-nutritive sweeteners (especially saccharin) have a bitter aftertaste that can be quite unpleasant.

Modest evidence supports the notion that consuming foods made with non-nutritive sweeteners instead of higher calorie foods made with sugars can help individuals cut calories. While some people claim that non-nutritive sweeteners induce people to eat more than they normally would (thus consuming more calories overall), the evidence appears to contradict this statement. Replacing caloric foods and/or beverages with ones made with alternative sweeteners does not cause increases in intake, but rather promotes modest decreases in caloric intake.

SO…if preventing obesity and obesity-related complications is your main health concern, replacing a sugar-loaded snack with a lower-calorie one made with artificial sweeteners is probably a good idea.

Today’s B3,RD challenge only applies if you are generally a consumer of regular soda or sugared gum: Purchase a sugar-free variety of your favorite soda or gum and taste test it to see how you like it. If you like the alternatively-sweetened version, you can save some calories by switching over.

Stay tuned for more information on the safety of artificial sweeteners tomorrow!

How HFCS affects farmers

October 26th, 2009

Davene asked me a great question about this morning’s B3,RD post:

How about the way the HFCS industry affects farmers? I don’t know much about it – something about HFCS affecting the price of corn, and that affecting the price of feed for dairy and beef farms. Just thought I’d pick your brain. :)

I’d like to clarify that I am not an expert in farming or agricultural economics, but I do have some interest in the subject. So, please read judiciously (as you always should, but especially when the speaker/writer is not an expert in the field.)

The United States’ federal government subsidizes corn, making HFCS a less expensive option than sugar for many food processors, which is why many food processors switched from using sugar to using HFCS in the ’70s and ’80s.

Since a majority of American domestic corn use is for animal feeds, anything that increases the demand for corn (without also increasing supply for corn) would increase the price of corn–and thereby, the cost of meat. However, despite the ubiquitous-ness of HFCS in the American diet, HFCS remains a small player in overall demand for corn.

According to an article published in the February 2008 edition of “Amber Waves” (a USDA publication), total demand for HFCS reached a peak in 1999 and has since begun to decline.

The below graph, using data from the USDA on US domestic corn use, further supports my assertion that HFCS is unlikely to be a key player in raising the prices of feed, and therefore meat.

US Domestic Corn Use

This graph indicates that total domestic corn use in the United States has doubled in the past 25 years. Twenty-five years ago (in 1983), almost 81% of all corn used in the United States was used for animal feeds. In 2008, animal feed made up only 51% of all corn used in the United States.

What made the difference? Probably not HFCS. In fact, in the 25 years since 1983, total corn used for food, as seed, or for other industrial purposes (apart from fuel) decreased from 16% to 13% of total corn usage.

In the last 25 years, corn use for feed has multiplied 1.3 times. Corn use for food, seed, and industrial purposes has multiplied 1.7 times. Corn use for fuel (as ethanol), on the other hand, has multiplied 23 times.

Demand for ethanol has increased significantly in the last 5-10 years. According to a USDA briefing on corn, “strong demand for ethanol production has resulted in higher corn prices.” This has then led to the higher meat and dairy prices you may have noted in the last few years.

So, in answer to Davene’s question (and perhaps yours), HFCS is unlikely to be a cause of concern to our farmers–or a cause for higher meat or dairy prices.

(Ethanol, on the other hand–well, that’s opening a whole new can of worms. I personally have my doubts about how environmentally friendly ethanol is–but beyond that, I think it’s foolish to use FOOD to fuel our cars. Wouldn’t it be a lot smarter to use something humans can’t use otherwise?)

B3,RD: Demystifying HFCS

October 26th, 2009

You’ve probably heard warnings about high-fructose corn syrup (HFCS). You’ve heard that HFCS is responsible for the obesity epidemic. You’ve heard that you should go for products made with regular sugar instead.

Perhaps someone has cited studies that link high fructose diets with heart disease. They’ve talked about how fructose doesn’t act the same way as glucose in the body.

They’re right–except that they’re wrong.

High fructose diets are linked with heart disease. And fructose does act differently than glucose. But High Fructose Corn Syrup is not the problem.

There are two types of HFCS: a syrup that is 42% fructose (HFCS-42), and a syrup that is 55% fructose (HFCS-55). HFCS-42 is used in baked goods and non-carbonated drinks, whereas HFCS-55 is used primarily in carbonated drinks.

Table sugar, on the other hand, is 50% fructose. So, depending on which “version” of HFCS you’re talking about, HFCS either has slightly more or slightly less fructose than “regular sugar”.

So a high fructose DIET might cause problems–but high fructose CORN SYRUP is not the culprit (since high fructose corn syrup and sugar contain very similar proportions of fructose.)

