Archive for August, 2008

Health benefits of mushrooms

August 22, 2008

A Johns Hopkins researcher reports that substituting mushrooms for meat may be an effective way to lower calorie intake and increase nutritional value. The study, by researcher Lawrence Cheskin, MD, was funded by the Mushroom Council.  I’ll bet you didn’t know there was a mushroom council; I didn’t.

Here is a summary of the study provided by Medical News Today:

Study Shows The Power Of Energy Density In Mushrooms

8/18/08

Preliminary research, led by Dr. Lawrence Cheskin, MD, Director of John Hopkins Weight Management Center, suggests increasing intake of low-energy density foods, specifically mushrooms, in place of high-energy-density foods, like lean ground beef, is a strategy for preventing or treating obesity. This is good news for the more than one-third of U.S. adults age 20 and older who are obese, according to the Center for Disease Control. Obesity is a risk factor for cardiovascular disease, certain types of cancer, and type 2 diabetes.

In the study led by Dr. Cheskin, and funded by the Mushroom Council, study participants were randomly chosen to receive either beef or mushroom lunch entrées over four days – lasagna, napoleon, sloppy Joe and chili. Subjects then switched entrées to consume the other ingredient (mushroom or beef) the following week.1

Energy (calorie) intakes were significantly higher during meat meals than mushroom meals, a difference that averaged 420 more calories and 30 more fat grams per day over the four-day test period. Subjects’ ratings for palatability (meal appeal), appetite, satiation (after meal fullness) and satiety (general fullness) did not differ between groups.

“The most intriguing finding was that subjects seemed to accept mushrooms as a palatable and suitable culinary substitute for meat,” said Dr. Cheskin. “They didn’t compensate for the lower calorie mushroom meal by eating more food later in the day.”

The preliminary findings of Cheskin’s team follow findings from other initial data that suggested if men substituted a 4-ounce Portabella mushroom for a 4-ounce grilled hamburger every time they ate a grilled hamburger over the course of a year, and didn’t change anything else, they could save more than 18,000 calories and nearly 3,000 grams of fat.3 That’s the equivalent of 5.3 pounds or 30 sticks of butter. More research is needed to further understand mushrooms’ role in weight management as a low-energy density food.

More Health Benefits of Mushrooms

In addition, mushrooms4 may be nature’s hidden treasure for vitamin D, a nutrient many Americans do not get enough of for the required daily intake.5-7 Mushrooms are the only fresh vegetable or fruit with 4 percent of the daily value of Vitamin D per serving4 and preliminary research suggests that a standard serving of mushrooms can provide up to 100 percent of the daily value of vitamin D after just five minutes of contact with sunlight.8,9

A serving of four-five white button mushrooms has 20 calories and no fat, saturated fat or cholesterol but is nutrient-rich. In fact, mushrooms are also the leading source of the antioxidant selenium in the fruit and vegetable category and a good source of the B vitamins riboflavin, niacin and pantothenic acid, which help break down proteins, fats and carbohydrates. Toss in a handful of delicious, nutrient-dense mushrooms into your favorite dish.

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Three short videos to make your day

August 18, 2008

These 3 videos are well worth watching (and brief: 1 min, 4.5 min, and 4.5 min).

[note: If you have a good internet connection and a wide screen monitor, be sure to watch them in full-screen mode (click on the icon in the lower right corner of the video frame on the website).]

  1. If your life is like this,
  2. take a deep breath, and watch this.
  3. Then go out and do this (or one of these affordable versions: here and here and here).

Let me know what you think!

Give up a car? Get a bike? Maybe.

August 13, 2008

After decades of being a two-car family, my wife and I recently gave up one of them and bought two bikes. Now, don’t think we are being heroic — we are both retired and live in a very convenient in-town neighborhood. We can walk or bike to many stores and restaurants and friends’ houses, and the climate here is pretty good. Still, it is very nice not paying for insurance, taxes, upkeep and depreciation on the car we gave up. We definitely are driving less than we used to, and I go days at a time without driving (my wife often takes the car on out-of-town trips to visit family, and at those times I am completely car-free).

A huge bonus is that we have found we love cycling around town, and I went in with a friend who has an SUV to buy a very good bike rack, so we can sometimes take the bikes to other places for a change in scenery.

