Archive for the ‘Research findings’ Category

Surgery, and airports, could be more user friendly

August 28, 2013

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The other day in the Seattle airport security line I was randomly assigned to an experiment:  I did not have to remove shoes, computers or liquids, and went through the line much faster and happier.

Similarly, surgical prep and post-op could be more comfortable and efficient.  This NPR blog post challenges, among other things, the practice of starving ourselves before and after surgery:

Patients Love a Gentler Approach to Surgery, But Surgeons Balk


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Clitoris Awareness Week meets National Bike Month

May 7, 2013

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May is National Bike Month and this week is International Clitoris Awareness Week. So, how do the two fit together?

Clitoris awareness, unlike penis awareness, is not a given. Female children and girls are less aware of the details of their anatomy than boys are. And historically the clitoris has been an object of denial, scorn and even violence (as in female circumcision). This article, for example, documents the  psychological harm done by lack of accurate emphasis on this important organ.

So what does any of this have to do with cycling? Aside from anecdotal reports of spontaneous orgasms occurring during cycling (both men and women), there are other effects of bicycle seats meeting female genitalia, as well described in this blog post . Similar problems occur for men (sometimes resulting in impotence), but this is not Penis Awareness Week — one could argue that every week is.

If you find yourself shocked, embarrassed, or snickering about this blog post, you have just demonstrated the need for Clitoris Awareness Week. I admit, I first heard about it on Weekend Update (on SNL, a comedy TV show) and thought it was pretty silly. But further thought has convinced me it is also serious, and worth publicizing.

For all you ever wanted to know about the clitoris, and more, see this web site.

Diet advice for 2012 – from Cleveland Clinic

January 5, 2012

It’s  a new year and I resolve to write more blog posts this year than last. So, I’ll start with what is on many people’s minds now: which diet should I choose? Here is the latest from a respected source – Cleveland Clinic.

This New Year’s, losing weight will undoubtedly top many Americans’ list of resolutions – and it’s an important one. One reason? Heart disease is the main health threat caused by obesity. Make your efforts to slim down more successful this year by becoming wise to the “secret of calories!”  …

Just follow these 5 rules:

1. Understand the basic principal of dieting for weight loss. With all of the opposing diet plans forbidding carbohydrates or preaching against fat, it’s easy to see why confusion prevails. But, Cleveland Clinic experts say, recent studies comparing these different diets have found that the proportion of carbohydrates, proteins and fats in your diet do not influence weight loss. 

This means, in a nutshell, you can lose weight with any diet as long as you burn more calories than you take in. That’s the secret.

2. Know how many calories you need. Would you believe that of the half of Americans who are dieting at any given time, only 12 percent know how many calories they should consume daily? This number, which for adults ranges from 1,600 to 3,000 a day, depends on your age, gender and activity level. [Here is a useful daily calorie calculator]

3. Change your calorie intake to lose weight. If you want to lose weight, eat fewer calories than you burn. Eat 500 to 1,000 fewer calories per day and you will lose weight, often one to two pounds per week. But don’t be discouraged when weight loss begins to slow after a few weeks of dieting – this is a normal event as your body adjusts to your new diet. Keep watching calories and exercising and you will keep heading toward your weight loss goal!

4. Don’t be fooled by fad diets. More isn’t always better. In fact, it can be harmful. Any loss of more than two pounds a week is usually just water weight. Studies also show that the faster weight comes off, the quicker it is regained. Stick to a diet that has a goal of only one to two pounds weight loss a week [even better, in the long run, would be one pound per month].

5. Choose a diet you can live with. For your weight loss and weight maintenance efforts to succeed, you must continually manage your calories. No one diet is better than another. Studies show dieters tend to lose five to 10 pounds over the course of a year, regardless which diet they pick. What’s important is to pick a diet that works for you and that you can stick with. And if you’re not successful, pick a different diet next time.

Willpower and Fun: a win-win combination

December 12, 2010

In a few weeks it will be January, and at least half the U.S. adult population will be groaning about how much they overdid the holiday spirit and how much they need to suffer to get back in shape. It doesn’t have to be that way.  Exercising willpower and self-control now can put you way ahead of the game later.  But how to do this and still have fun is the big question.