Increased sugar intake is the problem, regardless of its source. Americans are consuming more calories than ever, and more and more of those calories are coming from sugar (either HFCS or table sugar). This is contributing to an overall increase in fructose consumption–and an overall increase in calorie consumption.

So, if you want to do what’s best for your health, don’t worry about choosing BETWEEN regular sugar or HFCS. Instead, work on cutting down sugar intake altogether (regardless of the source).

Today’s B3,RD challenge is to avoid the anti-HFCS hype and instead work on choosing a lower-sugar version of your favorite snack or soft-drink (or just eat/drink less of the high-sugar version.)

B3,RD: THE Nutrition Professionals

October 23rd, 2009

Three years ago, when I started my venture to read every book in Eiseley library, I used Pearl Buck’s rules to give myself an out. If, after reading 50 pages of a book, I was not interested in continuing on, I had permission to stop.

After three years and over 1400 books, I am using that rule for the very first time. Because I absolutely cannot stand Oz Garcia’s The Healthy High-Tech Body.

The Healthy High-Tech Body

Garcia’s biography in the back of the book states that he is “one of the best-known nutritionists and health authorities in America.” Problem is, he’s an absolute quack. Sure, he can throw around chemical names like no other and give incomprehensible explanations for why we should follow his recommendations–but the real science behind his recommendations is tenuous at best.

I know this because I’ve devoted the last six years of my life to learning the science of food, nutrition, and health behavior change. But what’s the average consumer to think? If you can’t trust “one of the best-known nutritionists and health authorities in America”, who can you trust?

That’s where the Registered Dietitian comes in. You see, anyone can call themselves a nutritionist–even someone with marginal education and no credentials (for instance, Oz Garcia.)

The designation Registered Dietitian (RD), on the other hand, carries distinct educational and professional requirements. RDs are required to complete a core curriculum in nutrition, food science, and health behavior change from an accredited university. RDs are required to undergo at least 900 hours of supervised practice. RDs are required to pass a Registration Exam and complete at least 75 hours of continuing professional education every five years in order to attain and maintain their credentials. Additionally, RDs are bound by a Professional Code, which, among other things, insists that they provide evidence-based nutrition services.

You wouldn’t go to your next door neighbor–or even Oprah–to get your broken arm set. Your next door neighbor is nice enough–and Oprah is popular enough–but neither have the credentials to set your broken arm. You’ll go to someone who does have the credentials: an MD (Medical Doctor), a PA (Physician Assistant), or a NP (Nurse Practitioner).

Likewise, no matter how nice or how popular a “nutritionist” might be–they don’t have the credentials unless they’ve got an RD behind their name.

So next time you’re looking at an article or a book, or evaluating something someone is saying on the television or online, look for the RD behind the name. Because RDs are THE food and nutrition professionals.

Today’s B3,RD challenge is to think critically about the nutrition information you see and hear today. Ask yourself whether the speaker has the credentials–an RD behind their name.

A search for Garcia’s education and credentials produced only the most tenuous results.

Mr. Garcia is occasionally ascribed a Ph.D, but I have been unable to find any explanation for this designation. He has certainly never listed where he attained his doctorate or what his doctorate is in.

B3,RD: Am I hungry?

October 22nd, 2009

Confession: I, Rebekah Menter, Registered Dietitian, don’t just eat when I’m hungry. Sometimes, I eat because I’m tired, because I’m stressed, or because I’m bored–even though I’m not hungry.

And that’s okay.

I attended a fantastic session at FNCE that dealt with this very issue. Megrette Fletcher, RD and Michelle May, MD spoke on “Improving Self-Management with Mindful Eating.”

Megrette Fletcher Michelle May

Ms. Fletcher and Dr. May had a number of insights for dietitians, but one thing Dr. May said struck me as being worth sharing with my readers. She encouraged us (and our clients) to ask ourselves one question before eating.

Before eating, ask yourself: “Am I hungry?”

Many of you are probably rolling your eyes right now, thinking “I’ve heard this before–Eat only when you’re hungry, stop when you’re full.”

But that isn’t what I said. I said, “Before eating, ask yourself: ‘Am I hungry?’”

The point is not that you only eat when you’re hungry. The point is that you are aware of whether you are hungry or not when you’re eating. The point is KNOWING. The point is being mindful.

Sometimes, we eat because we’re tired, because we’re stressed, or because we’re bored–even though we’re not hungry. But none of us should eat without knowing why we’re eating.

We can talk about when to eat and when not to later. For now, let’s just focus on being aware.

Today’s B3,RD challenge is simply to ask yourself before eating: “Am I hungry?”

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