To really see what is possible (and difficult) when you become car-free, check out this blog.

If you have found a way to cut down on driving, and increased your use of more healthy forms of transportation (for you and the planet), let us know.

The stigma of not owning a pet

August 12, 2008

I confess, I don’t have a pet in my house. Increasingly, I feel I have to defend myself for my non-pet status, or at least fend off well-meaning friends and relatives who clearly believe I am deprived (at best) or depraved (at worst). People assume, because I don’t want a dog, that I “don’t like dogs.”

I love animals, and have had pets (dogs and cats) most of my life, but when our last cat died a few years ago, I vowed to go pet free for the indefinite future. My wife is ambivalent about this, and would love to have a dog or cat, until her emotions calm down and she reasons it out. We are extremely busy, love to travel, and don’t have good outdoor space for a dog. But more and more people we know are getting dogs, and apparently feel it is their duty to convince us to get one, too (cat-owners seem less interested in spreading the joy). We tell them that as soon as I die  my wife will get a dog (on the way home from the Emergency Room, she says), and we have named him or her “Skippy.”

Pets (“animal companions”) do seem to provide people with some health benefits (dogs, for example, take us for walks), and they are great for lonely people and people who like being a caregiver. I am not denying they can be a lot of fun.  Now, 39% of U.S. households own at least one dog (of those, 37% own more than one), and we in the U.S. spend over $43 billion a year on our pets (up from $23 billion in 1998). The average dog-owning household spends $1425 annually (estimated) on food, boarding, vet care, toys, etc. (the comparable figure for cat-owners is $990). See these sites (here and here) for statistical information.

I am interested in what you think. If you have a dog, do you want others to, also? If you are not a pet owner, do you ever feel defensive because of it?

Coping with loss

August 4, 2008

A close family member is dying. She is 87 years old, has inoperable cancer, is in hospice care at home, and is fully alert and aware. She made the decision to reject any active treatment that would prolong her life (such as IV fluids, transfusions) and has bravely provided her many friends and family members the opportunity to tell her “Goodbye” and whatever else is on their minds. The fist thing she said to me when I visited her a few weeks ago was, “I’ve accepted it; I don’t like it, but I have no choice.” Her accepting attitude, and calm and upbeat demeanor, has allowed me and many others to talk openly with her about her life, her death, and things we have put off saying.  Mostly, the conversations have been completely ordinary, including the usual amount of laughter and humor. Many tears have been shed, but I think all would agree that she has provided us with a rare and valuable experience.

The recent death of Randy Pausch (author of The Last Lecture) has sparked interest in talking about life and dreams with someone who is dying.  Here is a talk (10 minutes) he gave shortly before his death. This kind of openness is a welcome change from the days when terminal illness and death were taboo subjects. When my grandmother died of cancer 40 years ago, I remember how the family never mentioned cancer or death, and all of the conversations with my grandmother were stilted and superficial, because we didn’t want to “upset” her. I was a medical student at the time and begged my parents and aunts to talk openly with her, but they refused.

All of us, especially if we live long enough, experience loss — of friends, family, pets, dreams, situations, things. The loss may be from death, but may be from some other form of separation or change. It is my belief that how we cope with these losses determines to a great extent how we cope with life. I also believe that our grieving these losses is cumulative, and that how we “resolve” each one affects how we cope with the following ones. The overused metaphor that occurs to me is an onion, with its concentric layers.

There are many dimensions to coping with loss, and a huge variation within us and between us in how well each loss gets resolved before we experience the next one. Some of us are lucky, having fewer losses, or at least having them spaced out in manageable portions. Others are extremely unlucky, having major losses when we are least prepared, or having multiple losses at one time.