My take is there is no fun, in the long run, in acting as if there is no tomorrow.  This applies all year long, not just during a hectic holiday season.  Being mindful of the beauty and joy of this, and every other, season is what it takes to truly appreciate what we have.  Eating mindfully allows us to truly savor the good food.  Being fully present, and not rushed or distracted, when with friends and family enhances the good feelings (practicing mindfulness also helps combat depression; see here).  On the other hand, neglecting yourself (eating and drinking too much and not exercising) leads to bad feelings and regrets.

Willpower is a controversial topic, but should not be.  We all have it in varying degrees, and there is a lot we can do to get the most good out of it.  See these previous posts for some ideas.  Mainly, treat your willpower and self-control as a valuable but limited resource.  Don’t expose yourself to extreme amounts of temptation (see this study).  Strive for balance in your life, during holidays and all the rest of the time.  Finally, I suggest, don’t define “fun” as a continuous orgy of indulgence.  What is your definition of “fun”?

Do you know a fat person?

July 20, 2010

Call them obese, huge or fat — the stigma won’t go away. And I’m not sure it should.  Obesity is bad for a person’s health, bad for the planet, bad for fellow airline passengers, and even bad for babies born to obese mothers (which, in turn, is bad for the economy; see NYTimes article).  When something causes this many personal and social problems we usually assume it is not a good thing to have or be.

“But,” some say, “we mustn’t blame the victim.  Obesity isn’t a weakness or a fault; it’s genetic. When we stigmatize people, they suffer even more, and may even avoid seeking help.” There is a kernel of truth to this concern, but it distracts us from the main point: obesity can and should be eliminated over time, through more research, and through attacking many known contributing factors (factors such as the  marketing and subsidizing of unhealthy foods).

The most active researchers who advocate against “weight bias” and “weight stigma” (Kelly Brownell and Rebecca Puhl at Yale, for example) also tell us that the obesity epidemic is growing and the health consequences are horrible.  They do not claim the problem is due to a change in genetics.  People can do a lot to prevent and even treat obesity, without altering genes (see many of my posts in this blog).

An anti-obesity program in Singapore that targeted overweight children was discontinued because of concern about stigma, even though the program was effective (reducing the percentage of overweight children from 14% to 9.5% in fourteen years — 1992 – 2006; click here for more information). I don’t know what should have been done in this case; there are no easy answers.

Outright discrimination against people based on appearance is generally wrong, and fat people should be treated sensitively and humanely, no matter what caused their affliction.  (Many equate stigma with discrimination, but I see a difference between the two concepts.)

Whether or not it reduces stigma, television has recently upped its focus on obesity by producing such shows as “Drop Dead Diva,” “Huge,” “Mike and Molly,” and, of course, “The Biggest Loser.”  A new series starts next month, “Too Fat for Fifteen: Fighting Back,” and at least one other obesity-related series is in the works. See this article for a discussion of how obesity is being addressed on TV.

[The photo at the top of this post is from ABC Family’s series “Huge”]

How many times a day should we eat?

May 26, 2010

I stated in my last post that we cannot trust “hunger” as a cue for when to eat. But how do we know when it IS time to eat?  For me, and I suspect for many others, the three-meals-a-day “rule” works well.  In fact, I believe that for most people who struggle with weight control, eating more often, “grazing,” or snacking between meals only adds to the problem.

Now, many of you believe that six or more small meals per day, or three meals plus two or three snacks, is best (e.g., see comment by Personal Trainer on my last post).  And for some people there is a medical reason for eating more often than three times per day (e.g., people with dyspepsia, GERD, hypoglycemia, etc.).  Some of these medical indications are valid, and some are not.  I won’t get into that here.  What I do know is that the more we snack, the more likely we are to consume excess calories (see this research report).

A survey reported this year in the American Journal of Clinical Nutrition found that in the thirty years between the 1970s to the early 2000s, for adults and children, the average time between eating occasions shrank by one hour (most recently, 3 hours apart for adults and 3.5 hours apart for children).  Daily calories for both groups increased from roughly 2,090 in the 1970s to 2500 in the 2003 – 2006 period.