Here are some of the factors which determine the extent to which a loss gets “resolved:”

  • We grieve the loss and, depending on the circumstances and culture, go through a period of formal or informal mourning.
  • We acknowledge and think about our ambivalence about the person or thing which we lost. The more conflicted the relationship, and the more ambivalent we are towards the lost person or object, the harder it may be to get resolution. This may require years of introspective work and even the help of a therapist.
  • We free ourselves from guilt and self-reproach surrounding the lost person. This, too, may require much effort and the help of a therapist.
  • We forgive our self (and, if possible, the lost one).
  • We retain a positive image of the lost person or at least of the lessons learned from our exposure to the person and how they were lost. Recent research shows that this is a double-edged sword; some people cannot let go of their attachment to the lost person enough to move on with their lives.
  • For some, it helps to have faith in an afterlife, or a “better place” where we might even reunite with the lost person in the future (although, with some losses, we may wish to never see the person again).
  • The most important “rule” for coping with loss is that there are no set rules or patterns and that each person and each loss is unique. For example, you may or may not feel like crying, and it does no good to berate yourself for crying too much or too little.
  • In many situations involving loss there is an opportunity for anticipatory grieving, as there is in the personal example I opened this post with. When we have time and opportunity to cope with loss before the person actually leaves, we may do a lot of the “work” of grieving in advance.
  • A loss may trigger, or activate, unresolved feelings of grief from one or more previous losses. This provides a challenge, but also an opportunity to “work through” psychological issues. Even if an earlier loss was appropriately grieved and resolved at the time, as we age and develop psychologically the earlier loss may acquire new meaning and significance, so re-grieving it is not a sign of illness or weakness.
  • We experience loss and grief in conjunction with others (family, friends, co-workers, etc.) so there is a communal dimension to our grief. How one person in a connected group grieves affects the grief process of the others. Spouses, for example, may grieve the loss of a child in different ways and that can lead to marital stress. Siblings may grieve differently when they lose a parent, and should be aware that old rivalries and jealousies may get reactivated. Also, having emotional and material support from other people makes a huge difference in our own grieving and can be life-saving.
  • Times of loss and grieving can increase any tendencies we have to “indulge” in unhealthy behaviors (e.g., overeating or over drinking). We may have to be especially careful to limit the long-term damage that would result.
  • Ultimately, accepting the loss(es) and moving on with your life is considered a healthy outcome, though in many circumstances one never fully “gets over it.”

I have experienced a lot of personal loss in my 65 years (grandparents, parents, parents-in-law, sister, brothers-in-law, nephew, spouse, friends, pets, etc.) and for me there has been a learning process. I grieve differently now than I did when I was in my 20s, 30s, 40s and 50s. I am not sure I am any better at finding resolution, but I know what to expect of myself, and that is somewhat comforting.

The power (and controversy) of self-change

August 4, 2008

I have written before (here) about self-change and its relevance for adopting a healthy lifestyle. This recent article in Scientific American Mind summarizes the issues (and controversy) quite well. In case the link to the article goes away, here is the article:

Do-It-Yourself Addiction Cures?

Former drug and alcohol users can show impressive results without professional treatment, through the phenomenon of self-change

By Hal Arkowitz and Scott O. Lilienfeld

July 31, 2008

“To cease smoking is the easiest thing I ever did. I ought to know because I’ve done it a thousand times.”—Mark Twain

Samuel Clemens (Twain was his nom de plume) humorously mocked his inability to end his nicotine-fueled habit. But he might have gone for Quitting Round 1,001 had he had the benefit of recent research.

In 1982 Stanley Schachter, an eminent social psychologist then at Columbia University, unleashed a storm of con­troversy in the addic­tions field by publi­shing an article showing that most for­mer smokers and overweight people he interviewed had changed successfully without treat­ment. He also cited a study that repor­ted even higher rates of recovery among heroin users without treatment.

A particularly controversial finding was that the success rates of his so-called self-changers were actually greater than those of patients who underwent professional treatment. Schachter discussed two possible explanations. First, treatment seekers may be more severely addicted than self-changers. Second, studies typically examine only one change endeavor, whereas his interviews covered a lifetime of efforts. Perhaps it takes many tries before a person gets it right, he suggested.

Schachter’s findings were met with intense skepticism, even outright disbelief, particularly by those who believed in a disease model of addiction. In this view, addictions are diseases caused by physiological and psychological factors that are triggered by using the substance (drugs or alcohol); once the disease is triggered, the addict cannot control his or her substance use, and complete abstinence is the only way to manage the disease. Proponents of this model did not believe that so many people could change their addictions at all, let alone without treatment. Other criticisms came from researchers who questioned the scientific value of Schachter’s work because it was based on a small and selective sample and relied on self-reports of past behavior, which often are not accurate pictures of what really happened. Nevertheless, his findings served as a catalyst, encouraging many researchers to study self-change in addictive behaviors. Let us examine what the research tells us about how widespread successful self-change is for problem drinking and drug addiction.