Calories from snacks more than doubled: for adults, from 200 calories per day in the 1970s to 470 calories in the recent time period; for children, from 240 to 500.  A significant portion of snack calories came from beverages.  It can be assumed that these numbers are underestimates, since surveys usually under-report the number of calories consumed.  [The above research was described in the May 2010 issue of Nutrition Action Health Letter]

It makes sense to me that the more often one eats, the more one is exposed to temptation and calories.  Also, we know that “willpower fatigue” occurs, so that the more often we have to decide what and how much to eat, the less “willpower” we are left with by the end of the day.

One known cause of overeating, which is also closely related to snacking, is “emotional eating.”  The solution to that problem is mindful eating, plus tending to emotional issues in a more appropriate way.

Personally, one of the most effective things I have done over the years to maintain my weight in a healthy range is to eliminate snacking.  It takes some getting used to — for example, eating dessert just before bed was a long time habit for me — but it really makes a difference.  And I haven’t developed hypoglycemia, insomnia, or any other health problem as a result.

If eating three daily meals (assuming the portions are reasonable and the food is mostly “healthy”) works to maintain weight, would two meals be even better?  Apparently not, according to several studies.  People who skip breakfast, for example, tend to weigh more than people who don’t.

Why “Eat only when you’re hungry” won’t work

May 15, 2010

During a recent social event, the conversation turned to weight loss and dieting. One of the women said she read a new book and it had “the answer” to her problem of weight gain: eat only when you’re hungry.  Many books and weight loss plans, in fact, emphasize this point, offering various tips and methods to define “hungry” and help the reader learn what kind of hunger, exactly, they should satisfy and what kinds they should ignore.  The worst books (in my opinion) give the message that people gain weight because of various psychological or “spiritual” hungers that we try to assuage with food.  There is little to no consistent science to back up these claims, and I believe the message does much harm, because it implies an almost magical answer to the problem  of overeating.  When it inevitably fails to work, the victim of this propaganda is left with yet another cycle of failed dieting and increased weight.

As recently as hundreds of years ago, most people did need hunger as a cue to begin eating, because their days were full of physical labor and food was not always readily available.  But, in recent decades, this situation has changed dramatically.  Now, most have relatively low levels of physical activity and the availability of food has increased exponentially — to the point where there is a glut of high calorie, low cost “food” in our faces continually.  We rarely get hungry in the old sense of the word, because these cleverly marketed and subsidized foods (high in sugar, salt and/or fat) overwhelm our biological regulatory systems.  Instead, we develop cravings and hungers triggered by environmental cues and implanted “beliefs” from our culture, no longer based on biological requirements.  In a sense, we get “addicted” to unhealthy foods and lose our ability to trust our hunger.

So, what can we do?  Easy — and difficult.  Train ourselves to ignore these contrived temptations; limit our exposure to them (most importantly, protect our children from them!).  Learn what a healthy lifestyle looks like and adopt it.  Avoid frequently eating “addictive” foods containing large amounts of  sugar, salt and fat.  And advocate, loudly and often, for changes in our culture so that fruits, vegetables and other unprocessed foods are cheaper and more available than the junk food that now receives so many economic advantages.

For more information and tips, check out these links:

Food Industry Pursues the Strategy of Big Tobacco

Coping with the obesity epidemic

Ending overeating

Overeating leads to more overeating

What does 200 calories look like?

Do not — DO NOT — deprive yourself

Mindful eating vs. mindless munching

Weight Management for Your Life: Ten Steps to Prepare You for Adopting a Healthy Lifestyle

I recommend Nutrition Action Health Letter, available by subscription from the non-profit CSPI (regarding today’s post: see the May, 2010, cover story “How the Food Industry Drives Us to Eat” featuring an interview with Yale’s Dr. Kelly Brownell).

P.S.  I have not posted in the last 3 months for several reasons, one of which is having surgery and recovering.  I’m fine now, though.