Rates of Success
Psychologist Reginald Smart of the Center for Addiction and Mental Health in Toronto recently reviewed the findings on the prevalence of self-change efforts among problem drinkers. We draw the following conclusions from his review and from our reading of the literature:

  • Most of those who change their problem drinking do so without treatment of any kind, including self-help groups.
  • A significant percentage of self-changers maintain their recovery with follow-up periods of more than eight years, some studies show.
  • Many problem drinkers can maintain a pattern of nonproblematic moderate use of alcohol without becoming readdicted.
  • Those who do seek treatment have more severe alcohol and related problems than those who do not.

Although fewer studies of self-change in drug addiction exist, the results generally mirror those for problem drinking. In summary: self-change in drug addiction is a much more common choice for solving the problem than treatment is; a substantial percentage of self-changers are successful; a significant percentage of those who were formerly addicted continue to use drugs occasionally without returning to addiction-level use, and they maintain these changes fairly well over time; and those who seek treatment usually have more ­severe problems than those who do not.

The experiences of Vietnam veterans are especially instructive. Sociologist Lee N. Robins, then at the Washington University School of Medicine in St. Louis, and her associates published a widely cited series of studies beginning in 1974 on drug use and recovery in these veterans. While overseas, about 20 percent of the soldiers became addicted to narcotics. After discharge to the U.S., however, only 12 percent of those who had been addicted in Vietnam were found to be in that state at any time during the three-year follow-up. Fewer than 5 percent had overcome their addiction through therapy. Additional findings from Robins’s studies suggested that abstinence is not necessary for recovery. Although nearly half the men who were addicted in Vietnam tried narcotics again after their return, only 6 percent became readdicted.

The results of Robins’s studies suggest the power of self-change in drug addiction, but they also have been the target of many criticisms. For example, most men who became addicted in Vietnam had not had that problem before their tour of duty, suggesting that they may be unrepresentative of the general population of drug addicts. Moreover, their drug use may have been triggered by the stress of serving in Vietnam, making it easier for them to stop when they returned home. This last criticism is weakened, however, by the finding that most men who continued using some narcotics after discharge did not become addicted and by the fact that the return home was also very difficult because of the popular sentiment against that war in the U.S.

Next Steps
We need more and better research on the potential for self-change to conquer problem drinking and other addictions. Studies suffer from differences in the definitions of important terms such as “addiction,” “treatment” and “recovery.” The use of reports of past behavior and relatively short follow-up periods are problematic as well. We also do not know of any studies on self-change with prescription drug addiction. Finally, we need to know if recovery from drug addiction leads to substitution with another addiction. At least one study revealed that many former drug addicts became problem drinkers. Because of these caveats and others, the percentages we have reported should be taken only as rough estimates.

Although we have reviewed some encouraging initial results from the literature, it is our impression that many addictions professionals do not view self-change as very effective. Their conclusion may be largely correct for those problem drinkers and drug addicts to whom they are typically exposed—treatment seekers.

Generalizations from those who seek treatment to the population of problem drinkers and drug addicts as a whole may be incorrect for two reasons, however. First, those who seek treatment have more severe problems than those who do not; second, they may overrepresent those who have failed repeatedly in their attempts at self-change.

We may learn a great deal from people who successfully change addictive behaviors on their own. Whatever they are doing, they are doing something right. In addition to the work with problem drinkers and drug addicts, we are beginning to make headway in the study of self-change in other problem areas, such as problem drinking, smoking, obesity and problem gambling. Greater knowledge about self-change and how it comes about might be used to help people who are not in treatment find ways of shedding their addictions as well as to enhance the effectiveness of our treatment programs.

Note: This story was originally printed with the title, “D.I.Y. Addiction Cures?”.

ABOUT THE AUTHOR(S)
Hal Arkowitz and Scott O. Lilienfeld serve on the board of advisers for Scientific American Mind. Arkowitz is a psychology professor at the University of Arizona, and Lilienfeld is a psychology professor at Emory University