S – – t, the new four-letter word

February 3, 2010

Why, I wonder, is it still so hard to fix a meal or go to a restaurant and not overdose on salt? This New York Times article, for example, claims one pastrami sandwich (with only two pickles)  at Katz’s deli in NY City has 4,490 mg of sodium.  That’s  at least a two-day dose, going by the recommendation of the FDA that we consume a maximum of 2,300 mg per day, and only 1,500 if we’re at risk for hypertension (which is 69% of the U.S. adult population!).  A large take-out container of Manhattan clam chowder at the Oyster Bar weighed in at a scary 3,100 milligrams.

“Oh, that’s just alarmist thinking,” you say.  “Only some of us are salt-sensitive.”  Well, before you relax too much, read the latest on sodium health risks from the New England Journal of Medicine (here).

Eating tortured sick contaminated animals

November 20, 2009

If you eat meat (or dairy products), there is a lot you can do to minimize the damage to yourself, your family, the planet and the animal. A new book on this subject (Eating Animals by Jonathan Safran Foer) has gotten a lot of attention, and I have included some key links below.

Despite some controversy, there is widespread agreement that meat produced by factory farms causes a lot of problems, such as astounding energy inefficiency, vast amounts of toxic waste, production of antibiotic-resistant microbes that pose a threat to us, severe pollution, and shocking cruelty and suffering of animals on a massive scale.

And, there is growing evidence that red meat (especially beef, also pork) is unhealthy (see The Real Cost of Red Meat: does it boost your risk of cancer, heart disease, & diabetes?).

What can we do about it? The best answer is simple: Cut back on meat consumption, especially red meat. Even a small decrease will help. And, if you decide to include meat in your diet, at least try to buy meat (and dairy) raised on sustainable non-factory farms. Yes, it will cost more, but you can offset the increase in cost by just eating less meat. Go for quality over quantity.

Here are very interesting and helpful resources to check out:

In closing, here is a quote from Jonathan Safran Foer:

Two friends are ordering lunch. One says, “I’m in the mood for a burger,” and orders it. The other says, “I’m in the mood for a burger,” but remembers that there are things more important to him than what he is in the mood for at any given moment, and orders something else. Who is the sentimentalist?

Ending overeating

July 7, 2009

Kessler overeating

A very important new book (The End of Overeating: Taking Control of the Insatiable American Appetite by David Kessler) accurately describes major factors contributing to the obesity epidemic: cleverly formulated manufactured food designed to seduce us into overeating, addictive ingredients (salt, sugar and fat) which act like nicotine in cigarettes to keep us coming back for more, a profit driven system of marketing and government subsidies which works against our best interests, and the loss of boundaries limiting when and how much we eat. It is indeed frightening to think that a 2-year-old’s appetite “knows” to shut down when enough calories have been consumed, but by the time that child is four (in our culture) there is often a loss of that self-control mechanism.

Kessler’s solutions include re-training our minds to devalue unhealthy processed foods loaded with the Big Three (salt, sugar, fat); reforming our policies and practices which encourage this vicious cycle; and doing much more to educate people as to what they are consuming (such as requiring nutritional information in restaurants).

I agree with all this, but take issue with some of the concepts Kessler promotes. My main complaint is he oversimplifies the issue of food containing salt, sugar and fat by using an addiction model. Too much of these ingredients is indeed unhealthy, but a simple addiction model will not work.

Another problem is his use of the term “real food” (see NPR interview) which is a vague concept, at best. Many seemingly real foods contain salt, sugar and fat (either naturally, or because of the way they are produced), and not all “manufactured” foods are bad (e.g., some fish farmed in a sustainable way are better for us than some “wild-caught” fish). I can buy a chicken that has been doctored with added salt and fat, or I can buy one (usually smaller and more expensive) which has been grown almost organically. To the average consumer, both seem “real.” Also, I can buy “sea salt” and “unrefined real sugar” and think I am getting something healthier than standard table salt and corn syrup, but the bottom line (sodium and calories) may be exactly the same.

Finally, he promotes a black vs. white dichotomy between a disease-like state we cannot directly control (“conditioned hypereating”) and old fashioned willpower, telling us “it is not our fault” that we overeat. Fault, per se, may not be the issue; rather, we should learn ways to increase our resistance to external cues and marketing, educate ourselves about nutrition and portion size, and practice coping skills to enhance self-regulation. I have written about this at length elsewhere.